SPECULUM Matricis Hybernicum; OR, THE IRISH MIDWIVES HANDMAID. Catechistically Composed, BY JAMES WOLVERIDGE, M. D. With a Copious Alphabetical Index. WRITTEN IV Xta MagnaLIa DeI sCrIptor, Anno Domini, 1669. Chronogramma, 1669. Damnosa quid non imminuit dies? Aetes' parentum, pejor avis, tulit Nos nequiores, mox daturos Progeniem vitiosiorem. Horat. Lib. 3. Carminum, Ode 6. London, Printed by E. Okes; and are to be sold by Rowland Reynolds, at the Kings-Arms in the Poultry, 1670. THE AUTHOR TO THE READER. IT may perhaps be wondered, why the Author should expose his Book, not only to be tossed by the impetuous waves of the Irish Seas ( it could set foot on the English-shore) but more to be admired, that he should expose it to be tumbled, and searched by the Accustomed, Ingenious Censure, and scrutiny, not only of Learned Scholars, but of Grave Matrons, and Expert Midwives. Since also it is manifest, that very many have not only bestowed their Oil, but their Ink upon this Subject; It may not only be accounted Arrogancy and Presumption, but impertinent folly, and improfitable endeavours in the Author; either to think to outdo former Writers; or in his own Conceit to be wiser than the present Readers, so as to outdo the one, or out-wit the other. Assuring you, therefore, that his aim is at neither, he hopes it will be candidly received by all. Though the Title-Page may arrive your view in an Irish Garb, Speculum matricis; or the Irish Midwives Handmaid, etc. with her Handmaid barefoot, and barelegged; or at the best, in Brogues and Kerchers, (according to the Custom of the Country;) yet, be assured, It hath an English dress under an Irish mantle; it being never intended for the Irish, (though I hearty wish it may be serviceable to them also, if occasion be,) whose fruitfulness is such, that there is scarce one barren among them; and whose hardiness, and facility in bringing forth, is generally such, as neither requires the nice Attendance of diligent, vigilant Nurse-keepers, or the Art of expert Anatomists, or the unwearied pains and skill of dexterous Midwives; being, more like the Hebrew women, Exod. Cap. 1. Ver. 19 than the native Egyptians; delivered before the Midwives can come to them. And that this truth may gain the more Credit; mind a Story related by as * Dr. William Harvey, de Generatione Animalium, Chap. de Partu Page 276. An History. Learned a Physician as our Age hath known; who reports it (as he saith) from the mouth of the Lord Carew, Earl of Totness, and Lord Precedent of Munster, for many years together; who also wrote the Annals of those times. The Story is this; There was an Irish Woman, wife to a Common Soldier, who, though big with child, accompanied her Husband in the Camp; and whereas the Army daily was in motion, marching from place to place; it happened, that by reason of a sudden flood after a hasty rain, a small Brook began to swell so high, that it hindered the Armies marching for one hour: In which time of the Armies halting, the woman's pains of childbearing came upon her; insomuch, that she withdrawing herself to the next thicket of shrubs (without the help of any Midwife, or any other preparation of Baby-clouts) there, all alone, brings forth Twins; (whom God surely seeing in their blood, Ezekiel, Cap. 16. Ver. 5.6. said unto them, live, when no eye pitied them;) both which she brought down to the River presently, and there washed both herself, and them; which done, she wraps them up (not swaddled at all) in a course Irish mantle, and carries them at her back, marching with the Army the same day barefoot & barelegged (as she was) twelve miles, and that without the least prejudice to her health, or to the lives of her children. The next day after, it pleased the Lord Deputy Montjoy, (who at that time commanded the Army against the Spaniard, who had besieged Kinsale) and the Lord Carew, to be Godfathers to the Children, being much Admirers of the novelty of the thing. Neither could the Author suppose, or intent his Book useful to foreign parts, it being published in an English Dialect (no Language being more current than the Latin.) It will therefore consequently be concluded, that it was meant for the English, his Countrey-folk, whether at home, or in foreign Plantations; and undertaken by the Author, because, in all his Readins of Authors (and those not a few) he had not seen any that had written in so plain and perspicuous a method (as may appear by perusing it,) and suitable schemes in various figures, sufficient to direct and inform Midwives in their office: As also, to contribute all things necessary in such cases. The Author therefore commends this Book to the Patronage of the most Grave and Serious Matrons of England and Ireland, the first being the Kingdom of his Nativity, the latter his Country, whilst obliged to it. Farewell. James Wolveridge. From my Study in Cork, Jan. 12 th'. 1669/70. To his deserving Friend, Dr. James Wolveridge, On his Speculum Matricis. IF that Sicilian was admired, because He framed the Machine which disclosed the Laws And motions of the greater World, what fame Shall equal be to eternize thy Name: Who greater secrets in so little can Unravel, in this lesser world of man? Volumes that swell, like over of Gold, have much Of earth and dross, which ne'er can pass the touch; But in this little scheme, behold and see The essence and extract of Midwivery. Tredeskin's nutshell, or that German fly, Were ne'er composed with greater industry. What pangs and throws do others brains torment, (Like Jove's, which Pallas teemed who scarce can vent What they contrive, who labour to ensure That which Abortive proves, and not mature. But thou hadst quick delivery, thy brain ne'er wanted Midwife, neither felt it pain: In this thy true Production, which from thee Came like full-ripe fruit dropping from the tree: The Ladies, sure, their glasses will neglect, When on thy mirror they shall once reflect, Which teaches to preserve their beauties more Than all their Paints and Washes e'er before. jonathan Ashe, è Coll. Oriell, Oxon. A.M. Author in Libellum, ejusque; picta Schemata. QUaeritur ovata quare sit sculpta figura, Demonstrans faetum pagina quaeque suum? Omnia credibile est formari Animalia ab Ovo, Posse sui generis tale referre genus. Cernis ut ova trahit solers formica, labore Parvula, quae in cumulos Irrequieta locat. Ovorum ex numero sunt subventanea, (Inertis Molae instar) pullos non paritura suos: Hinc hominum, pecudumque genus, genus omne ferarum Fit sterile, & sterilis dedecus arbor habet; Edere sed foecunda mihi sperare licebit, Ovaque Prolifica ponere fida manu. Sin secus, Obstetricum nullos Quaesita jabores Gens hominum, cesset, vel labefacta Ruat. Sic parere, aut calamus doceat parere, precamur: Illud naturae est, hoc erit Artis opus. Anser Ovans alas scriptoribus explicat, artes Ind docens, variis pictaque; schematibus. Ille meam pennis, si sit culpabilis, Artem Delirare suis, & volitare dedit. Ova traham Reliquos scriptores inter, Acervo Pulchrum erit ex magno tollere delicias. James Wolveridge. On the Praise, and the happy delivery of James Wolveridge, Dr. of Physic, in his labours on the Labour of Women, etc. Delivered by Aquila Smyth, M. D. HEre is the Key unlocks a Cabinet, So quick, so safe, by art not known as yet: More friendly than the gourd o'er Ionas head, It breaks the Hymen, and the Maidenhead. What shall I say! mysterious is thy art, But so, that labour labours in no smart; Thy clouded Genius 'mid'st the Curtain fogs, Swallows thy worth in the Hibernian bogs; Dismantle then thyself, appear to be Happy to all in thy delivery. So the production of thy brain shall make Midwives themselves produce; and for thy sake Sol teeming thus, man-Midwives out a birth, That is the product to the globe, and earth: But whilst thy brain doth labour, we do too Bring but an Embryo out, which though t'out-do Mountains (full gravidated, but produce A mouse) when thou dost open nature's sluice; So riper seeds are sown on barren ground, So th'Reaper hath a sickly harvest found. The pregnant pia mater of thy brain Doth settle in his place the womb again: There is no Mola in thy wit, what's here, Of truth is the effect and character. Teeming this nine months, we did surely look That thou shouldst be delivered of thy Book; Prodigious Birth! who e'er the like did know A child brought forth, straitt to a Midwife grow? Cease nature now thy tyrannies in vain, Here's one doth teach to mitigate a pain, Sets open Nature's Gate, so that the birth Walks from the mother-womb to mother-earth: No throws we have in this, no skreaks, no cries, No Instruments, no Cupping of the thighs: Here is an Art that after-age will boast, And tell how Wolv'ridge hath delivered most With ease, producing forth what's safe we see, To which whole Colleges thy Gossips be. Septemb. 9th. 1669. Cork. Your Devoted Friend and Servant, whilst Aquila Smyth, M. D. Ad Authorem, Encomiastichon. ABdita dum teneri pandis mysteria foetus Numina secretis quae posuere locis, Diversis diversa paras medicamina morbis; Picta refers variis schemata multa modis; Signaque conceptus monstras, signantia sexum, Sive puella siet, sit ve puella puer Obstetricas; varias calamo monstrante figuras, Qua methodo mulier sit paritura doces. Nuribus, Infanti, Medicaris matribus aeque; Dum te nec lactis cura vel ulla latet. Nonjacet Aurato licet ulla puerpera lecto, manu. Ipse struis facili mollia lecta manu: Parturit ipse liber, dum pro sponsoribus astant Zoilus aut Momus, parturit imo aliquid: Quem Matrona gravis si qua lactaverit ulnis, Et dederit Cunas, has vagus orbis agat. Dabam Cork. 17 Calendas Octobris, 1669. Honoris & Amoris ergo dicavit, Jonathan Ashe è Coll. Oriel, Oxon. A.M. In Authorem, Amicum suum Integerrimum. PErlege (Lector;) opus, Wolv'rigii; quod tibi aperte Ostendit docti pectora digna viri, Hoc; secreta suis naturae vultibus ornat, Ordine perspicuo conspicienda patent: Codice nam clari Doctoris dicta Jacobi: (Alter Galenus, Justinianus Item) Qui quorum merito; studiis, satis acta duorum Voluerat, & Tomos quoslibet ille suis. Hic decus, hic lumen, hic fons sermone Latino Orbis, en! Emeritus tempus in omne micans, Cujus florebit studiosos inter utrosque Perpetuo Juris, non minus Artis Amor. Danielis Colman. J. V. D. Ex Musaeolo meo in Suburbiis Borealibus Coreagiae, Idibus Septembris, 1669. The Author to his Book. GO little Book, I envy not thy hap, Mayst thou be dandled in the Lady's lap; I hope the Ladies will not thee disdain, thou'rt clean, though in a homespun dress, and plain: Nor mayst thou to a gaudy Garb aspire, Thy native Idiom is thy best attire; Yet Phydias and Apelles do declare, Such Schemes of Births in thee accounted rare; Thou show'st no monstrous births that may affright, (Though thou mightst do't) but such as may delight, With admiration; then go kiss their hands, Tell them thou'rt subject unto their commands; Thy Country dress composed for their good, Brooks no scurrilities, if understood By Gravest Matrons, never penned, nor meant To be the subject of a lose intent; Nor yet to please lascivious, wanton eyes, Whose thoughts to Venus are a sacrifice. Go visit Nunneries, whose chaster fate Perchance may pregnant be without a mate; Except bald time, with his suspected pate Teach th'Abbess Midwivery within her grate; Be there probat'neer but a year, and then, If useless, hope thou mayst come out again. Perlustrate all the World, let women know To help themselves, their children, nurses too. Visit the Nurseries of Learning's fame, Salute those fountains in thy Author's name; Their pardon crave, whilst not from disrespect They are accosted in a dialect As uncouth to his pen as to their view, which had been dressed up in another hue, Had he been sure to have been understood, (As was his only scope) for public good; Yet mayst thou be so wheresoever thou'rt brought, not be said that thou art good for nought: Beware the Press awhile, 'twere better tarry, Lest being pressed too hard thou mayst miscarry. If't must be so, those Medicines of thy own Must cure thy sad Abortion, or else none: Nor art thou smutty to set out thy feature, But yet mayst show the curious works of nature. Teach Ladies Nett-work then, and tell them plain They have a wondrous nett-work 'bout their brain; And yet thy fringed skirt adorned may be With ornaments, and by Authority. Here's Vest and Tunick, Amnios, and Chorion, And Jus de corae too, that thou be in fashion: We admit no Allantoides in the least, Because thou treat'st of man, and not of beast. thou'rt furnished with a Royal Sash (withal, Ne'er out of fashion) Cord, Umbilical; When all is done, then let thy schemes and fashions Successful prove to future Generations. To my most Worthy Friend, Dr. James Wolveridge, upon his Book, Speculum Matricis. AN ACHROSTICK. If I were skilled in Chaldaick, or in Syriack, As others, who might well thy Praises show; My muse would then compel a Panegyric Even for the debt which to thy worth I own; S i'th' I to that could never yet attain, Which makes thee famous in the Art of Physic, Or imitate thy Great Heroic strain, Lo, I begin to try in tones of Lyric. Let Grave Physicians greet thee with a kiss, Unskilful Quacks may hence learn to amend, Expel their poisons, which for want of this Rent many a heart, and brought untimely end: I mean, because they knew not man's first being, Do still mistake; I say't cannot be fit Giving Remedies which in no way are 'greeing Express men's ruin by prescribing it. Your Obliged Friend, Richard Samson. An INDEX containing the Contents Alphabetically. A. ABortion what, with its causes and sings. Page 104, etc. How prevented, and cured, pag. 112, etc. Air ambient dangerous in childbed p. 111.116. After-pains what, their causes, and cure p. 133, etc. After-burden what it is. p. 84, etc. Why so called. p. 90, 91, 92, etc. Must be brought away, and why. It's danger being left behind. How it is hindered in its coming forth. How drawn out. ibid. Aged women commonly bring forth females, and why. p. 101. They are subject to the falling down of the womb p. 163 Age of the best nurse described p. 141 Allantois part of the secundine (in beasts, but not to be found in men) and is as a girdle p. 90 Amnios the inward membrane of the secundine p. 89, etc. Anger in nurses naught p. 143 Aorta what artery, and how generated p. 8 Arterial vein what it is ibid. Astringent powder useful for Midwives p. 30 B. Bag described. Page 76. etc. In use. Behaviour of nurses to be enquired into p. 124, etc. Birth natural what, and how, described p. 24. How facilitated 110.130 Blood after conception distinguished three ways p. 14. Bones generated from the seed p. 12. Botches in children, their causes p. 115.145 Brains, how generated, and for what p. 9, etc. Breath stinking argues a child dead, and putrified in the womb p. 79 Breasts sore to cure p. 101 Breeding women, what forbidden them p. 101 C. CApsula of the heart generated p. 6 Cake of the womb what p. 88, 89, etc. Cartilages whence generated p. 11 Cataplasms against a looseness in childbed. 137. Against miscarrying, to be applied to the navel p. 118 Cataplasm in case of sore breasts p. 102 Caudles in after-pains, and in case any of the secundine be left behind p. 134 Causes of immoderate flowing of the Lochia in childbed, with their cure p. 119, 120. Cautions to Midwives in their business p. 28, 29 a Caution to the Irish women in a looseness p. 105 Child, when so properly called p. 112 Childbearing women ought to be cheerful p. 110 Children how overlaid, with the reasons. p. 141. Of their pining away 150 Chorion what, and why so called p. 88 Coats of the Arteries, whence p. 11 Cold in childbed dangerous, with its cure p. 124 Cold dangerous in Childbearing 111 Calostrat, what children p. 144 Conception, with its signs 95, 96, etc. Conception in Nurses make the child diseased p. 144 Conditions of Nurses to be inquired into, with her complexion p. 143 Convulsion-fits in infants, whence, and how cured 134, 135 Cordials against fainting fits, p 112. A general excellent Cordial-water, p. 113. Against a nauseous stomach p. ibid. Costiveness the cause of difficult birth p. 35 Costivenes in breeding women naught, how it may be prevented p. 112 Cotyledons of the womb what p. 104 Courses, why stopped after conception, p. 14. How they are to be provoked p. 115, etc. They are stirred up by the use of Venery, & are destructive to milk p. 144 Cranium what, & how generated p. 10 Critical Fevers in childbed, their cure p. 123, etc. Crying in children discovers want of milk p. 151 Cupping-glasses how, and where to be applied p. 147 D. DAncing in the childbearing women, or running, naught for the child p. 110 Dancing of the child a good exercise for the Nurse p. 147 Danger from being not well purged in childbed p. 115, etc. a Decoction against too much milk p. 148 Dead child, how delivered of p. 93, etc. signs of a dead child p. 102, etc. 108.131. Diet prescribed for breeding women p. 111. For childbed women p. 120 Diarrhaea, see Looseness in p. 131.136 Different postures of infants in the womb, why p. 78 Difficult births, their causes p. 34, etc. Distinction of parts, when p. 12 Dreams in the infant discover want of milk p. 151 Dropsies, how distinguished from a Mola, or false conception p. 82 Drunkenness not to be endured in nurses, p. 140 The dura mater, how generated p. 10 E. EAting flesh in childbed the cause of Fevers p. 124 Eating and drinking to be observed by nurses p. 143 Eight month's birth not like to live. p. 19, etc. The reasons ibid. Emplaster against abortion p. 113.132 Against Convulsions in infants p. 135, etc. Against the inconveniency of milk to be applied in the breasts p. 122.146 Embryon what p. 87 Epar uterinum, that is, the liver of the womb, what, its use, and why so called p. 86, 88 Exercise attenuates milk. p. 146. In the nurse good for the child p. 147 Experiments to know if a woman hath conceived or no p. 98, etc. Experiments to try milk p. 126 The Excrements are not voided by the fundament whilst the child is in the womb p. 16, etc. F. FAlse conception what. p. 79. How it differs from a true conception p. 81. How distinguished from a Dropsy. p. 82. How delivered of p. 94 Falling out of the womb p. 162, etc. Fainting fits in breeding women, how prevented p. 112 Fevers in childbed in general, and of a Fever of milk, what it is, with the cures p. 121 Female when conceived, and how known p. 200 Fibres in the first generation what p. 2 Figure of a child of 18 days old p. 12 Fume, or suffumigation in fits of the mother p. 160 G. GAlea is part of that coat of the secundine called the Amnios' p. 87 a General cordial water against all fainting fits, at all times p. 128 a Gibbous infant the cause of a difficult birth p. 35 Glisters for a looseness in childbed. p. 136, etc. For the retention of the Lochia then p. 116 Gluttony in nurses condemned p. 143 Great breasts, and great nipples in nurses not commendable, why p. 141 Grief in nurses naught for the child. p. 143 Naught for childbearing women p. 110 Gripes in the belly of infants, whence p. 149 H. HAndsome children, why some so, & why others unhandsome p. 21 Hastiness in the Midwife not good p. 27, 29 Hasty rising up of the mother naught for the child in the womb p. 110 Hard breasts the signs of the infants thriving in the womb p. 101 Haemorrhoids the cause of difficult birth p. 35 Heart generated, when p. 6 Heat of the seed the cause of generation of males, they are generated in the right side p. 21 Helmet called the Galea, part of the Amnios' p. 87 Heavy burdens carried by the mother are naught for the infant in the womb p. 111 Hysterick fits: see Strangulation of the womb, and mother-fits p. 155, etc. I. INnate heat in infants requires constant aliment p. 150 Infant, when said to be, p. 16 How it lieth in the womb, p. 33, etc. How nourished in the womb, p. 14 It attracts the purest blood, ibid. Hath more from the mother then from the father, ibid. Why like their Parents, p. 21 To know whether it thrive in the womb, or not p. 101 Infants participate of the nurse's food, and physic, p. 151 How to be received by the Midwife p. 29 Impurities are communicated to them by the Qualities of the milk p. 151 Inflations the cause of after-pains p. 133 Inflammations of the womb the cause of difficult birth p. 35 Intemperance in nurses the ruin of their nurseries p. 140 Immoderate flowing of the Lochia in childbed dangerous p. 118, etc. Juleps in case of retention of the Lochia in childbed p. 118, etc. Against Convulsion-sits in infants p. 135 K. KNots, as many as are to be observed in the navil-string, so many males p. 103 L. LAdies may nurse their own children with the greatest conveniencies p. 135 Leprous infants, how so begotten p. 102 Liver first generated after the coats by the Vena bifurca, p. 4, etc. Is a concrete blood ibid. Lochia retained in childbirth, dangerous, p. 115 Flowing overmuch, dangerous also p. 119 Looseness in childbed dangerous, p. 131.135 Lungs, when, and how generated p. 8 M. MAle conceived, how known p. 99 Man, his dignity, and titles, vid. Pref. Manner of generation p. 2, 3 Marrow of the bones what, with its use p. 11 Matrix to be anointed in difficult births p. 40 Meats to be avoided by nurses, what p. 144 Medicines usual in Fevers of childbirth p. 124 Members distinguished by the tenth day p. 7 Menstrua the cause of strangulation of the womb, or fits of the mother p. 156 Midriff how made, p. 7. The best Midwife described, p. 27 Her posture, p. 28, etc. Her office, Number of her assistants, Her furniture ibid. Midwives are not to take more care of the infant then of the mother p. 93, 94 Milk, how generated, p. 14.98 It is the cause of Fevers, p. 121 Driven back too soon dangerous, with the reasons of it, p. 122 fried by its colour and quality, p. 145 Of milk too thick corrected, p. 146, etc. Too thin corrected, ibid. How to cure the too great abundance, p. 147. The want of milk supplied, ibid. No milk at all, the worst p. 150 Mirth good in breeding women, p. 110 In the nurse, best for the child p. 141 Mola, or false conception, what p. 79 Mother contributes more to the infant than doth the father p. 15 Motion too violent in the nurse, naught for the child, and so in the mother p. 147 Mourning either in the mother, naught for the infant in the womb, p. 43 Or for the nurse ibid. Mothers, if able, fittest to nurse their own p. 152 Mother-fits, see strangulation of the womb, p. 155. How cured, p. 159 Mucilage what p. 126 N. NAtural form of birth, what it is p. 24 Nauseousness prevented p. 113 Navel how generated p. 3. How to be cut, ib. How it attracts blood for nourishment, p. ib. Cords of the navel, so many twins 103 Needing what p. 108 Nerves of the back, their original, p. 11 How dispersed through the whole body by a figure p. 13 Nipples, what are the best, p. 141, etc. Sore nipples to cure p. 137, etc. Nurse's the best, described, p. 140, etc. Not to be chosen in poverty, p. 150. Nurses purged to cure the child, why p. 15● Nurse's not to rock the infant too violently presently after suckling it, why p. 153 O. ORiginal of the nerves, p. 10 Of the spin of the back ibid. Oxycrat what p. 129 Oils, what fit for Midwives, p. 26 Their use in difficult births p. 41 Ointment in case of the Lochia suppressed, p. 118 in case of too immoderate flux of them, p. 120 An excellent ointment in a difficult birth, p. 41.126 For sore nipples, ibid. In Hysterick fits p. 160 P. PArsly an enemy to milk p. 144 Passions in the nurse hinder good milk p. 143 Pains in childbearing, whence they are p. 23.133 Pains after the childbirth, what p. 52.116.124 Pericardium generated with the heart Piles in hysterick fits p. 161 Planets, their aspect, the cause of good features and forms in children, and of bad p. 21 Placenta uteri what, p. 86, 88 But one, though there be never so many infants; Its use ibid. Plenty of milk ever best, p. 142 Postures of the infant many, p. 37, etc. Postures of the infant naturally, how, p. 33 Many preternatural postures described in sixteen several figures, from p. 37, to p. 72 Their helps resolved by way of Dialogue ibid. Potions useful in difficult births p. 134 Powders for sneezing in difficult births, p. 127, etc. Against Abortion, p. 131 Against Convulsion-fits in infants, p. 136 Against immoderate flow of the Lochia in childbed, p. 119 Pulsatile veins from the great Artery of the heart p. 7 Purgation of women how long, p. 115 Not being well purged, dangerous ibid. Purge not to be given till seven days after the birth, in case the Lochia be stopped p. 117 Pustules and whelks in infants, their cause p. 149 Q. QUalities of milk pass into those that are suckled by that milk p. 152 Quarrelsomeness in nurses naught p. 143 Quicken, when women do p. 17 R. REmedies overhot in difficult births, how inconvenient, p. 126, etc. Retention of the Lochia in childbed dangerous, with its causes, and cure p. 116 Riding in the mother naught for the infant p. 110 Rocking of the infant too vehemently presently after sucking naught p. 153 Running in the mother naught for the infant p. 110 S. SColding in nurses not tolerable p. 142 a Scruple what p. 128 Scull, how generated p. 10 Seventh month birth may live p. 19 Secundine what, p. 84 Described by figures p. 85 Sexes distinguished p. 99 Sixth month birth cannot live p. 19 Signs mortal by the infant's motion in the womb p. 20 Sleep in the mother good for the infant, p. 11 Often sleep in nurses is good for the infant p. 141 Sluttish nurses make nasty children p. 140 Sneezing good in difficult births, p. 127, etc. And in fits of the mother p. 159 Soul when infused p. 17 Spine of the back, how generated, p. 11 What it is, ibid. It's use ibid. Stature of the nurse p. 104 Stinking things and smells, how useful in mother-fits p. 161 Stool for Midwives described p. 28 Stone in the bladder the cause of difficult birth p. 35 Stopping of the terms no sure sign of conception p. 95 Strangulation of the womb a fierce distemper, p. 155 Its definition. What it is, ibid. Parts affected what, the causes, p. 156 Signs of the fit in its augmentation, state, and declination, p. 157 How it differs from a Syncope, or Swooning, 158, etc. How from an Apoplexy, ibid. How it differs from an Epilepsy, p. 159 Its cure ibid. Strength, how to be restored p. 123 a Suffumigation in fears of Abortion, p. 113 In hysterick fits 160 Superfoetation what 102 Suppositories, p. 124 For infants, p. 136 In the strangulation of the womb p. 255 Sweet smells, how used in fits of the mother p. 161 Symptoms grievous in breeding women, their danger, how corrected, p. 24 In childbed women not well purged, dangerous p. 112 T. TArtness of milk, how corrected p. 146 Terms in childbearing to help p. 113 Timpany, how caused p. 82 Truncus phrenicus what, p. 7 The trunk of the hollow vein, ascending and descending p. 5 Trial of milk p. 135 Twins have so many navil-cords as there are twins, and yet but one Placenta p. 103 V. VEin hollow what, p. 9 Vein two forked what; It's ose, p. 3 The Venal Artery, with its use p. 7 Venery, and its use, spoil the milk in the nurse p. 144 Venereous thoughts in the nurse spoil the milk ibid. Ugly children, the reason why they are so p. 21 Vicious seed the cause of strangulation of the womb p. 156 Virtue of the milk of a male child, if a female suck it; and of a female, if a male suck it p. 145 Unguent against Abortion, p. 41.126. See Ointment. Vomit of Oxymell good to attenuate thick milk p. 146 Urine of the infant in the womb, by what passages voided in the womb p. 16 W. WAnt of milk, the causes, and cure p. 147 Waterish humours flowing out of the breasts of its own accord, is an argument of a weak child p. 105 Weakness of the matrix is the cause of the secundine not coming forth p. 90 Whelps die with sucking women p. 142 Winds sharp and cold not good for the child in the womb p. 106 Women meet helps for man, p. 27 Fit helps for women, by reason of the modesty of their Sex, p. 27, etc. How delivered, ibid. How long to keep their beds in childbed with safety p. 115 Women above 40 years old bring forth with more difficulty, p. 30 They are to be dealt withal in childbed, as with wounded persons p. 124 Womb, its natural property to receive seed, p. 1 The falling out of it, p. 162 The signs, ibid. The causes, p. 163. Prognostics, and cure p. 164 Y. A YEar sufficient for a child to be suckled p. 153 Young women bring forth males most commonly, why p. 100, etc. The end of the Table. THE PREFACE. SInce all Arts and Sciences tend to the use and benefit of Mankind, all things by the Almighty Creator being subjected to him, who is no other than a little World in himself: Man would not only be ungrateful to his Creator, but wanting to his offspring, should he not endeavour to improve his whole industry, Reason, and skill, to propagate his kind to all posterity. And therefore, besides other helps, as Physical, Anatomical, and Diaetetical, etc. The art and skill of Obstetricie (commonly called Midwivery) is none of the least: Non minor est virtus quam quaerere parta tueri. It being no less virtue and prudence to preserve a child when begotten, than content and pleasure in begetting; in both which, both Sexes are, and ought equally to be concerned; for where the womb proves the tomb, there is neither room for Physic, Anatomy, Chirurgery, or diet, etc. or any thing like it. This then being the first work in reference to man's future well-doing, laying aside all other Argumentative circumlocutions, and deviations; let us, by way of discourse, examine, and contrive, how that creature man may be preserved, from the beginning of his Conception, to the hour of his birth, and that with safety too to her that bore him. And truly, it may be worth the while, if we consider the excellency of man, whom some call (as like unto God, The dignity of man described. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 so) The Interpreter of the gods. Pythagoras calls him The Measure of all things; And Plato calls him The Wonder of Wonders. Theophrastus' styles him The Great Pattern of the Universe. Aristotle terms him A Politic Animal, born for society, whom God made with his face upright; whereas all other creatures look with their faces downward. Pronaque Ovid. Met am. Lib. 1. cum spectant animalia caetera terram; Os homini sublime dedit, coelumque tueri Jussit, & erectos ad sydera tollere vultus. Horizontem corporeorum & incorporeorum. Divinum animal, plenum rationis & consilii. Mundi Epitomen, & naturae delicias. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 P. 8. ve. 4, 5, etc. Synesius terms man the Horizon of all corporeal and incorporeals. Tully calls him a Divine creature, full of Reason & counsel; whom Pliny also calls the Epitome of the World, and delight of Nature: And whom all with one consent, call, a Microcosm, a little world in a bigger. Of whom, the Kingly Prophet David, in Psalm the 8th. saith, Thou hast made him little lower than the Angels; thou hast crowned him with glory and honour, and hast placed him over all the works of thy hands. Now then, man being so excellent a Creature, who, though the last in the Creation, yet not the least; God making him as after his own Image and Likeness, Gen. the 1 Chap. ve● 26, 27. and instructing him with so large a Commission, (and a blessing annexed to it) as to subdue the Creation, making all the creatures subject to the dominion of man, whom God had or dained as his Viceroy on earth, with this blessing, viz. be fruitful, and multiply, and replenish the earth: Let us make a nearer indagation and scrutiny into the formation of man, as to the order of the generation of the parts, and increase of the infant, according to the days and times, from the first conception till the day of his birth: And then, the more we seriously weigh it, and pry into it, Ps. 139. ver. 13. the more, with the Psalmist, we shall admire our Creator by our creation, and bless that God that hath covered us in our Mother's womb, and praising him, say; We are fearfully & wonderfully made, marvellous are thy works, Ver. 15. Septuagint, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. My bones 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. Vers. 16. etc. My fubstance was not hid from thee when I was made in secret; and curiously wrought in the lowest parts of the Earth. Thine eyes did see my substance yet being unperfect, and in thy Book all my members were written, which in continuance were fashioned, when as yet there was none of them. And if God, who created male and female, thought it fit to provide the woman as a help meet for him: Gen. 2.20. Women being most fit to help women in their deliveries, by reason of the modesty of their sex; It shall be the whole subject of this ensuing small Tract, to describe a Midwife, and such a woman too that may be most apt for so necessary an employment; and then (still aiming at a public good) declining that Idiom best becoming the Pen of Doctors, The Latin Tongue. shall shape my Quill to an English Dialect, and (avoiding intricate and Bombastick words, and Acroamatical sentences, where they may be otherwise expressed) afford such material directory assistance in the business of Midwivery, as shall be suitable to the meanest capacity; not presuming to instruct the Learned, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. Noctuas Athenas. lest I seem to bring Owls to Athens; but to inform the less knowing. And ending this Preface, we will begin with Generation itself, and the rest in Order. SECT. I. Of the True generation of the Parts, and Increase of the Infant in the Womb, according to the days and times, till the time of the Birth. The property of the womb. WHen the womb (whose property it is naturally to receive seed unto generation, as a Loadstone attracts iron, or as Jet straws or feathers) hath received the seed for generation, and by its virtue hath shut up the seed for generation; Presently, from the first day until the sixth or seventh, there grow and arise very many and very small fibres or hairs, beginning with a hot motion, See the figure marked. by which vital heat the liver with his chiefest organs are generated by a natural virtue; as this following Scheme may the more illustrate, marked as in the margin. The small first fibres. depiction of an embryo For the vital spirits, giving down seed towards conception, forms and distinguisheth the chiefest members by the tenth day, being let in by certain veins of the secundine, The navil' how generated. to which the matrix is fixed, and by which the blood is imported, and of which the navel is generated. But at the very same time three small spots (not unlike to curds of milk) arise, where the liver, the heart, Nourishment of the Infant by the navel. Vena bifurca. and the brain have their places; and then presently a vein directed by the navel, attracts the thicker blood confused with the seed, and makes it fit for nourishment: from whence also there ariseth a vein with two forks, which is generated according to the form of this figure. depiction of the development of the navel in an embryo In the one of which branches there is a collection of blood, of which first the liver is generated by a natural faculty. The genetion of the Liver. From whence it easily appears, the liver to be a congealed and concrete blood: and also it may be manifest, how many and various veins it hath prepared and fitted, for the expulsive and attractive virtue. But in the other branch are generated those textures, or rather web of veins, with the dilatation of other veins, as of the stomach, spleen, and intestines, in the lower part of the belly. And from hence immediately all veins are recollected together, as so many branches into one trunk, in the upper texture of the liver towards the hollow vein; Venae Cavae truncus ascendens, descendens Diaphragma. truncus descendens. and this trunk by and by sends down branches to make the midriff, and directs not a few branches to the lower parts, even to the very thighs: and then the heart, with his veins extended into seed from the navel, is generated by a vital virtue, Spina dorsi. and is directed towards the spin of the back, as is demonstrated in this figure, 3. depiction of the development of the liver and the branching of veins in an embryo But those do attract the hottest and more subtle blood, The generation of the heart. Pericardium, vel Capsula Cordis. of which the heart is generated, incased in a membrane, naturally fleshy and thick, necessary upon the account of so hot a member. But the hollow vein extending itself, and penetrating the inward concavity of the right side in the heart, etc. derives thence blood for the nourishment of the heart. From the same branch also of this his vein, and in the same part another vein ariseth, called, by some, Truncus Phrenicus, vel Diaphragmatis. by some, the , or quiet vein; because, according to the account of the pulsation of other veins it beats not at all, but lies quiet; ordained for this end, Vena Coronaria. that it should let go the purest blood to the lungs, being vested with a double tunicle like an Artery, from whence it is called the Arterial vein. Vena arteriosa, er Pulmonaria. But in the left concavity of the heart there are two Arteries, that is to say, the Venal Artery, and the Great Artery, which carries a great pulse with it, and diffuseth the vital spirits by the blood of the heart into all the pulsatile veins of the body. For, as the hollow vein is the original of all veins, by which the body doth attract its whole nourishment of blood; so, Aorta. Venae p●…satiles Aorta. from the Aorta (or great Artery) all pulsatile veins are derived, diffusing the vital spirits through the whole body. For the heart is the fountain and original of vital heat, without which no creature or member can thrive. Arteria Venosa. Under the abovesaid Artery in the left concavity of the heart, another vein ariseth called the Venal Artery: And, although that be really a pulsatile vein, and doth direct the vital spirits, yet according to the manner of all pulsatile veins that have blood, It hath but one coat, and therefore made for that end, that it should derive the cold air from the lungs to refresh the heart, as also to attemper its overmuch heat. The generation of the lungs. And, because veins issue out from both the concavities of the heart, and are inserted into the lungs, and of which the lungs are form; for the vein that proceeds from the right concavity of the heart produceth the most subtle blood, which by small fibres dispersed here and there, is changed into the fleshy substance of the lungs. But from the great vein of the heart (viz. the Aorta) and from the great vein of the liver (viz. the Vena Cava, Vena Cava, the great vein of the liver, whence the breast, arms, and thighs proceed. or hollow vein) the whole breast is generated, and so successively the Arms and Thighs. depiction of the development of the heart and arterial veins in an embryo Within the time aforesaid also is generated the highest and chiefest part of this noble structure, The generation of the brain: the Brain; in the third Region of this mass; for the whole mass of seed being filled with the animal spirits, that contracts a great part of the genital moisture, and concludes it in a certain concavity wherein the brain may be form: but, as to the outside, The Cranium, or the Dura mater. The Scull. it is enveloped with a certain covering, which being toasted and dried with heat, is brought into a boney substance, and becomes a scull, as appears by this precedent figure. But the brain is so form, that it may conceive, retain, and change the natures of all the vital spirits, from whence also proceed the beginnings of all Reason, and of the Senses: For, as veins have their original from the liver, The original of the nerves. and as arteries have their rise from the heart; so also nerves being of a softer and milder natural existence, arise from the brain, and are not hollow as the veins are, but solid; for they are the first and chiefest instruments of all the senses, by which the motions of all the senses, by which the motions of all the senses, by reason of the vital spirit, are justly made. After the nerves, The original of the pith of the backbone, called the Silver cord, Eccles. cap. 12. ver. 6. from the brain also is form the pith of the backbone, not of an unlike nature from the brain, so that it scarce can be called marrow, because it hath no likeness to marrow, either by sight, or in substance; for the marrow is a kind of superfluous aliment, arising from the blood of the members, The marrow, what, and how generated. The Spinalis medulla, what. appointed to moisten and make the bones of the body grow; but the brain and pith of the back have their original from the seed, not deputed for the nourishment and growth of the other members, but that by themselves they might make private parts of the body, The brain and Spinalis medulla ordained for the use and motion of the senses. for the use and motion of the senses, that from thence all the other nerves may take their rise. For, from the pith of the back many nerves arise, from which the body hath sense and motion, as may appear by the difference betwixt the vital and animal faculties, as hath been before hinted. Cartilages, bones, etc. generated from the seed. Moreover, here it is to be observed, that from the seed itself cartilages, bones, coats of the veins of the liver, and of the arteries of the heart, the brain with the nerves, and again the tunicles, and as well other pannicles or membranes as those that wrap up the infant, are generated; but from the proper blood of the infant is the flesh itself engendered, and all those parts that are of a fleshy substance; as the heart, the liver, and lungs: And then at length all these grow together by the menstruous blood, attracted by the small veins of the navel, which are observed to be directed with their orifices into the womb. All parts distinct by 18 days. All which are distinctly made by the eighteenth day of the first month, from the very conception, at which time it may be called seed, but afterwards it becometh to be, and is called a child; When called a child. which the Ancients have comprehended in these two verses, Sex in lacte dies, ter sunt in sanguine trini, Bisseni carnem, ter seni membra figurant. depictions of an embryo in the womb and of the development of the nerves The lesser figure denotes the Nerves derived from the Back and dispersed through the whole. The explanation of the larger figure see in the following page. Cross sculpsit ' Englished thus, Six days in milk, thrice three the seed's in blood; Twice six makes flesh, thrice six makes members good. FF Sheweth a young one of 18 days (though some hold it but 14 days in which all the members may be discerned apart.) GG The four Umbilical Vessels meeting in one. HH How the Umbilical Vessels become thick by degrees, that that doubt amongst some may be resolved, whether they spring from the womb, or no. III Sheweth how the Umbilical veins and arteries are spread throughout the Chorion by infinite branches. KKK Sheweth the membrane called Amnios', in which sweat and urine are gathered together, in which the infant swimmeth, and sits as safe as in a Bath. SECT. II. Of the Nutriment of the child in the womb, and by what nourishment it is preserved, and when it groweth up to be an Infant. Infant, how nourished. Whilst the young one is in the womb, it is nourished by blood attracted by the navel; by which it is, that women after they have conceived have their terms stopped; Why courses stopped after conception. for then the infant gins to crave, and attracts much blood. For the blood presently after conception is discerned by a threefold difference. A threefold didst nction of blood after conception. The first and purest part of it the young one attracts for nourishment. The second, less pure and thin, the matrix forceth upwards by certain veins to the breasts, Venae mammariae. The generation of milk. where it becomes milk, by which the infant is nourished so soon as it is born. The third, and more impure part of the blood, remains in the matrix, and floweth out with the secundine, both in the birth, and after the birth: Hence it is that Hypocrates saith, Hippocratis Aphor. lib. 5.39 & 52. there is much affinity betwixt the flowers and the milk, since the one happeneth to be made out of the other. And Galen also, by reason of this thing, The infant hath more from the mother than the father. elegantly adviseth, that the infant hath more from the mother than from the father; for this reason, because the seeds are first increased by the menstruous blood, and then by these the infant is presently nourished in the womb; and again, being newly born, it is nourished with milk: And, as roots have more nourishment from the earth than the plant that bore them; (that is, from whence they came): so also infants receive more from the mother than from the father. And hence he saith that it comes to pass, that so much more is attributed to the mother, by how much more she contributeth more towards generation. depiction of a foetus in the womb A rule to know it. If the infant be form in 45 days, it will stir in 90 days, which is the middle time that it lies hid in the womb; for in the ninth month it will come forth, and make haste to the birth; although females are oftentimes born in the tenth month. And so much for the formation, increase, and perfection of the infant, according to the account of days and times. SECT. III. How the infant doth in the womb the fifth, the sixth, the seventh, and eighth month; and also of the difference of sexes, and forms. AFter the third and fourth month the infant useth a more plentiful nourishment, by which it groweth more and more until the time of birth shall come: Therefore it is to be understood, that when it is born in the sixth month, it cannot in nature live; because, though it be form distinctly, yet it is not of its just perfection. But if it be born in the seventh month, Why an infant born in the seventh month may live. it may easily live, because than it is sufficiently perfect. And, whereas those that are born in the eighth month can rarely live; whereas, such as are born in the seventh month are often times living, it is not without reason; for on the seventh month the infant is ever moving towards the birth, at which time, if it be strong enough, it comes to the birth, but if not, it remaineth in the womb till it groweth stronger, (viz.) the other two months. After the motion at seven month's end if it be not born, it removes itself into some other place of the womb, and is so weakened by that motion, that should it come to the birth in the following eighth month, Two mortal signs by the infants moving. it cannot live by reason of that motion; and neither is the infant endangered by this only, but by a double motion. The first is, that when after the motion of the seventh month, it is born the eighth month, (as aforesaid.) The next is, because (by reason of the influence of the stars) every seventh month produceth a dangerous and hurtful motion to the infant; for the Sun is ever standing in an opposite sign at that time, and because the 8th. month is ever nearest unto Saturn, an enemy to all that receive life. And it is to be conceived, The difference of the sex. Hypocrates Aphor. v. Book, and 48. that the males are generated in the right side of the matrix; but females in the left, out of the left testicle; for the right side, by reason of the Liver is hotter, but the left cooler; but principally the abundant heat of seed is the cause of the generation of males. Of infants being like their parents. And, because males are sometimes like their parents, is from the virtue of the seed, that the infant should most resemble those whose seed is most in virtue. But 'tis believed that the motion of the stars can do somewhat, Stars have influence. The reason of handsome and unhandsome children. as when the seed is conceived under the aspect of some good Planets, this makes an excellent form; but when under the aspect of some untoward Planet, than it produceth an ugly shape, and unbeautiful form. depiction of a uterus with foetus This figure showeth the Womb Anatomised and how the Infant lieth in it. The parts are described in the following page. C●oss sculpsit SECT. IU. Of the due time and form of the Birth; and what are the causes of pains in Childbearing. THe ninth month being now at hand, the nourishment of the infant in the womb beginneth to fail, by reason of that bigness to which the infant is grown; or now being big, it requires much nourishment, which, because it cannot longer attract by the small veins, and by the navel, it is moved with great struggle and force in the womb, insomuch, as it breaketh the ligaments, the veins and coats in which the infant is involved (I mean the secundine) with the other coats, of which hereafter, and according to this figure, fitteth itself toward the birth. What are the pains in Childbearing? By this indication Midwives and other women which sometimes are assistant unto pregnant women, may observe the true pains of a woman in travail, which in truth are nothing else but the force of the infant now perfect, by which they are enforced and tossed, and with which they contend downwards, that they may go forth; for the membrane being broken by that force, and the womb open, the humours begin to flow down, of which the infant being now freed, he presently is sensible of the air, and being desirous of this life, is turned toward the outlet of the matrix, with his head towards the orifice of the same: And this (see the precedent figure) is the form of a natural birth; A natural birth, what if the head tend forth to the out let, with the hands drawn down to the sides, and placed on the hips, as in the last figure. An unnatural birth (of which more at large, God willing, hereafter) may be said to be where any of these conditions are wanting, or defective; therefore let the Midwife take care that she be timely prepared for the reception of any birth, with all necessary depiction of a uterus with foetus correctly presented for birth A Natural Birth. Cross sculy conveniences, as with a fit stool, The Midwife's furniture. a sharp knife, astringent powder, a sponge, swaths, etc. warm oil of Lilies, with which she may aptly anoint both the womb of the woman, and her own hands: but of that also more particularly hereafter. Let us now, in the next Section, make inquiry for the fittest and best Midwife, with whom we may discourse. There is a good woman called Mrs. Eutrapelia, who promised to undertake the office, and to be satisfied with directions. And see, here she comes, and offers discourse. SECT. V A Dialogue between Eutrapelia the Midwife, and Philadelphos the Doctor. Eutrap. Sir, I understand you are enquiring after a woman that may make a fit Midwife; the employment being such a necessary and public good; I should be willing (if your Worship, and other Learned Physicians think me fit) to be serviceable in my generation, and to take upon me that employment. Dr. Philadelphos, Your name, I beseech you, Mistress. Eutrap. Sir, my name is Eutrapelia; and I am she that last night promised to wait on you this morning. Philad. Are you she? Welcome Mrs. Eutrapelia, your name bespeaks you fit for the work, as being a well-bred woman; therefore give me leave to tell you what kind of person a Midwife ought to be, and that in the subsequent description: A good Midwife described. The best Midwife is she that is ingenuous, that knoweth letters, and having a good memory, is studious, neat and cleanly over the whole body, healthful, strong, and laborious, and well instructed in women's conditions, not soon angry, not turbulent, or hasty, Exo. 1.15. Shiphrah Puah. Exod 1.17. and ver. 20 and 21. unsober, unchaste; but pleasant, quiet, prudent; not covetous, but like the Hebrew Midwives, such as fear God, that God may deal with them, and that the people may multiply and increase after their hands, and that the Lord may build them houses. By this description I tell you only how the best Midwife must be qualified; let me hear from you somewhat of your experience and skill, that I may the better judge of your abilities, and approve of them. First, than Mrs. let me know how women are delivered? depiction of a birthing stool B. the Back of the Stool o o o o. the feet a a. rests for the hands r r. the ring in shape like the Moon c c c c. the Cloth round the ring to keep out the Air etc: Crofs sculpsit An astringent powder. ℞. of Aloes, Frankincense, Dragons-blood, of each a drachm; of Hartshorn, sealed earth (called Terra sigillata) fine flour, of each two drachms; of the wool of Hares shred small, half an ounce; of these make a fine powder. As to the washing of the child, and swathing, I need not give you any account, I suppose you take it for granted, that most women understand that I only here show you the shape of the stool I use, which, I hope, you will not disapprove of, though all Midwives (nay few) have them, or use them. Dr. Philadelphos, I like, Mrs. the use of your stool, as being most useful, and especially by reason of the skirt of cloth that usually aught to be about n =" *" Of a black colour. it, to keep away the air, which gives me occasion to give you one necessary admonition by the way. A Caution. Therefore let all Midwives take heed that they expose not their women that are in labour to the cold air, but rather that they cover the privities with the secundine also whilst it is yet hot, or else with warm clothes presently after the birth. For, believe me, (neither is it only my opinion, but also the opinion of the most Learned Doctors) that there is nothing worse to childbearing women than the cold air, Rodericus a Castro part, 2 lib. 4. Cap. 12. because that entering into the womb, the womb itself is distended, waxeth cold, and swelleth, and its orifices are shut, from whence cometh the menstruous matter, and thence arise grievous symptoms, and often times death itself. But as to the suppression of them, and their cure, we shall (by divine assistance) treat more largely we leave this subject in hand. This precedent figure is the form of a child lying in the womb (according as cut in Tho. Bartholinus, in Page 197.) naked, and out of all its coats, both proper and common. The description of it appears by the explanation of these letters in it, viz. AA Shows the parts of the Chorion diffected, and removed from their proper place. B A portion of the membrane Amnios'. CC The membrane of the womb diffected▪ DD The placenta Uteri, or hepar uterinum, being a fleshy substance full of many vessels, by which the infant receives its nourishment. E The varication of the Vessels which makes up the navel string. FF The navel string by which the Umbili or vessels are carried from the placenta to the navel. GG The infant, as it lies perfect in the womb near the time of travel. H How the umbilical vessels are inserted into the navel of the infant. SECT. VI Of the site of the child in the womb. The infant, how it lieth in the womb. THE infant in the womb lieth altogether bowed and contracted together, his knees to his belly, and head to his knees, the ankles being joined to the buttocks, crosslegged, his hands lifted up towards his head, on which he so leaneth his head, that his eyes seem to be fixed to the thumbs of his hands, the one placed on the temples, the other on the cheeks; insomuch, that white spots may be seen in the skin, as if they had been fretted the one against the other. The former part of the body tends towards the lower part of the belly of the mother (if it be a male) and the hinder part towards the back; but if it be a female, the posture is clean contrary. But the usual posture is as in this figure which goeth before. SECT. VII. Of difficult births, whether preternatural, or whether they proceed from Causes external or internal. DIfficult births from external causes may be either, first, from excessive heat, dissolving the strength of the women; or second, excessive cold, condensing the womb; Their causes. or third, from sweet things, often applied to the nostrils of the woman, that by smelling to sweet things she may recover her strength and faintings; for sweet smells do attract the womb upwards, and so render the birth more difficult. Difficult birth from internal causes may be either, first, from the woman; second, from the womb; third, from the infant; fourth, from the membranes of the womb. 1. From the woman, as when she is too angry, too fearful, or too modest; or if she be in age above 40 years, Women of above 40 years bring forth with difficulty. from whence the muscles of the womb may be concluded to be dry, and so the less extensible; or, when she is so thick and fat, that the passages be narrow: Or, 2. From the womb itself, as, when it is so small, & nature so weak and feeble that it cannot expel the birth: Or, if there be any inflammation, Inflammation. The stone. Costiveness. Haemorrhoids. or other preternatural affect in the privities, be it the stone, or haemorrhoid's, or extraordinary costiveness; all which may so compress the womb with their weight, that it cannot expel the birth. 3. Is from the infant itself, as if it be of an unusual bigness, of a great head, or a monstrous birth, hydropical, gibbous, (that is crook-backed) full of wind, dead in the womb, or lying there in a posture beyond nature; as when it comes overthwart, with the feet forward, and not the head, or if the thigh before the head. 4 th'. From the membranes of the womb, as when they are so forcibly broken by the child in the womb that the moisture floweth thence, leaving the infant behind, that when the child should come forth, that moisture faileth, and so the membranes being dryer, maketh the birth the more difficult; or when it is so firm and solid that it is broken with much difficulty, and so makes the labour the harder. SECT. VIII. Of the Schemes, Fashions, and Figures of the birth lying in the womb, and how they are born, or may be born. THE postures of the infant in the womb are generally four: First, they offer to come with their heads forward (which is the natural birth.) Secondly, with the feet forwards. Thirdly, overthwart. Fourthly, doubled; to all which the Midwife's care and skill is required, but especially in the three later. But chief very many postures and schemes have been observed, and are to be found by continuance of practice; for that child that comes with his head forward, sometimes hath his head right as to the orifice of the matrix, but the rest of the body crooked, and sometimes overthwart: and sometimes the infant pitcheth his head either in the former part from the orifice, or backward, or comes crooked; and sometimes also these schemes are without any tye as to the bottom of the matrix, and sometimes with it; sometimes also it puts forth one hand, or both, so as that they are twisted above the head: sometimes it cometh forward, with its feet asunder, and those fixed in the parts of the womb; sometimes the feet being doubled, it endeavours to come forth with the knees forward; sometimes it is so doubled, that it shows forth its little buttocks like one that is sitting; or contrarily may be so doubled, that you may find the soles of the feet joined to the head in the orifice of the matrix; but those that lie o'rethwart, sometimes lie on one side, and sometimes with the face upwards, and sometimes downwards: But if there be twins, then that which presenteth itself fairest, must be laid hold on, and the other put back. As to all which, the next 15 or 16 Sections will not only furnish with schemes, but with directions. Hitherto having described the Midwife and her office, together with the site of the infant in the womb, as natural; together with difficult births in general, and their causes. It is reasonable, (good Mrs. Eutrapelia) that we discourse of preternatural births because those bring the greatest danger with them, both to the mother and infant. SECT. IX. Scheme the first. Of preternatural Births. Quest. 1 DR. Philad. Courteous Mrs. Eutrapelia, If you perceive a child come with his feet forwards, and the hands drawn downwards to the thighs, according to this next ensuing form, How will you deliver the woman? depiction of a uterus with foetus in an abnormal birth position Eutrap. In this, I will take care to be furnished with Oils, Answer. and convenient liniments, and only to help the coming forth of the infant, by anointing and cherishing it, lest it go back again, but that it may come forth the same way as it began. But first of all I shall take care, that both arms of the infant so stretched downwards, be so secured by me, that the infant may not have power to draw them back again, but that I may compel it to come forth, after this very same manner: But if the infant breaking forth after this manner, and by reason of its bigness as well as his arms drawn down, be so straightened by the narrowness of the matrix, that of itself it cannot wholly come to the birth; then the womb of the woman is to be anointed with oil of Lilies, Oils. Opus est Elleboro. or sweet Almonds, and some sneezing Powder of Hellebor, etc. blowed up into her nose, to help the sending forth of the birth, and the womb gently to be compressed with both hands, that it tend not upwards, but downwards, as it ought, until it comes forth entirely. SECT. X. Scheme the Second. DR. Philadel. Quest. 2 But, tell me, I pray, Mrs. Eutrapelia; What if an infant come with the feet forward, and the hands lifted up above the head, and not drawn downwards to the thighs, (as in the following figure) what course will you take with most safety? depiction of a uterus with foetus in an abnormal birth position Eutrap. Sir, I am not at all to receive it so lying, Answ. except the infant be very small and little, and the matrix so extensive, and open, that it may be hoped a safe delivery, both to the woman and to the child; neither must I receive it before the matrix and the infant be diligently anointed. But it were much better to thrust back the infant into the womb, and to turn it to the right form, which may be done after this manner. Let the woman lie on her back upon a bed, with her buttocks raised higher, and her head lower; which done, I must swath her belly toward the midriff gently, that I may drive back the infant again into the womb, by which means it may give an occasion of coming forth in another form; but above all, I must take care to turn the face of the infant toward the back of the mother, and then I must lift up the buttocks and thighs of the infant toward the navel of the mother, that it may hasten toward a lawful birth: and there cannot be a safer experiment in this case, (as I conceive) which is also most useful in such births as come praeternaturally. SECT. XI. Scheme the Third. PHiladelphos; Quest. 3 I pray forsooth tell me, If the infant happen to come forth but with one foot, and the arms let down to the sides, but the other foot turned backwards; How will you help? Eutrap. Answer. In this case, Sir, I must not trouble the woman, but must bring her to her bed again, and so by the assistance of other women, bend her, and turn her after the same manner as was formerly proposed, putting back also the other foot into the womb; which done, she must often tumble herself upon her bed, till I find the infant in some measure turned, and the woman brought fitly to her labour, and helped with all means possibly to be used. And this kind of tossing and tumbling may be used in all births, where the infant depiction of a uterus with foetus in an abnormal birth position appears after an unapt manner: In the mean time, when there is need, she ought to be refreshed with such Physical means as may be proper. But if it shall happen that either by the rolling to and fro of the woman, or my industry, that the foot so bend back come right to the birth; then I must take care that (laying hold of the arms otherwise drawn downwards toward the sides) I bring the infant handsomely out, so as is answered in the first Chapter. SECT. XII. Scheme the Fourth. PHiladelphos; Quest. 4 If an infant lie on the one side, or on its back, with the hands and feet up; how will you help it? Eutrapelia; Answer. Sir, In this case and condition, I must not trouble the woman, nor expect the infant to be born so lying, which without some way of turning is impossible. Therefore I am to take care that I reduce it to the true form of a natural birth, by lifting up depiction of a uterus with foetus in an abnormal birth position the buttocks, and directing the head to the birth; and if this course succeed not, to see that by often rolling upon the bed, as aforesaid, the infant return to its right form of lying. depiction of a uterus with foetus SECT. XIII. Scheme the Fifth. PHiladel. Tell me, Mrs. Eutrapelia, Quest. 5 What if the infant happen to hasten to the birth with his arms and legs distorted and crooked, according to this figure; How then will you help? depiction of a uterus with foetus in an abnormal birth position Eutrap. Answer. As things so stand, Sir, I must not endeavour the birth of the child, but must bring her from the stool to the bed, where I must press back the womb as before-said, or must desire her to roll herself about, till the infant depiction of a uterus with foetus in an abnormal birth position is turned to a more commodious posture: And if this course prevail not, I must endeavour to join both feet together, and, if possible, must bring down the hands so to the sides, that I may direct it to the birth. But the safest way is, that it be converted, in the womb, to its right posture. SECT. XIV. Scheme the Sixth. DR. Philadel. Tell me, Midwife, Quest. 6 what if the infant fall down with both the knees bend, and the hands hanging down to the thighs; How will you go to work? Eutrap. Here, Doctor, Arswer. I must with my right hand lift up both knees upward, till the feet happen to come forth foremost, then with my left hand I must lay hold on the feet, and with my right hand keep the hands to the sides, and encourage the infant toward the birth. But if this way be not thought safe enough, I must bring the woman to the bed, where lying in such a posture as before, she shall so roll herself up and down, till the infant come to a better and more commodious posture. SECT. XV. Scheme the Seventh. DR. Philadel. Quest. 7 But, Mrs. Eutrapelia, What if the infant come out hastily with one hand, and the other hand down towards the side, and the feet stretched out straight into the womb, according to this figure; How will you receive it? depiction of a uterus with foetus in an abnormal birth position Eutrap. May it please you, Sir, Answer. I am not at all to receive it so, nor to suffer it to proceed farther toward the birth; but must bring her to the bed, where her head must lie lower than her buttocks; then I must swath her belly gently, that the infant may fall back again into the womb: but if it fall not back of its own accord, I must put in my hand, and press back the shoulders, and must reduce the arm that hanged out to the side, that it may be disposed of to a natural form in the womb, and so may come forth easily. SECT. XVI. Scheme the Eighth. DR. Philadel. Quest. 8 But, Mrs, Suppose the infant come forth with both hands stretched forth above the head, and the feet straight stretched into the womb, which is here figured, and is much more dangerous than the former? depiction of a uterus with foetus in an abnormal birth position Eutrap. 'Tis true, Sir, Answer. this posture is much more dangerous than the former; but I shall take all the care I can to bring back again this birth into the womb wholly. And first of all, I shall anoint my hands, and the womb of the woman, with oils for this purpose, (for this requires no small labour) then, if possible, with my other hand shall drive it back so by the shoulders, that it may wholly fall back into the womb: And again, lest the infant should return to the same form of birth, I must put in my hands, and bring down the arms of the infant to the sides, and by that means bring it to the form of a natural birth. If this course take not, I must bring the woman to the bed, where, after she hath lain quiet a while, I must proceed after the same manner as I have before delivered: and if this also be to no purpose, and that it neither be changed to another form, she must be brought to the stool; and the womb, by the help of the women that are assistants, must be depressed on both sides, and downwards: And (my hands being anointed as before-said, together with the womb, and both the arms as they come) I must do what I can to join them together, and so receive it as it comes forth. And in this birth, there is the less danger, if that I or any other Midwife do our duties with all possible diligence, and in case the infant be not too weak. SECT. XVII. Scheme the ninth. PHiladel. But I beseech you, Quest. 9 Mrs. Eutrap. How will you deliver a woman of a child that falls down with its buttocks forward, and the hands spread over the head, according to this figure? depiction of a uterus with foetus in an abnormal birth position Eutrap. Here, Answer. Sir, I must anoint my hand as abovesaid, and putting it up, must lift up the fundament of the child, and turn the head to the Birth. But, in this case I must not make too much haste, lest it fall into some worse form; neither is it possible that a child should be so born, without great loss to the mother and the infant; therefore, if it cannot be turned with the hand, she must be brought to the bed, where, if she be very weak, she may be refreshed with convenient meats and cordials, and then often proceeded with as is said before, until the infant shall come to a more commodious form of birth. SECT. XVIII. Scheme the tenth. DR. Philad. Quest. 10 But sometimes (Mrs.) it happens that it offers itself with its shoulders forwards, and the head turned backwards, but the feet and hands lifted up, as in the ensuing figure; How will you help here? depiction of a uterus with foetus in an abnormal birth position Eutrap. In this case, Sir; I must in the first place move backward the shoulders of the infant, that it may first appear with the head forward; and this may easily be done, because the shoulders being but a little up, the head of itself will fall down to the orifice of the womb, as being nearest to it. But if there must be any other way attempted, she must be brought back to the bed, and then so stirred and rolled, and used according to those directions formerly hinted. SECT. XIX. Scheme the Eleventh. DR. Philadel. Mrs, Quest. 11 I fear I trouble you with many Questions; be pleased to satisfy me in this, and four or five more, and I shall forbear. What then if the infant incline to the birth with the hands and feet together, as if it stood upon all four, with the back upward into the womb, (as in this figure) What, I say, will you do? depiction of a uterus with foetus in an abnormal birth position Eutrap. Here, Answer Sir, I must take care, lest some danger happen from this difficult and unshapely figure; therefore I must do thus. I must so move up the feet of the infant, that I may handle the head, and do what I can to direct that first to the birth: I must also move up the arms, lest of their own accord they fall down to the sides of the womb. And if this way succeed not, she must be brought back to the bed, and the same means used for the turning of the infant as hath been formerly described. SECT. XX. Scheme the Twelfth. PHiladel. Sometimes, Quest. 12 Mrs. it falls out, that (contrary to the former shape) the infant falls down upon its breast, with the hands and feet cast backward into the womb, as in this figure; what will you do in such a condition? Answer. depiction of a uterus with foetus in an abnormal birth position Eutrap. Truly, Sir, this case is the most dangerous of all hitherto proposed. First, therefore, I must carefully anoint both my hands, and also the womb of the woman; which done, I must inquire after the arms of the infant, and lay hold of them so, till I can lay hold of the head also, and with all care hold it so fast, that I may direct the head first to the birth; next I must dispose of them to the sides; for this being done, the birth will come forth the sooner, and with less danger; but if this succeed not, it will be safest to bring the woman to the bed, and to proceed as formerly showed; that, if perhaps, by this kind of delay, the infant may accommodate itself to a more fit posture for the birth. SECT. XXI. Scheme the thirteenth. DR. Philadel. There being the same reason in twins as in a single birth, Quest. 13 except that the single birth is natural, and the twins not so; certainly the same method must be observed (Mrs.) Tell me then, if there be two or more, and all come fair with their heads toward the birth; What is to be done? depiction of a uterus with twin foetuses in an abnormal birth position Eutrap. Here, Answer. Sir, I must observe that which lieth readiest and fittest in the womb, and first receive that, and not to let the other go till the first is born, lest it turn into another shape by sliding back again into the womb; but the one being born, I must presently lay hold on the other. Now, this birth will be easier, and without danger, because the first birth hath made the way for the second so plain, that it may come forth without any difficulty at all. But in this birth I must take care that I bring forth the after-burden timely enough, After-burden. lest that the womb, being freed from her infants, presently fall down, and so keep in the secundine or after-burden with great danger. SECT. XXII. Scheme the fourteenth. DR. Philadel. But, Quest. 14 Mrs. What if there be twins, and they both come praeternaturally with their feet forward, as in this figure; what course will you take? depiction of a uterus with twin foetuses in an abnormal birth position Eutrap. This birth, Answer. Sir, is dangerous enough, and yet it is to be mended by the prudence of a discreet Midwife. Wherefore, I must anoint the womb of the woman, that the passages may be the easier for the infant; which being done, I must take care to lay hold of the arms of one of them, and bringing them down to the sides, secure them so, that I may lightly promote the head to the birth; and the first being born, I must presently proceed with the other after the same manner: but if I can lay hold of neither of their arms, so that there is no good hopes of a happy birth, I must have recourse to the former method; if at least the infants may come into the world by that pains and conversion which is wrought upon the bed. SECT. XXIII. Scheme the fifteenth. DR. Philadel. Quest. 15 I come now to the last preternatural birth of twins. If then there be twins, (these form being compound as of a natural and preternatural birth) the one coming down with the feet, what is to be done in this case? depiction of a uterus with twin foetuses in an abnormal birth position Eutrap. Answer. Where infants offer themselves after this manner; I must first bring forth that which presents itself with a natural form, and must move up the other, that is with the feet forward, and if possible, cause it so to return into the womb, that that birth also may be disposed of to a natural birth; but if it cannot be converted to be in a better posture, I must lay hold presently on the hands, and encourage it to the birth. But it were safer that this should be brought to a natural form; to which end I must diligently endeavour it, by anointing, directing, moving it, tumbling and rolling the woman, lest perhaps the womb be hurt by the form of such an unnatural birth, and the privities swell with n =" *" See the page toward the later end of the fifth Section. wind, from whence the birth cannot come forth without danger, or be hindered too long: All which danger may with provident care be avoided, or at the least very much corrected and amended. SECT. XXIV. Scheme the sixteenth. DR. Quest. 16 Philadelphos; Courteous Mrs. Eutrapelia, I have hitherto troubled you with many Questions, that I might not only be sure of your abilities, but also give testimony of your sufficiency, if need require. I have now only one Question more, and then I have done, as to these postures and schemes: And this, though the last, surely is a miraculous posture. What if the infant be so involved in the womb (the head and the neck being of such a length) that it is so bend back, that the face lieth betwixt the buttocks, the right hand to the left region of the reins, but the left hand to the knee of the same side; the right leg being across the left, in form of the letter X, and both legs bend up toward the breast? depiction of a uterus with foetus in an abnormal birth position Eutrap. Answer. Worthy Dr. This case is the hardest of any that hitherto you have propounded to me; and though it may never fall out to be so in one amongst 5000, yet (because, in your description of the best Midwife, you tell me that a Midwife must have a good memory) I remember a learned Doctor, not long since acquainted me with such a posture, which he told me he had from the hands of an expert n =" *" Gulielm●s Fabritius Hildanus, Century, the sixth; Observation, Lxiv. Chirurgeon and Physician, whose wife also was an expert Midwife; and the course the Midwife took in such a case, he told me was this, which must serve also for my answer, because I think there cannot be a better. After the woman had been eight days in labour, and given over by all Midwives as desperate, being in a violent Fever, with no throws, but very weak, and (by reason of hot medicines given to expel the birth, and strong wines given to support the spirits) those humours that usually accompany the infant had so flown out, Blood and water. that the genitals were so dry and closed, that they would scarce admit the probation of two fingers. This method was used: First, instead of wine, she gave her good store of Almond-milk; and because her belly was very costive, she gave her Clysters; and to keep up her spirits she gave her Cordials, (of which in their order.) She laid plasters to her hand-wrists, and anointed the whole region of the belly, hips, loins, the rump-bone, and privities, Os sacrum. with anodyne Oils, with emollient and relaxing Unguents; and then she made a triangular bag stuffed with emollient and relaxing herbs, boiled in water, according to this description, (and of which more hereafter.) depiction of a triangular bag used as a hot compress during labour It is of such a bigness, as that it might cover the lower part of the belly, and the privities, and with tapes fitted to the corners was applied hot, and continued on some hours; after which, though her hand were well anointed, she could scarce thrust in the top of her finger into the orffice of the womb, the womb was so closed, Called the Os pubis. and the infant so depressed toward the share-bone, by reason of the precedent throws and pangs. But at length, when with much labour and industry the genitals were somewhat dilated, that she could get in her fingers farther, she found the loins and the right hand of the child first offer itself to the birth: that therefore she might correct this monstrous and so inverted posture of the infant so doubled and twisted, and either persuade the head or the feet to come forward, she useth the best of her skill, but to little purpose, the genitals were so narrow and straight. But yet not giving off her endeavours, she did deliver her within eight hours after she came to her assistance; but the child was dead. Dr. Phila. Mrs. You give a very good account of an expert Midwife's practice, which you may follow with safety, expecting the succcess from Heaven; but it is no wonder the child should be stillborn, (as you phrase it;) for being so turned and doubled, the child must of necessity be strangled in the womb. Having thus run through births, as well natural as preternatural, I shall give you the reason (and that in my own opinion) why these births are of so various & different postures in the womb, observing not always the same posture: and 'tis thus. The reason of these different postures. Because the infant swimming in water, and moving itself, sometimes this way, sometimes that way, and is bend and tumbled several wates; insomuch, that sometimes it is strangely entangled with its own navil-cord, which I am confident you have seen in your own experience oftentimes. SECT. XXV. Of a Mola. DR. Philadel. We have hitherto, Quest. Mrs, discoursed of births natural and preternatural; there is somewhat more not like these, but often with them, and without them, which Physicians call a Mola, but you call it a false Conception: I pray, Mrs, therefore, what is that Mola, or false Conception? Answers A Mola, or false Conception, what. Eutrap. A Mola, (Mr. Doctor,) generally called a false conception, is a hard inform tumour, full of pores, (like so many ugly eyes) scarce to be cut by a knife, of a stony substance to touch, and round, appearing sometimes at the entrance of the womb, sometimes over the whole womb, and is generally thought (by the n =" *" Fernelius, lib. seven, cap. de faeminarum semine. Learned'st Doctors) to be begotten by the woman herself without the help of a man. (Qualis & quanta ea sit vis declarant rudiores moloe quas faeminae quandoque proprii duntaxat seminis vi, Fran. Valesii controversianum, lib. 11. cap. 6. in fine. Ex pauco semine eaque impure. nullo viri concubitu concipiunt;) And so another Dr. in these words (I beg your pardon, Mrs. that I am enforced to use authorities in Latin) (some affirming that it cannot be without the seed of the man.) Valesius, as before quoted. Hinc cognosces, quod faemina saepe ex se sola solet utero concipere; foetus tamen ad perfectionem nunquam perducitur; ex his tamen imperfectis conceptionibus quae dicuntur, molae matricis generantur & informia carnis frusta. And therefore inanimate, because not generated by two, N●…●…et affectu quod 〈…〉. without the help of a man (I say) by the force of her own seed, mixing itself with much menstruous blood, retained in the womb, which by immoderate heat it changeth into the shape of flesh, and that altogether preternatural, as is the stone in the bladder, and in the fingers of gouty persons, etc. Dr. Philadel. Well, Mrs. since 'tis so (as in truth it is; tell me, I pray, wherein it differs from a true Conception? The difference betwixt a true and false conception. Eutrap. It may, Sir, be like a true Conception in three respects, yet differ in six. As first, 'Tis true that a false conception stoppeth the monthly terms as doth the true. Secondly, The belly also doth swell, and the breasts grow big. Thirdly, There is an alteration both in the colour and appetite; but yet they differ in these six ensuing following ways; as, First, A false conception hath no ordinary nor periodical motion, neither doth it stir from side to side, except it be pressed. Secondly, In a false conception the belly is harder, and the feet are much more swelled. Thirdly, The woman is more heavy and unweeldy, and not so nimble as with a true conception. Fourthly, The breasts swell not so much as in a true conception. Fifthly, The whole body grows soft, and consumes away in a false conception, but not so in a true. Sixthly, a false conception may be moved in three months, but the child stirreth not till after three months, or usually in the fourth month: And again, the birth of an infant never exceeds the eleventh month, whereas a false conception may continue for fourteen years, A Mola may lie 14 years. or as long as they live. Moreover, there may be a Tympany caused by air included in the womb. Tympany, what. Hydrops uterinus. Or else there may be a Dropsy, by reason of the many humours contained in the womb, both which may give a false supposition of being with child; but these also are easily distinguished from a false conception. A Tympany may be moved from place to place, but not the other: A Tympany will sound, if lightly strucken, but not the other; and a Dropsy, caused by those many humours as aforesaid, will show some marks, being depressed with the fingers, whereas a Mola is hard, and yieldeth not to the pulsation or depression of the fingers. And lastly, in both these most commonly the thighs swell, but in a false conception or mola the thighs whither, and are lesser. Now having discoursed of these things, Sir; if you please, in the next place, let us discourse of the secundine, or after-burden. Dr. Philadel. I shall, Mrs. very willingly. SECT. XXVI. Of the Secundine, or After-burden. DR. Philadelphos, Come then, Mrs. if you please, tell me what the Secundine is. After-burden, what. Eutrap. The Secundine is that in which the infant lieth in the womb, and may be called a second house, or covering, made by the womb for a receptacle of the infant; and it hath with it three membranes; but how Physicians name them, I know not. Dr. I will inform you then, if you please, with their names and uses; and describe them to you in these two figures following, which are explained by letters also, as may appear. The explanation of the first Figure. BBB Signifies that part of the Secundine called the Chorion, which is the depiction of the placenta prop of all the vessels of the young one. CCC Denotes the branches of the Umbilical veins and arteries dispersed through the Chorion. EEE The membrane called Amnios, and is the thinnest of all the membranes, and is white, soft, and shining, with few (and those very small) veins and arteries dispersed among the folds; and this is the very next coat to the infant, and is the receptacle for sweat and urine; that membrane called Allantois not to be found in men, though an Urachus be to be found. DD Denotes all the vessels meeting about the navel, by which the infant is nourished. P. Q Denotes the membrane called Amnios', and is the first that involveth the infant. RRRR The Liver, RRRR. Epar uterinum, or, Placenta uteri. or cake of the womb, or after-burden, by which the infant receives nourishment, and this is fastened to the womb. SS The inward and outward veins. m.m.m. The Umbilical vein, with its branches dispersed into the after-burden, by which the child is nourished, and upon which it lieth, as upon a pillow, though in the Amnios it swimmeth as in a bath. W How all the vessels meet about the navel. b. b.b Denotes the infant newly born, annexed to the secundine, the navil-string not cut. depiction of a new-born infant attached to the placenta Chorion Amnios' A●…v 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, The first Galea. The first membrane is called Amnios, and this membrane covers the infant from the head to foot; insomuch, that part of it sticks to the head of the infant when it is born, which they call a helmet, though this is not always, being left behind with the secundine in difficult labours: this is so called from its softness and thinness; others resemble it to white paper, or a shirt, and is the thinnest of all, in which is found great plenty of humours, caused of urine and sweat, in which the infant swimmeth as in a bath, and lieth so easy and secure, lest it should fall foul against those neighbouring parts that are harder; and besides that, when the membrane is broken in the birth, this water breaking out, may make the passages by the neck of the womb more plain and slippery for the infant; and this membrane also is every where concluded within the second, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, The second. which is called Chorion, because it wraps the infant like a ring; and this immediately compasseth the former, to which it is joined as it were in a round figure, like to a cake, whose inward and hollow part it covers and involves, and doth extend itself to its dimensions, and can scarce be separated from it, but doth firmly knit and bear up the vessels of the after-burden, Epar Uterinum. which immediately sticks to the womb by a certain fleshy mass that is form, being round, and of somewhat a ruddy colour, not compassing the whole infant, by reason of innumerous springs of veins and arteries by which the blood is inter-woven, as if it were poured in, and by which the infant is nourished. This towards the infant is smooth, but that part which is towards that fleshy round mass, is rougher. Of the Placenta Uteri, or Epar Uterinum. This round fleshy substance is called the liver of the womb, or the cake of the womb; which, having (a parenchymas) such a substance as the liver hath, no wonder if it should make and prepare blood for the nourishment of the infant. On that side towards the womb it is rough, and unequal, like clefts in a baked cake; and being cut in this part, it showeth an infinite company of fibres, which, if you trace, they will bring you to the orifice of the veins themselves. And, although there be twins, or more, yet there is but one placenta; for into one placenta so many navil-strings are inserted (in divers places) as there are young ones; Embryones. though it may differ as to the bigness, according to the body and condition of the infant, yet the ground is still the same in the diameter. The use of the Placenta. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 The third. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. The use serves as a support of the unibilical vessels, for which it serves as a pillar; it is also called (secundae) the secundine. The third is called Allantoides; 'tis a coat betwixt the Chorion and Amnios; 'tis difficulty. Be it as it will, wheresoever these make but the least stay, I must endeavour, all that I can, to bring them forth: for when they are detained longer than their due time, they cause bad symptoms, Symptoms. as a horrible stench, which fumes up to the stomach, heart, liver, midriff, and so consequently to the brain; from whence ariseth great pains in the head, at the heart, decay of spirits, faintings, swoon, often Convulsions, cold Sweats, Apoplexies, Epilepsies, sometimes Gangrenes, and often death itself: but of this Cure, hereafter, Sir, I shall beg your advice. Philadel. Quest. Mrs. you shall have it at your pleasure; you answer expertly; tell me now how they must be persuaded out? Eutrap. Answer. I shall, Sir; I must first anoint my left hand with convenient oils, and after I have laid hold of it, must not violently draw it away, Secundine, how to be brought away. nor yet force it directly downward, lest I draw down the womb and all together; but I must shake it lightly and gently to and fro, till I persuade it to follow my intention; and whilst they are thus retained, I must refresh her with Caudles, A Caudlebroth. or Panatells, wherein the yolks of Eggs in Wine, with some Saffron and Cinnamon strewed; or broth of a Hen or Capon, with mace, saffron, and cinnamon boiled in it. As to other means, where the danger is more, I think it ever best and safest to consult with learned Physicians, or with experienced Ladies, whose Closets are furnished with choice prescriptions which they have had from Doctors, in such cafes. Philadel. But, Quest. Mrs. we have formerly discoursed of Births, natural, and preternatural, with their respective schemes. Tell me now, A dead child, how delivered, and how of a Mola. how you will deliver a woman of a dead child? and how of a false Conception, or Mola? Especially, where no pains or throws are, which are most commonly occasioned by the motion and force of the child only alive (as hath been showed in the 21th. Page, and 4th. Section?) Eutrap. Answer. Here, Sir, is great danger and difficulty. I have, by God's blessing, with safety to the women, delivered them of many a dead child, and of a Mola, or false Conception, also; and believe the method of curing one of them, will serve to cure the other; as I have been informed by learned Physicians; but where Chirurgical Instruments, or other Physical means must be used, I ever recommend such a case to learned Physicians, and Surgeons, expert in Anatomy, both for assistance and direction. SECT. XXVII. Of the signs of Conception in general, and the different Sexes in particular. DR. Philadelphos. Good Mrs. Eutrapelia, Quest. vouchsafe me your observations about Conceptions, Signs of Conception. and let me understand what are the signs of Conception in general; and what signs distinguish the Sexes? Eutrap. Although, Sir, Answer. 'tis hard to know whether a woman hath conceived yea or no, yet it may be conjectured by many experienced Arguments; as, for instance, First, it is thought a credible sign of Conception, if a woman either the tenth day after coition, or sooner, perceive, by reason of any humours, any of her terms, be they whites, or reds. Stopping of the courses no sure sign. And, though the stopping of those be accounted for a sign, yet that fails often, because it may be as well before conception as after. But, waving this, let us find out other marks and prognostics of a true conception, gathered from the state and condition of the woman herself, being seriously examined from head to foot. Secondly; pains and giddiness in in the head, and a mist over the sight, if they meet together, these portend conception. Thirdly, the apples of the eyes are lessened, the eyes swell, and become swarthy; the veins of the eyes grow red, and are full with blood; the eyes sink, the eyelids are remiss; divers colours are seen in the eyes, and are observed in a looking-glass; the veins betwixt the eyes and the nose are turgid with blood, and are seen clearer; the veins under the tongue are somewhat greenish. Fourthly, the chest is warm, and the back cold. Fifthly, the veins and arteries are turgid, and the pulse easier; the veins in the breast are first black, than either yellow or blue. Sixthly, The breasts grow big, and hard with pain; the nipple grows red; if she drinketh that which is cold, she feels cold in her breast. Seventhly, there is a great loathing of meat and drink, and destruction of the natural appetite, with long after various meats, with an absurd appetite, a continual vomiting, and weakness of stomach, sour belchings, loathing of wine, an inordinate pulsation of the heart, sudden joy, and after that, as sudden grief; pains about the navel, Invicem cedunt dolour & voluptas. heaviness about the loins, swelling toward the bottom of the belly; inward pricking in the body; chillness of the outward parts, after coition; retention of the seed seven days after copulation; about the beginning of conception a shooting pain about the back and belly. The courses are stopped; for those veins from which they flow carry the blood (through certain holes that are at the end of them) for the nourishment Acetabule, of the infant by the navel; and part of it is conveyed upwards into the breasts, Milk, how generated. and there is prepared for milk. Eighthly, the thighs swell with pains, but the body is weaker, and the face pale. Ninthly, the belly is costive, by reason of the compressure of the intestines. The urine is white, with a cloud swimming at the top, wherein are to be seen many atoms, like those observable in the beams of the sun: but, when in the first month many of these sink to the bottom, and the vessel in which it is, being shaken, it seems to be drawn out like to wool. In the later months the urine is reddish, or yellow, it becomes blackish, with a red cloud at the top. I will here-with relate to you two experiments, Experiments. by which it may be known whether or no a woman hath conceived. First. And the first is this; Stop up a woman's urine three days in a urinal, at the end of which strain it (or, rather drop it through fine linen) and if she hath conceived, you shall see little creatures like to louse; if these be red, 'tis a token of a male; Signs of a Male. but if white, they portend a female. But this is said to be sure; Experiments. If a woman's urine be put in a brass Bason, and stand there one night; if you put into it a bright needle, if she hath conceived, that needle will be bespeckled with red spots; but, if otherwise, it will be rusty all over. Dr. Philadel. These, 'tis true, Quest. may be promiscuous signs of Conception. But, Mrs. how know you the Sex, whether male, or female? Eutrapelia. By these signs, Sir, Answer. First usually; as First, If she hath conceived a male, the right eye moves oftener, and is better, as to its native colour, than the left. The belly is sharper about the navel. Second The right breast groweth turgid before the left, and the nipple is sooner changed. Thirdly. The milk increaseth sooner, and if it be milked out, and set in a glass in the sun, it will grow into a clear mass, not unlike to an oriental pearl; as also, if the courses appear about the 40th. day after the Conception. The right cheek is redder, Fourthly. and the whole colour of the face better, neither is she so heavy as otherwise; and the first stirring on the right side is the sixtieth day, and that strongly too; and the right foot moves first in walking; and in arising from a seat, the right foot is first apt to bear up the body. The pulse is more frequent on the right side than on the left. Fifthly. Signs of a Female. Now, the signs of a female are contrary; and these are most commonly the signs. The first motion after conception is felt the 90th. day, The 90th. day. and that first in the left side. Secondly, Females are born with more sickness; the thighs and privities swell, the colour is paler, the appetite stronger, and yet apt to loathe that which is contrary to it. Thirdly, the Courses appear about the 30th. day after conception. Youth bring males. Fourthly, the age of the woman is very considerable; for the younger women most commonly bring males, by reason of their greater heat in the womb: And the more aged, females, Aged, females. by reason of the defect of heat contracted in the matrix, by their age; and females are more often generated by such Patents that are more cold and moist by nature, and of seed that is too moist, cold, and liquid. Dr. Philadel. Since you have given such a character of the signs of Conception, Quest. and the distinction of Sexes; let me know by what signs you apprehend the infant to be well, and thrive in the womb, or not. Answer: Sign of the infant's thriving Eutrapelia, I shall, Sir. And first, if it be well, the breasts will be hard; but if otherwise, they will be flaccid, and a waterish humour will flow out of them (like to milk) of its own accord. Secondly, if the courses flow too often out of the womb in the time of childbearing, it is an argument of an unhealthy child. And, moreover, the fattest women commonly bring forth the weakest infants. Thirdly, if a woman bring twins, the one a male, the other a female, there is great danger of the female, because they are nourished by a different aliment in the womb: but if they be both females, there is the less danger. Fourthly, if the child be gotten in the time of the monthly terms, they are mixed with untoward humours; from whence it is experienced that many leprous infants are begotten. Superfaetation, what. Aristot. Hist. Animal. Lib. 7. C. 4. Fifthly, if there be superfaetation, the last conception seldom liveth. Now, superfaetation is, when a woman having once conceived, conceiveth again after a certain time, which sometimes happeneth. Hence the Poets feign Iphicles and Hercules to be twins by Alcmaena the wife of Amphitryo; the first, begotten by Amphitryo; but the last, viz. Hercules, begotten by Jupiter. But this by the way, although more instances might be alleged nearer home. Signs of a dead child. Sixthly, if a Dropsy overtake the pregnant woman, and that her nose, cars, and lips look red; it is a sign of a dead child. Seventhly, if the infant come forth after the ninth month, 'tis oftentimes very weak. Eighthly, if a virgin conceive before her first flowers, it proves a lusty and perfect child. Lastly, all these things praemised, Note. Midwives also usually observe, that as many knots as they find in the navil-string of an infant, so many males, they say, she will have. But, so much for Conception. Tell me now somewhat of Abortion, with its Causes and Signs. SECT. XXVIII. Of Abortion. DR. Philadel. Tell me, Quest. Mrs. Eutrapelia, what is that which you call Abortion, or miscarrying? Eutrap. Answer. It is, to bring forth an untimely birth; which may proceed from divers causes, and those either internal or external. First, from internal causes, as, from the infant itself; Internal Co●yledons, what. as, when the Cotyledons (that is, the mouths of the vessels ending in the womb through which the blood is conveyed into the womb from all parts of the body) are so infirm, that those vessels, by reason of their rarity and weakness, are sooner broken; and so of consequence, and Abortion. Secondly, if the tunicles (that is, the secundine) wherein the infant is wrapped, be so weak, that it break, and the humour contained therein flow out, by which the matrix is slippery & weak, and the infant being destitute of those humours, faileth. And also, when virulent moistures flow forth, and provoke the expulsive faculty of the womb. Thirdly, the third cause is, when the Woman is so weak and consuming in herself, that she withdraws the nourishment from the infant; insomuch, that it hath neither matter to grow by, nor to generate the parts and members of it. Fourthly; the fourth cause may be the wideness of the orifice of the womb, and its overmuch moisture, and an evil temperature of qualities and ventosities included in the womb; as also Ulcers and Apostemations in the womb, besides other distempers; As are, too many Courses, too great a Flux of blood, A caution to the Irish, where these distempers are Epidemical, and Sporadical. too great a Looseness of the belly, or, too great Costiveness; a Tenasmus, (called commonly a Needing,) a Cough, a constant Sneezing, and all things that shake the body too much; and lastly, any acute sickness, which doth so afflict the woman's body, that, by them, the infant is deprived of its nourishment. Quest. The external causes of Abortion. Answer. Philadel. Now then, Mrs. pray inform me what are the external causes of Abortion. Eutrap. Sir, the external causes are many. As, first, to fall, to run, to leap, to ride, to exercise too immoderately, and to be smitten with strokes. Again, too much cold, and too great heat; for overmuch cold killeth the child, and too great heat intercepts the air from the infant, and so suffocateth it in the womb; and this may be done by hot baths, if women use them in the first months after their conception. Thirdly, Stinking smells, as the snuff of a candle, or lamp, newly extinguished. Fourthly, an absurd appetite, and manner of eating and drinking; as, to cat salt, coals, dirt, etc. by which, either ill humours, or a dangerous thirst are procured. Fifthly, too great hunger; for by overmuch fullness the infant is sooner suffocated, the passages appointed for nourishment being the sooner obstructed. Sixthly, immoderate exercise and labours, overmuch sleep, and a continual laziness, unseasonable and unreasonable watch; besides other accidents: As, sudden fury, great wrath, overmuch fear and sorrow, sudden joy, and a dull appetite, longing for that which is not to be had, unsatiable copulation and lust. Dr. Philadel. Quest. You have now discovered the causes of Abortion. What, I pray, (Mrs. Eutrapelia) are the signs of Abortion? Eutrap. Answer. Sings. The signs of Abortion are twofold. First, before conception in those that use to miscarry; as, superfluous moisture, sudden and unusual fatness against nature, which was wont to be of slender and lean constitution, or, which are ever pained about the loins and kidneys, or fall suddenly into other dangerous diseases. Signs of Abortion. Secondly, the signs of Abortion after conception are these, viz. when the breasts that at first were turgid and hard, are observed to grow flaccid and soft of a sudden; if there be too great a flux, and a continual flowing, of the terms. Moreover, if there be horrors, colds, pains in the head, or a swimming there be in the eyes; these be sure signs of Abortion. Dr. But, Quest. what are the signs of a dead child? Answer. Of a dead child. Eutrap. Where the child is dead, Sir, there is no motion perceived; when the eyes of the woman sink, when her colour is turned into a tawny whiteness, when there are great pains about the navel and loins, when, by reason of the lower parts being compressed, there happeneth a Strangury, a * A Needing. tenesmus. Again, when the ears, the lips, the top of the nostrils are taken with a pale coldness, and the face swells, and the belly (though it sinketh not yet) groweth soft; so that lying to either side by the touch there may be perceived a hard mass; Stinking breath a sign that the child beginneth to putrify. as also stinking breath, an argument that the infant doth begin to putrify. These are manifest signs of a dead child. The cure whereof I leave to the care of the expert Physicians and Surgeons. SECT. XXIX. Rules for Childbearing Women. EUtrap. According to your promise, I beseech you, Doctor, lay me down some Rules to be observed by Childbearing women. Dr. Philadel. Good Midwife, I shall, and that very necessary ones too, that she may know how to go on safely through (by God's blessing) to the last hour, or by neglecting them, may make her delivery the harder: and I shall reduce them under ten heads. First, let her be cheerful; (not breaking herself with mourning, and careful anxiety) for this doth exhilarate the infant, Res sex non naturales. and stirs up all the faculties, and confirms it in its parts and members. Secondly, let her avoid all violent motion, and abstain from all hard labours, not rising up too hastily, not leaping, running, dancing, riding; not lacing herself too straight, or carrying too heavy a burden; but surely sleep is very fit for her. Thirdly, let her beware of sharp and cold winds, of excessive hear, anger, perturbations of the mind, affrights & terrors, overmuch venery, and of intemperancy of eating and drinking. Fourthly, let the diet of breeding women be frugal, and moderate, abstaining from gross meats hard of digestion; let her eat eggs, chickens, land-fowl, birds of the mountains, etc. variety of broths, grewels, panadoes, mutton, veal, lamb, kid, rabbits; she may use in her meat's nutmeg and cinnamon; she may drink wine moderately. Fifthly, in the first four months let her open no vein, use no cupping or scarrifications, fontanelles, nor use any pills, or other Physic, without the advice of a prudent Physician; for in these months the ligaments of the child are very tender, soft, and feeble; and therefore the easier destroyed, and the nourishment kept from him. Sixthly, if it shall happen that the woman be too costive (by which many miscarry) let her boil spinach, Against Costiveness. and lettuce, well buttered, with salt and vinegar, or wine; which, if they will not move the belly, Suppositories. let her use suppositories, with honey, and the yelk of an egg, or of Castile-soap: and if these common things will not do, let her advise with an expert Physician. Seventhly, if it happen that she conceive with grievous symptoms, Symptoms. and after conception is troubled with faintings, let her take this Cordial following. Take of Sorrel-water, and red-Rose-water, of each one ounce; of Cinamon-water one ounce; Against fainting. of Manus Christi pearled, (called in the Shops Saccharum tabulatum & perlatum simplex) half an ounce, or as much Diamargariton: this may be taken as need requires. Eighthly, if she fear that she may come too soon (that is, before her time) as in the seventh month, or some other unscasonable time, and feels throws, as of childbearing, occasioned by immoderate exercise; too great costiveness, from a Fever, or some other disease; A suffumigation. Let her sit over a suffumigation of Frankincense; for that contributes no small strength both to the matrix, and to the infant also. Ninthly, if she nauseate her meat, she may use a plaster of Mastic to her stomach, and take this following Cordial every morning, fasting, to strengthen her stomach. The Cordial. Take syrup of Pomegranates one ounce and half; of Mosch and Ambergris, of each two grains; of Lignum Aloes finely powdered, one scruple; of Cinnamon half a scruple; the water of Sorrel three ounces; let these be mingled, and drank off bloodwarm. Against terms it Childbearing. Lastly, if, whilst she goeth with child, she perceiveth her terms, let her eat milk made boil with red-hot steel, and in that let Plantain and Comfrey be boiled. But, in all these cases, let her advise with learned Physicians, which will direct them with medicines, and advice from time to time. I shall now treat of some few distempers incident to childbed; and leave you some choice Remedies in the following Sections; and then wind up all. SECT. XXX. Of the Retention of the Lochia, (in Childbed) known by the name of Courses (though improperly so called) and of their immoderate Flux. THE retention or suppression of the Lochia in Childbed, Hippoc. lib. de natura pueri. by the consent of Hypocrates, as well as other Learned Doctors; (to which daily experience may be added;) brings the greatest inconveniences to women, Purgations of women in Childbed, Hippo. ibid. and often death itself. I shall therefore in this Section treat of the purgations of women in Childbed, which Hypocrates determines to be at the most but 40 days, By the Levitical Law 33 days was in case of a male, Levit. cha. 12. verse 4. and for a female, 66 days, ve. 5. if the women bring forth a female; and 30 days to a male. But withal saith, that a woman is passed all danger after 20 day's purgation: Now, if women be not sufficiently purged in Childbed, either it causeth a great * A swelling, hot and red. Phlegmon in the womb, by reason of the inflammation of the blood; or else those lochia being carried to some higher part, bring dangerous affects to the part that receiveth them; as, Squinancies, Pleurisies, Fevers, Frenzy, Nauseousness, Unquietness, Dropsies, and what not? Cause. The cause of their retention is (generally) cold, by reason of the ambient air which the woman receiveth in her delivery; Ambient air. (perhaps through the improvidency of Midwives; who, most commonly, take more care of the child than of the woman;) or else, by reason that the woman may be delivered in some cold, moist room; which cold suddenly rushing into the inward parts of the womb, suddenly stoppeth them. See Sect. the fifth. Therefore Midwives must not only be very wary in this case, as hath been already hinted in the latter end of the fifth Section, (to which I refer you) but also proceed to the Cure. The Cure. A clyster. First then, this Clyster may be given: Take of the roots of Marshmallows, * Aristolchia ●…ga & 〈◊〉. long & round Birthwort, of white Lilies, of each half an ounce; of the leaves of Mallows, Pellitory of the wall, Mercury, and Violets, of each half a handful; of Chamomel flowers, Melilot flowers, Elder flowers, each two * A pugil is as much as may be held betwixt the thumb and two fingers. pugils; of the seeds of Dill, Foenugreek, and Seseli, of each two drachms; let these be boiled in spring-water, till a third part be consumed; strain it, and to ten ounces of the straining, dissolve the yelk of two eggs; of Sal-Gemm, and unguent de Arthanita, each one drachm; oil of Dill, and of Bays, each half an ounce; of these make a clyster. A bag. You may also make a bag triangular, (whereof you see a description, with its use, in the xxuth. Section) in which you may quilt these herbs following, being grossly bruised and pounded. Take of the roots of long and round Birth-wort, of Gentian, Angelica, Bryonie, * Cyclamine. Showbread, of the herbs of Mugwort, Balm, Savin, Orgamint, and Calamint, of each one handful; of the flowers of Chamemile, Ingredients for the bag. Tansy, and Elder, each half a handful; of the seeds of Dill, Caraway, Anniseeds, and Seseleos, each one drachm: These being mashed, and pounded, and quilted into a bag big enough to cover the lower part of her belly and privities, and well secured with strings, must be boiled in spring-water, and applied warm; Two bags best to be applied, the one hot, whilst the other groweth cold. but it were better to have two bags, to apply as they grow cold. The belly, hips, and thighs, which, by reason of the consent of parts, must consequently sympathise with great pains, may be anointed with this ointment: Take of the oil of Chamomile, The ointment. Lumbricorum Catellorum. Hipericonis. Dill, and of the oil of Eggs, oil of Worm's whelps, St. John's-wort; with these mixed anoint the parts abovesaid warm. At night you may let this Julep be given: take of the waters of Balm, A Julep. and Mugwort, of each one ounce; of the water of Cinnamon distilled without wine, one ounce; Confection of Alkermes, half a drachm; of Laudanum, two grains; of syrup of Poppy, half an ounce: the bag may be renewed as need shall require, warming it in the liquor in which it was first boiled; the next day you may repeat both the clyster and the bag, and expect good success: After which, if the woman be plethoric, A Purge. you may purge her with Manna, and syrup of Roses, in broth, and this may be given after seven days lying in. I come now to speak somewhat of the immoderate flowing of them, Immoderate flowing of the Lochia. which must be considered as well as being stopped, there being danger in either: for 'tis well observed by Hypocrates, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Hipp. Aph. 51. Lib. 2. Omne nimium vertitur in vitium. The Causes. that every thing wherein is excess, is an enemy to nature: Therefore let us endeavour to stop them in their overmuch flowing, with a very great caution, lest by stopping them all together, there follow worse effects. It happens many times, that both after the birth, and miscarrying, that there floweth out such a quantity of blood, by reason of the eruption or apertion of the vessels, immoderately, or, by reason of the great fervour of the blood proceeding from the use of overhot Remedies in laborious births. To remedy them; Then, First, use such alimentary food, as may incrassate and thicken the blood; Cure by Diet. as, Panadoes, Jellies, Rice, in the broth of Calves-feets, Pears, boiled Quince, and Roastmeats whereon the juice of Pomegranates have been sprinkled, yolks of eggs. Drink. Their drink may be red Wine mixed with water, wherein steel hath been quenched; then the blood may be drawn by revulsion to the upper parts, either by Phlebotomy, or Cupping-glasses under the paps, etc. Stupps dipped in [vinegar & water,] applied to the loins with an ointment. The whole belly must be swathed; there may be stupps dipped in Oxycrat, and applied to the loins; after which, take of Unguentum Comitissae two ounces; of juice of Plantain one ounce, beaten well together: these things being not hard to be gotten, I tender to you; but when they will not be stopped by these means, 'twere best to have recourse to Learned Physicians for advice. SECT. XXXI. Of the Fever of Milk. EUtrap. Quest. You have already discoursed of the danger of the secundine being left behind, and the Lochia stopped: now, Sir, be pleased to let me know what may be the reason why women fall into Fevers, although neither the Lochia be stopped, nor any part of the secundine left behind? I shall, good Mrs. Eutrapelia; Answer. for those Fevers that accompany women in Childbed are never without danger; of which I shall give you an account; some of them being critical, others putrid, others symptomatical. I call that a Fever critical, which I call a Fever of milk; so called, Fever of milk, what, and when. because about the third or fourth day after childbearing, the milk gins to have a more plentiful recourse to the breasts, whither it is carried with some force, by reason of the motion and agitation of the blood converted into milk for the nourishment of the infant: although this kind of Fever doth not happen unto all women, neither doth it usually continue above three or four days, Febris Ephemera. being dissolved by sweeting, and needs little other remedies (most commonly,) if the Lochia be not stopped. The causes. Cautions in driving back milk to soon. The causes may be, the driving back of the milk too soon (which ought not to be) which doth overrun the blood, and settle there; or else, because that the breasts being filled with milk, and distended very big and full, the vessels for blood are so compressed, that they will not admit of that blood that floweth thither; insomuch, that the blood being hindered in its circulation, beginneth to rage's over the whole mass of blood, whose spirits being inordinately stirred up, and confounded, take heat, and begin to boil, and leaving the womb, possesseth the whole mass of blood, and so perhaps turn into putrid and malign Fevers; Putrid. amongst which, many happen to be symptomatical; Symptomatical. as, a Squinancy, a Pleurisy, * Peripneumonia. an inflammation of the lungs, a dysentery, and the Smallpox or Measles: but these symptomatical Fevers being from the same fountain of * A Bloody Flux. Blood out of its vessels. extravasat blood, (which most times turns into Apostemations, Tumours, and Inflammations, if not prevented) will bear the same Analogy of cure, with respect to the parts they invade: but to begin with critical Fevers. The cure of which consists, first, Cure of critical Fevers. in an exact observation of diet, that the impurities of the blood, and the due purgation of the humours, the evil affections of the womb may be corrected, and the strength impaired may be restored. Strength, how restored. Diet. Wherefore, let her diet be Oatmeal-caudles, with white-Wine, and all mixed, wherein a top of Baulm, Speremints, Mugwort, or Orgamint may be boiled; as also, Panadoes, and Water-grewels, etc. with these she must be fed for a week at the least, by often supping; forbearing nourishments that are stronger and solid; as also all manner of flesh, which are usually the cause of those Fevers; Eating flesh in Childbed the cause of Fevers. for women in Childbed must be dealt with not only like those that are grievously wounded, but like those whose mass of blood is disturbed, and so apt to be incensed with the least flame. The next care conducing to the cure is, Cold. to prevent outward colds, (as hath been formerly observed, Section 5th. and 31th. in the 5th. and 31th. Sections.) Wherefore, I would advise, that women be kept in their beds for five days at the least after their delivery. I know 'tis usual for them to rise at three day's end; but this to be sure, the longer women contain themselves in their bed, the more secure they are from danger. The third observation is, that by a gentle proritation of the blood, the Lochia be continued; and to this end Midwives usually give Sperma Ceti, Usual medicines. Irish slatt powdered, or Saffron tinged in white-Wine, or Marrigold-flowers in posset-drink. If the belly be costive, it may be moved either with a Violet confect made for a suppository, Suppos toty. or some gentle emollient clyster, (avoiding stronger Glisters.) Where there hath been vomitings, thirst, and want of sleep, occasioned by the great perturbations of the blood, and stopping of the * Lochia. Lochia; I have known Laudanum mixed with Saffron, each two grains, and given in posset with good success. Instead of cooling Juleps, Julep. you may use this rather, of which you may give three or four spoonfuls often times in a day: take Pennyroyal-water, Balm-water, each three ounces; * Aqua Bryoniae composita. Hysterical-water, two ounces; Tincture of Saffron, two drachms; a * 20 grains Scruple of Castoreum tied in a fine rag, and hanged in the glass. Here also may be used Bezoardical medicines, such as provoke sweat; but these, as also the cure of those symptomatical Fevers before hinted, I leave to be considered of by Learned Physicians, to whom it is safest to have recourse in such cases of danger. SECT. XXXII. Dr. Philadelphos. I shall, Mrs. Eutrapelia, in this Section, afford you a Miscellany of Medicines, such as are most useful for you to have with you; and conclude all. DR. Philadel. Mrs. Eutrapelia, Oils. you may remember, in the latter end of the 4th. Section, I gave you an account of those things that a Midwife ought to be furnished withal, wherein mention was made of oils, which usually are, Difficult Births. oil of Lilies, of sweet Almonds, or Chamomile, mixed. I shall offer you one ointment, in hard and difficult Births: take of new butter not salted, and washed in Mugwort-water, two ounces; the * The mucilage is the quintessence of seeds and fruits boiled to jelly, and strained. Mucilages of Line-seeds, Figs, and the seeds of Marsh-mallows, extracted out in the water of Savine, of each half an ounce; oil of Lilies, half an ounce; make a lineament, with which frequently anoint the neck of the womb; you may use also sneezing-powder, made thus: Errhine, or Sneezing-powder. Take long Pepper, Castoreum, Betony, white Hellebore, sweet Marjoram, Cloves, each a drachm, made into very small powder, and kept for use; which may be snuffed up into the nostrils, to cause sneezing; or, of white Hellebore, An other. and Castoreum, powdered; this potion also may be given. Take of Cinnamon, A Potion. of the bark of Cassia fistula, of Dittany, of each one drachm and half; of white Sugar, as much as all; let all these be made into a fine powder, and of it drink two drachms, in that posset wherein Lineseed hath been boiled, or else in white-Wine. Or this, An other. Take of Cassia fistula powdered, two drachms; Red * A sort of red Pease, Ciceri rubri. Cicers, half a handful, let them boil in white-Wine and water, of each as much as will suffice, adding at the length two drachms of Savine, strain it, and add to it half a drachm of Cinnamon, and six grains of Saffron, and make a potion. Or this, Take Aegrimony, Another. Betony, Vervain, each a handful; Confection of Alkermes, A scruple is twenty grains. a scruple and half; Sugar and Cinnamon as much as will suffice to aromatize it, the herbs being first boiled in posset-brink. I shall give one general Cordial water, which I shall not only commend to Midwives to have ever by them, but also to other Gentlewomen; it being a general Cordial water against most distempers. Thus then; Take Baulm, Betony, Pellitory of the wall, A general Cordial-water. sweet Marjoram, Cowslip flowers, of the flowers of Rosemary and Sage, each a great handful; of the seed of Annis, sweet Fennel, and Coriander, Caraway and Gromel, of each half an ounce; of Cinnamon, Liquorice, and Nutmeg, all bruised, each one ounce; of Juniper-berries, one ounce and half; let the herbs be shred, and infused in a gallon of Brandy in an earthen pot well leaded, for the space of a fortnight; afterwards strain it, and put in twelve ounces of Loaf-sugar, Note, that a gallon of Brandy added to the ingredients after streining, makes as good water as the former, if ordered so. and of Musk and Ambergris, each two grains, tied up in silk, and hanged in the glass: you may put in another gallon of Brandy, after the first is strained. Against immoderate flux of the Courses. Take of the roots of tormentil, two drachms; Bole-armeniack the best, one drachm; the species of Hyacinth, Powder. half a drachm, all made into fine powder: of which, take half a drachm once in three hours, in this following Julep. The Julep. Take of the a Res. Aq. Scordii composit. compound water of Scordium, b Dracontii. Dragon-water, & c Ulmariae. Meadsweet, of each three ounces; of d Aceti Theriacalis. Treacle-vinegar, an ounce; syrup of Coral, two ounces; burnt Hartshorn, half a drachm; make a Julep. To facilitate the Birth, drive out the Secundine, false Conception, and dead Child. Take of the Trochisches of Myrrh, one scruple; of Borax half a scruple; of Saffron three grains; make a powder of these, and take them in white-Wine, or the decoction of Mugwort in Posset-ale; after which, drink a draught of the same Posset, with some few drops of oil of Amber, or oil of Juniper-berries infused in it. Or this, A Posset. Take Mother of Time, one handful; of Pellitory of the wall, and Chamomel-flowers, of each half a handful; of Fennel-seeds, and Liquorice, each half an ounce; Figs slit no. six; boil these in three pints of Posset-ale, till one pint be consumed; then sttein it, and of this drink a good draught thrice in a day. The next Receipt shall be directed to the false Conception, and dead Child. As thus; Take Styrax Calamita, Myrrh, Cinnamon, Cassia lignea, From the Apothecaries. To provoke the flowers, expel a dead child, and false Conception. of each half an ounce; Mummy, two drachms; Saffron, half a drachm; make all these into fine powder: this may be taken in white-Wine, a drachm at a time, for a week together, or more. To prevent Abortion. Take Sanguis Draconis, Red Coral, both made into powder, A powder to be taken in broth, etc. of each one drachm; of Ambergris, three grains; of Bezoar stone, four grains; of this powder, a scruple at a time may be taken, either in Mace-ale, or Broth, or Posset-drink, wherein Plantain, Comfrey, Knotgrass, Bramble-leaves, Periwinkle, with some Cinnamon, have boiled. Or this, A second powder, Take Kermes-berries, two drachms; red Coral, and white, of each one drachm and half; of Amber, one scruple; make these into powder, and put them into a Poch'd-egg, and sup it up; do so till all be done. Or this, A third powder. Take Mastic, Frankincense, Sang. Dracon. Myrtill-berries, Kermes-berries, Bole-armeniack, each half a scruple; and take a drachm of the powder, and fill the hole, whence the stone is taken out in a Date; moisten it in sack, and wrap it up in a paper, and put it under hot embers to be warmed; and, let those that fear Abortion, eat it often. A Caraplasme to the navel. Take a hot manchet out of the oven, cutting off the crust, dip it in Muscadine, and strew it with the powder of Nutmegs and Cinnamon, each as much as will suffice; and apply this hot to the navel of the woman. A plaster from the Apothecaries. Take of Emplaster ad Herniam, Caesaris, each half an ounce; Cocci Baphici, one drachm, made into powder; Emplaster of Diacalcythios, one ounce; and with as much oil of Myrtles as will suffice, make a Plaster to be spread on leather, and applied between the hips. Here may be used Unguentum Comitissae to the loins. Unguent. Of After-pains. Causes of After-pains. After-pains may proceed from the acrimony of the blood, being thinn and sharp; or, from the grumous part of it, being thick, and clotted; which nature endeavouring to discharge itself of, as to the settling of the womb, causeth these pains: Inflations. Ambient air. As also Inflations, by reason of the ambient air, seems to imitate those pains, with the Childbearing, which are not only Sympathetical, but Symptomatical; this being so usual, few women are free from it: And, Cure. because they often cease within two or three days, they seldom require a Physician's help. Nevertheless, that Julep in the 32th. Section, is very useful. Or else, The Julep in the 32th. Section, marked with this * Asterisk. Take the inward bark of an Elm-tree, and burn it to ashes; to which, add Cinnamon made into powder, some 10 grains of Cinnamon to one drachm of the ashes, and drink it with white-Wine. Or else, Take of oil of sweet Almonds, two ounces; syrup of Violets, one ounce; water of Penniroyal, half an ounce, for a draught. Potion. After-pains from windiness. If the cause be from wind, you may give a drachm of Barberries in powder, in the water of Vervain, or Baulm. But, most usually, these pains are eased by Caudles made with half white-Wine, Caudles. and half water, wherein Spermints, Baulm, Penniroyal, or Mugwort have been boiled. I will give you the form of a Caudle, which is not only of great use in the sending forth of the secundine (in case any piece of it should be left behind, as sometimes it may happen) but also to help nature in its work of throwing out this grumous blood; (which is the cause of the After-pains) And this is it; A Caudle, in case any part of the Secundine be behind. Take Oatmeal, and Hempseed, of each a sufficient quantity, with a top of Baulm; boil these in a sufficient quantity of white-Wine and water, of each alike, and with the yelk of one egg, make a Caudle. Of Convulsion-fits in infants newly born. Take the best Sack and Sugar mulled, and give it the first thing it takes; this will discharge the stomach of that viscuous phlegm that ever accompanieth infants; Convulsions, from viscuous phlegm possessing the stomach and nerves. and not only warm the stomach and nerves, (for all Spasms and Epilepsies proceed from the nerves being oppressed with cold, or gross, phlegmatic humours) but prepare it for future nutriment. If these prevail not, use this ensuing Julep and Plaster. The Julep. Take Black-cherry water, red-Rose-water, and Dragon-water, of each two ounces; one top of Rosemary, of Liquorice, a drachm; of the flowers of o Flores Tiliae. Lindentree, of the Lily of p Lilia Convallia. Convall, of each a pugil; boil them till a third part be consumed, and sweeten it with Sugar-candy; give the infant often of this, together with this Plaster. The Plaster. Take Mithridate, two drachms; Saffron, one scruple powdered; spirit of Wine, some few drops; Capons-grease, as much as a small nut; make a plaster to be spread upon a small piece of scarlet, and applied to the pit of the Stomach. And, if the child be costive, Suppositories. put up a Mallow-stalk buttered, or a Violet Confect, as Suppositories; this powder is good. Take n Rad. Paeoniae. Piony-roots and seeds; o Dictamni albi. Diptany; Misleto of an Oak, of each half an ounce; of the seed of q Seminis Atriplicis. Orach; of the scull of a man, p Visci Quercini. each two drachms; red Coral and Hyacinth prepared, of each a drachm and a half; of Elks-hoof prepared, half an ounce; Musk, fix grains; Leafgold, half a drachm; make a powder of this; give ten grains, or twenty grains in the Julep aforesaid, in a spoon. Of a Diarrhaea, or a Looseness in Childbed. Philad l. A violent looseness in childbed is not without danger; to prevent which, these Glisters may be given safely. n =" 1" Two Glisters. 1. Take Rice, one drachm and half; of Cork finely grated, two drachms; Red-rose-leaves, half a handful; strain these, and make a clyster, after they have been boiled in a pint and half of milk to a pint; the things that remain may be applied to the navel in form of a plaster. n =" 2" Cataplasm. 2. Take milk a quart, boiled to a pint; of Diascordium, half an ounce; the yolks of two eggs in form of a Caudle; make a clyster: Caution. but here care must be had, that by too astringent means the Lochia be not suppressed. Of sore breasts in Women. To preserve breasts against the inconvenience of milk. An Emplaster. To preserve the breasts, that if they nurse not their children, the milk offend not, or, being extravasate, cause Apostemations; Take Virgins wax white, four ounces; Spermaceti, two ounces; of Galbanum dissolved in strong vinegar, one ounce: Make an Emplaster, to be laid on the breasts, and continued for many days; let it be spread upon linen: if the breasts should tend to break, then, A Cataplasm, if the breasts should break, to be spread upon the wool. Take a Sheep's head, wool and all, bruise it, and boil it in water enough, till it be all to mash. In the top of the strained liquor of which, boil Rice enough to make it to the consistence of a Pultiss; to which, add some Saffron, and apply it, and the wool over it. Clefts in the nipples. If the nipples be sore with fissures and clefts; First, wash the fur and stuff off from the nipples, as clean as may be; with red-Rose-water, as hot as may be endured; Then use of white wax, one ounce; of Spermaceti, half an ounce; 1 Ointment. the marrow of Staggs-bones, two ounces; oil of St. John's-wort, one ounce: apply this. Or, 2 Ointment. Take Goats-suet, one ounce; oil of the yolks of Eggs; oil of sweet Almonds; oil of Henbane, and Poppy, by expression, of each half an ounce; the fat of Geese, Capons, and Ducks, of each three drachms; of lethargy; of Silver; white Led washed; Groundsel stamped, and applied, driveth back milk, preventeth Inflammations. Tutia prepared; of red Lead, of each one drachm and a half; of Pompholyx; burned Allom; white Sugar-candy powdered; of Olibanum, of each one drachm; of Saffron, one Scruple; of Camphire, and Opium prepared, Flax carded, and smoked over Frankincense, with which cover the breast. of each half a scruple: mingle these, and with as much white wax as will suffice, make of these an Unguent. SECT. XXXIII. Of Nurses, and the best Milk. SInce the choice of a Nurse is of so great a concernment; Philadel. (as upon which, the future being of the infant consists) surely this, Nurse's not sluttish. then, requires many serious considerations. For, though she may have milk enough, yet perhaps not good enough; or the woman either sluttish, or unhandy, or careless in the swathing and dressing of the child; by which many children (like new vessels, Quo semel est imbuta recens servabit oderem Testadiù. which will keep the savour of that liquor they are first seasoned withal) are sluttish or slovenly so long as they live; or else (being abused at nurse, are distort and Ricketty; full of botches, nasty, and nauseous to their own parents. And many, through the intemperancy of their nurses, who, by drinking, to increase their milk (and perhaps make it bad enough) sleep so securely and profoundly, that they overly their nurseries in the night, Children, how overlaid. Often sleep good. and the children dead by their sides in the morning. Therefore let Nurses sleep so often, that they may hear the least cry of the infant. But this as introductory to a larger discourse and description. Let the Nurse, then, be of a middle stature, The Nurse described; with her Complexion, her Age. and good complexion; active, not fat, (and of a sanguine complexion, if possible) and not in poverty; not under twenty years of age, nor above forty, but rather of twenty five, or thirty years of age, as a * Medio tutissimus ibis. mean betwixt both. Let not her nipples be great, lest it make the child of a wide mouth, Her nipples not too big. because it cannot suck without the contraction of the lips together; and, lest by forcing the tongue into too narrow a compass, it hinders the swallowing of the milk. Next, if the nipple be too small, Not too small. the child is apt to let it slip out of the mouth, and cannot handsomely hold it, so that the infant being frustrated of suck, and yet still exercising sucking, hurts the cheek, and attracts some kind of humours thither, which oftentimes become preternatural tumours; and oftentimes the cheeks of the infant seem as if they were stirred out of their places. Thirdly, by the consent of all, the Nurse must have a large breast (though some think that not so material, Pectorae late jacens mammis Virgil. moretum. Great breasts not good. and others are of opinion that she ought to have large breasts) because there is more milk collected together in great breasts than aught; and being there, is corrupted, to the prejudice of the Nurse. Wherefore, lest the milk should continue there too long, it is best to have a lusty young child to suck it away, or else to use some other way; (as, Young whelps killed with sucking of women. by the use of young whelps; whom I have oftentimes seen die with sucking women's milk; surely the reason must be, because the milk was * Of another nature. heterogeneous; or else, because grumous, and corrupted) or milked out some other way; especially, when the Nurse perceives herself prejudiced by it. But it is ever best, Plenty of milk ever best. that she abound, rather than want milk; and then in this case it is best they be big, though all Nurses need not have big breasts; for there may be as much milk, if not more, in a lesser breast, than in a great one. Our next enquiry will be into the manners and behaviour of a Nurse. The best Nurse than is, she that is mild, chaste, The Nurse's Conditions. sober, courteous, cheerful, lively, neat, cleanly, and handy; because bad conditions, as well as good, are sucked in with the milk, and so radicated, that it is a hard matter to pull out the bad conditions, and leave the good behind, but that there will be a remainder of the bad conditions, perhaps so long as they live: wherefore, let not the Nurse be of an angry, malapert, and saucy disposition, shameless, scolding, or quarrelsome; not gluttonous, but so careful of her nursery, that she neither eat or drink that which may be hurtful to the infant: Her care in eating and drinking. That she do nothing to anger herself, to grieve, or sad herself; Passion hinders the good milk. Mirth. for such passions will presently distribute themselves, to the prejudice of the infant; than which there is nothing of more efficacy to destroy the goodness of the milk. Neither is it sufficient that they abstain from the use of their husbands; Abstinence from Venery not sufficient. but when they have wanton thoughts, and lascivious minds, wholly upon Luxury and Venery, they cast off all care of their nurseries, and dreaming at night of that which their minds run on in the day, Somnians dixit quae vigilans voluit. Terent. Comaed. and by other filthy pollutions they infect the milk. So also, by the use of their husbands the Courses are stirred up, by which both the plenty and goodness of milk is derived another way; and so the child rob of its nutriment; or else the Nurse conceiveth with child, and so the infant becometh * Colostrati. diseased and Ricketty, by sucking grumous, curdy, and unwholesome milk, and is the worse for it during life. Therefore let all those things be avoided, Meats to be avoided by Nurses. that either do, or are supposed to provoke lust; as, junkets made with spices; also onions, leeks, garlic, and all salt meats are to be avoided: parsley, parsley, an enemy to milk. and smallage, some say, have a peculiar malice to the increase of milk: besides that, it doth increase lust, and is an enemy to the growth of infants. Again, that Nurse were best, that hath lately been brought to bed of a boy if to nurse a boy, the milk of such a Nurse being better tempered. The virtues of the milk of a male, and of a female. For the milk of a male child will make a female nursery more sprightly, and a manlike Virago; and the milk of a girl will make a boy the more effeminate. As to the milk, let it be a mean, The conditions of the milk. betwixt thick and thinn; which you may perceive, by dropping it upon the thumb-nails; for if it be too thinn, it will run off the sooner; but if thicker, Trial of the milk. it will stay the longer: let it be sweet, and pleasant, both to the smell and taste; not offending the palate with rancidness, sourness, sharpness, or saltness; or the nostrils with any strange quality. Let it be can did to the sight, By its Quality. in itself equal in each particles, not infested with brown, yellow, green, blue, Colour. or any other evil colour; or, as sometimes, with various colours and substance; as, with lines, and streaks upon it: but let that milk be most praiseworthy, that makes as much curd as whey; which may be tried by this Experiment, Experiment. viz, Put some of this milk into a glass, and put in some Myrrh, or Rennet; which being stirred together, will cured, and then may the contents be separated: the trial is, that if there be most whey, then is the milk thinner in its substance; but if most of curd, 'tis thicker: yet all these may be corrected and amended; for that which is too thick may be mended by an extenuating diet, Correctives of milk too thick. Vomit. and the phlegmatic matter may be avoided by a vomit of Oxymel, and Exercise before meat, the better to consume and attenuate the thickness of it. Of milk too thinn. Di●. Alica. The thinness of milk is amended by contrary food, such as doth incrassate it: as Formenty of Wheat, and Rice; Hogs-feets, Calves-feets, Trotters, and sweet Wine, unless somewhat else be in the way to hinder it. Sometimes it happens that the milk is more tart than it ought to be: Sharpness, etc. wherefore then, all diligence must be had to feed upon such meats as are of the best juice, till that acrimony at least be attempered. Want of milk, the Causes. Sometimes there is little or no milk in the breasts; as after some sickness, or notable distemper, now turned into a chacochymical habit, or any other of what kind soever, that possesseth those parts, or is the morbific cause: but that shall not be our business to consider of now. Now, if these be not the causes, let the Nurse use supping meats, as Broths, Possets, etc. and eat plentifully, and use frictions to her breasts and duggs, Exercise, and dancing of the child, good for the Nurse. Cupping-glasses. Fomentations. exercising her hands and her arms by domestic Employments; or instead thereof, let her dance the child, by which the aliment may be recalled into those parts. Sometimes cupping-glasses to the breasts, with a fomentation of emollient herbs boiled in water, and applied warm, either sponges, or wollen-clothes; after which, Embrocation. embrocating them with oil of Lilies. The seeds of Fennel, and the roots of Parsnips boiled in Barleywater, What food is best. and buttered. The broth of Hens, or Capons, with Cinnamon and Mace. Or Poch'd-eggs, with the seeds of Annis, and Dill; and all things else that are hot in the first and second degree, are good. Earthworms. Worms, such as come out of the earth, (not out of a dunghill,) six or seven of them dried, and powdered, and drank in Barleywater sugared, for a fortnight together: All these may be of good use in the defect of milk. But now let us see to the inconveniency (if there be any) in too much milk. If the milk abound too much, Milk in too great abundance. A Decoction. which sometimes is (though seldom) ; Then use the decoction of Myrtleberries, and red Roses, and with clothes dipped in it, lay them on the breasts. Or else clothes imbibed in Vinegar, wherein Cumin-seeds bruised have been infused with Myrrh and Camphire. The inconveniency of too thick milk. By reason of the thickness of the milk, all those excrements that the child should send forth, are intercepted; as by Stool, by Urine, etc. The passages for transpiration are stuffed up, so that the progress of the aliment being stopped, of necessity the milk must be regurgitated, and vomited up; after which will follow much phlegmatic matter, a sure argument of crudities. 'Cause of Botches, etc. Sometimes there will arise botches, and apostemations about the body; much matter, and snot, and quittor will come out of the nose, and corners of the eyes, and eyelids; and the appetite will be lost. Of too thin milk, the cause of gripe Contrarily, from the thinner and sharper sort of milk, the belly is loser than it ought, being troubled with pinches and gripes in the belly of the infant: Also, very angry pustules and whelks will arise about the body, like the small Pox; and the body groweth weak by little and little, 'Cause of pustules. the infant not caring for food; for the strength of the appetite will be more remiss, by reason of the acrimony of that which the infant desires; so that it is not much sensible of that aliment which it hath; and that aliment of which it is sensible is naught, and vicious. Of overmuch milk Now, from the overabundance of milk, the infant oftentimes, when it sucks, is overwhelmed, being so puffed up, and the belly distended, as if it would break; until by much pissing, or breaking wind, it is slacker. But where there is too much scarcity of milk, Of too little milk. here the infant being altogether destitute of its nourishment, will pine away; Marasmus. and all the parts of the body being starved, in those years when it most wants nourishment, by reason of the vehemency of the innate heat, Vehemency of the innate heat. and that habit of body (that the least blast will puff down) which requires much, and constant aliment. By all which, women ought to be the more provident, lest all these mischiefs happen, (especially, not to make choice of such a Nurse, A good caution, not to choose a Nurse in poverty. Another Nurse to be chosen. whose poverty must needs starve herself, and her nursery; and if they should so happen, to amend them, as hath been said before) they grow incurable, and require the help of another Artificer that may cure it. Or, if the fault in the milk cannot be cured and amended in the Nurse, (which she hath contracted,) Than you have no more to do, but presently to look for another Nurse, that hath none of these inconveniencies; that so the infant may have suck enough, which is all it requires; for want of which, you may hear sad ejulations, crying, and weeping. And this may be discovered by their dreams, Dreams. as by the often motion of the lips in the cradle, as if they were sucking when they are a sleep. The infant participates of that food which the Nurse eats or drinks. Neither is it strange, that the infant should be sensible of, and participate of whatsoever food (as meat, drink, and physic,) that the Nurse taketh: which maketh our modern Physicians purge the Nurse, to cure the child. And this also is concluded on by Hypocrates; * 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Hippoc. Epidem, vi. That if a woman take any purging Physic, she purgeth her child also. So, Galen reports of Goats, feeding in Asia, where Scammony did grow, did communicate a purging faculty to their milk. And so the milk of Asses, generally accounted the best in Consumptions, is counted better, if the Ass be fed with Capillary herbs, such as are Maidenhair, etc. And again, when young Goats suck Sheeps-milk, the rough hair shall lose its coursness, and become like a fleece of wool: and so contrarily, when lambs are brought up by Goats, their wool groweth the more hairy. If then the qualities of the milk pass into those that suck them, Qualities of the milk pass into those that suck them, and so impurities. (as without doubt they do) it is easy to gather, that other impurities follow thither also, neither is it improbable. Surely then, we ought to take no less care of the Nurse than of the child; as in her diet, exercise, physic, etc. since, whatsoever conduceth to the benefit of the Nurse, tends to the good and welfare of the infant. I have been the larger in this Section of Nurses, and Milk, because tender infants can neither make choice of their Nurses themselves; nor discover, or plead for their wants: Their own mothers, surely, (if they are able) both by duty, and nature, being the most fit to nurse their own children; The greatest Ladies, and all Mothers, fittest to nurse their own children. which the greatest Ladies may do, with the greatest conveniences; by reason of their plenty of all things; besides, their attendance of servants, who can bring their nurseries to them at all hours, be it by night or day, and take it from them again, not to disturb their rest: which also, they may intent at their own pleasures. The time of sucking not above twelve months. The longest time that a child need be suckled, is not to be above one year. I shall leave only one caution for Nurses, and wind up this Section: and 'tis this. Let Nurses ever milk out some milk they suckle the child; and after it is suckled, Nurse's not to rock the infant too violently after sucking. that they rock it not too much presently after, lest violent rocking disturb the meat in the stomach; or the other parts draw away the milk in the stomach, as yet unconcocted. SECT. XXXIV. EUtrap. Sir, I was unwilling to interrupt you in your discourse, (it being so profitable) till you had done: and truly, Sir, I must beg your pardon, if I mind you of some distempers incident to women, and are peculiar to the womb; and though there may be more, yet I shall trouble you but with two: And the first is, concerning your judgement of Fits of the Mother; and the second, of the Falling out of the womb; which sometimes happeneth after hard Labours, or an unskilful Midwife. Philadel. Mrs. Eutrapelia, I shall readily do both, as well to satisfy You, as other Ladies, whom I am willing to gratify. Of Suffocation of the womb, commonly called, Fits of the Mother. Section, 34. AMongst all the fierce distempers that women are affected with, the strangulation of the womb is accounted none of the least. This, by the Latins, Uteri suffocatio. is called the Suffocation of the womb, and so by the * 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. Greeks; which we render, Hysterical Fits, from a a 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. word which signifieth, The womb: It is called by most women, The Mother Fits, and that from another Greek b 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 from 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. word, which signifieth, the Matrix; which is from another word, which signifieth, a Mother; because women, after they have brought forth, are Mothers; and hence, Fits of the Mother. Which is, What is the suffocation of the womb. a retraction of the womb to the upper parts, making the principal parts fellow-sufferers of the distemper. For although the womb may be concluded to be moved out of its place, yet, except it be carried downwards, it never causeth a suffocation: for a suffocation is nothing else but a defect in breathing: Therefore it is necessary, that the upper parts that serve for Respiration be affected, The parts affected, what, and how. and carried upwards, by reason of that suffocation; and amongst all, the chiefest are, the heart, lungs, the midriff, and the brain, to which the force of the affection cometh, viz. to the heart, by the veins and arteries, and so to the lungs; to the brain and midriff, by the nerves and membranes of the spin of the back: The cause is from the womb, The causes. which being full of some naughty humour, as menstuous blood; Menstruous blood, Vicious seed. or vicious and putrid seed offendeth the noble parts, with some stinking, malignant, sharp, griping, cold vapours. The symptoms. The symptoms that follow are various, either according to the greatness of the efficient cause, or the variety of some qualities, or natures; for some women are without any sense or motion, and seem to have no pulse at all, or at least, that very small and weak; and sometimes lie without any manner of breathing at all that can be perceived. Others there are, that neither want sense nor motion, and seem not to be troubled with any passion of the mind; but they faint, and very hardly fetch breath: some also seem to have Convulsions in their joints, as in their hands, arms, feet; but these generally are the signs of the fit at hand, viz. a Signs of the Fit coming in augment. A dulness of the mind, a laziness, weakness of the thighs, paleness, and clamminess about the face: b Signs of the Fit present. but when the fit is come, than there cometh a c 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 profound sleep, like those in an Apoplexy, or Lethargy; the mind is dotish, the senses are intercepted, the voice ceaseth, the thighs are contracted, the cheeks look red, and the face is swelled. Signs of the declination of the distemper. But when the suffocation declineth, a certain moisture distilleth from the privities, with great rumbling and murmuring of the belly; and the womb by little and little is relaxed, and so the sense returneth. This disease is moved also by d Suppose of the moon. course; as is the Falling-sickness, and doth most of all infested young women desirous of husbands; and that about Autumn, and the Winter: as also, those that are childless, or unfruitful, or such whose womb is chilled upon any account. This differs from * How it differs from a Syncope, or swouring. fainting Fits, in this, (viz.) In a Syncope there is no pulse, but in the strangulation of the womb, there is ever a pulse, though small, rare, weak. In fainting Fits, or swoon, there are cold sweats, and paleness of the face; but in this the countenance is plump, How from an Apoplexy. and ruddy. It differs also from an Apoplexy; for women that have these Fits have not their parts deprived of sense and motion; and, although their senses be benumbed, yet, if they are pinched, or pricked, they are sensibly disturbed, and will make signs with their hands, that they are strangled; now it is clean contrary in an Apoplexy: And again, those in an Apoplexy do snore, which is never seen in these hysterick Fits. How they differ from an Epilepsy, or Falling-sickness. Spasmus Cinicus. A distortion of the mouth. Lastly, these Fits differ from an Epilepsy, or Falling-sickness, in this; that these parts affected are not contracted with Spasmes, or Convulsions; neither do they foam at mouth, except the woman be vehemently suffocated; and especially, when an Epilepsy is not stirred up out of the womb itself, as oftentimes it doth happen. Having thus discoursed of the causes, symptoms, and signs, we now come to the Cure. The Cure. First then, let the lower parts be strongly rubbed with clothes, and tied with strong ligatures; as also, let Cupping-glasses, Cupping-glasses, how to be used. be applied to the hips, groynes, * Os pubis, or Pectinis. Beware the navel. share-bone, (but not to the navel.) Next, sneezing is commended, (to which Hypocrates agrees.) 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. Aphor. lib. 5. & 35. And, though I have given you one Receipt for a sneezing-powder, in the beginning of the 31th. Section, which is proper not only in difficult births, but here also; I now will leave with you the Receipt of another powder, A sneezing powder. which shall be this; Take white Pepper, Mustardseed, Pellitory of Spain, Castoreum, of each a scruple; Euphorbium, and white Hellebore, of each one scruple; Twenty grains make a scruple. and make a subtle powder, which may be used so long as there is no redundance of humours perceived in the head. Suppositories. Suppositories are good: as, Take of Agarick Troschisc. of the species of Hiera logodii, of each a drachm; 60 Grains make a drachm. of Rats-dung, Figs, Rue-leaves, and Cumin-seeds, all made into powder, and with honey made up into a Suppository. An Ointment. Take oil of St. John'swort, of Orange-flowers, of Rue, of each one ounce; oil of Mace by expression, half an ounce; of a Beasts gall dried and powdered, six drachms; Venice-Treacle, half an ounce; Spiders alive, in number forty; infuse all these for ten hours in a vessel well stopped on the embers, that it neither boil too fast, not evaporate too much; of this make an Ointment, with which anoint the back, and loins, and the navel, avoiding all cold. A fume to sit over. A Suffumigation of Nutmegs powdered, and set in a close-stool to burn, receiving the smoke by sitting over it, is excellent. Stinking things to smell to. Stinking things are ever best to smell to, such as are Partridge-feathers, old Leather, Brimstone, burned all; Assafoetida, Castoreum, Galbanum, Rue, malaxed with Vinegar: Contrarily, all sweet things are proper to be tied to the thighs in a bag, but not smelled to. Sweet things best to be tied to the thighs. The scrape of Goats-horns, and Assafoetida, mixed, and burnt, is excellent. Take Assafoetida dissolved in distilled vinegar, of Castor prepared into powder, Pills. of each a scruple; Laudanum two grains, made into six Pills, and taken just before the Fit. Lastly, if these Fits proceed from the stoppage of the flowers, those medicines must be given proper to provoke them; but if from the retention of the seed, Quod si ex retento semine affectio proveniat, nullum proponerem nffectae mulieri praestnntius auxilium quam viri sui frequeates amplexus. Hieronymus Pulverinus, Cap. XCI. de Strangulatione Uteri. then let nature here be their best director; except they could construe the authority of * Learned Physicians, with whom, let them advis. SECT. XXXV. Of the coming forth of the womb. IN the last Section, Mistress, I described how the womb might be movable upwards, yea, & from side to side. I now come to speak of its motion downwards, which sometimes is so low, that it cometh forth, and is to be seen outwardly; and that which hangs out doth appear like a soft, The signs. Scrotum. and round tumour, and like the Testicles of a man; but the pain and the heat possess the privities, and bottom of the belly; and the urine, distilling by some and some, vexeth the privities. The causes may be many; as, The causes. First, when a woman, from on high, falleth upon her hips, those skins and membranes which support the womb, and tie it to the neighbouring parts, being broken. The second cause is, by extraction of the Secundine, as hath been formerly set forth, in the 26th. Section & that through the unskilfulness of the Midwife. The third Cause is, by a sudden and immoderate flux of blood; as is usually in Abortions, as hath been showed in the 5th. Section. The fourth Cause is, by an artificial extraction of a dead child, or overmuch holding the breath, to blow; or carrying of too great a weight. The fifth is, oftentimes, through overmuch humours, and the defluxions of them; and often bearing of children; which makes those Appendices, to which the womb depends, relaxed, and loosed. The sixth and last is, through some vehement passion of the mind, being affrighted with the sudden tidings of the loss of children, incursions of enemies, dangerous Sea voyages; and sometimes from neither of these, Old age. but from old age itself, or much weakness. But now, as to the Cure; in which, observe these Prognostics by the way; Prognostics. That when this affection is new, the womb is easily reduced to its proper place; and being right put up, it continues there, especially in the prime of age; and may both conceive, and bring forth again; but in riper years, it becomes contracted; it may be put up truly, but upon the least occasion slips out again. And in short, this; All fall down of the womb, which are not, and cannot be cured by proper means, show that the Appendices (as aforesaid) are either laxed, or broken. The Cure. The Cure is, First, to provide Glisters to be administered, by which the straight gut may be discharged of gross and hard excrements, and the bladder of its urine, by some pipe fitted for the purpose; for sometimes it happens, that the womb being in a straight betwixt those two, Nascim●… inte●…stercus & Urinam. cannot be reduced into its proper place. The first may be done by Glisters, the latter with a pipe put up in the neck of the bladder; Fistula urinaria. which done, the womb may be put up by this following method. Let the Patiented lie with her face upwards, her hams bend backwards, and thighs spread abroad; after which, foment it with the decoction; of Beets, Mallows, Marsh-mallows, Lineseed, and Foenugreek, A fomentation. made in spring-water. Then make a pledget of wool wrapped up in a linnenrag, to the proportion of the privypart; which being dipped in the juice of Acatia and Hypocistis, dissolved in red Wine, apply it to the womb; To be bought at the Apothecaries. and so without violence press up all that which is come forth: After which, foment the whole * The share-bone. Another fomentation. Pecten with this fomentation. Take red Wine a quart, red Rose-leaves, Bramble-leaves, Plantain, Myrtleberries, Shepherds-purse, Hagtaper, Horse-tail, and Comfrey-roots, applied with sponges; using afterward the oils of Mastic and Myrtles to the place, and Unguentum Comitissae to anoint the Reins. Now, because the main of our drift is to cure the falling out of the womb upon difficult births; add this method to the former. First, purge her with one drachm of Pulvis sennae compositus major, A Purge to be bought at the Apothecaries. given in broth, or Mace-ale, twice or thrice: then, Take the leaves of Plantain, of Withy, of Medlars, of the Oak, of Sloes, of red Brambles, of red Roses, of each a handful; of the roots of tormentil, Comfrey, and Bistort, of * Balaustia. Pomegranat-flowers, of Cypress-nuts, of each an ounce; of the seeds of anise, two ounces: let these be grossly bruised, and sewed up in a bag; A bag used. (of which you have a description in the 24th. Section of this Book.) Boil these in Smith's water, such as they use to quench iron, and apply it warm four times a day, wearing it continually, well trust up. — Si quid novisti rectius istis, Horat. Candidus imperti; si non, his utere mecum. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. FINIS. Imprimatur, Tho. Tomkyns. Ex Aed. Lamb. Maii ult. 1671.