Aristotle's works: / Containing the Master-piece, Directions for Midwives, and Counsel and Advice to Child-bearing Women with Various Useful Remedies

by pseud. Aristotle

BOOK I.—CHAPTER I.

Sect. I. Of the Womb.

In this Chapter I am to treat of the womb, which the Latins call matrix. Its parts are two; the mouth of the womb, and the bottom of it. The mouth is an orifice at the entrance into it, which may be shut together like a purse. When a woman is not pregnant, it is a little oblong, and of substance very thick and close; but when she is pregnant it is shortened, and its thickness diminisheth proportionably to its distension: and therefore it is a mistake of anatomists, who affirm that its substance waxeth thicker a little before a woman’s labour; for any one’s reason will inform him, that the more distended it is, the thinner it must be; and the nearer a woman is to the time of her delivery, the shorter her womb must be extended.

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

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

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

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

Before I have done with the womb, which is the field of generation, and ought therefore to be the more particularly taken care of, I shall proceed to a more particular description of its parts, and the uses for which nature hath designed them.

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

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

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

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

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

Sect. II.—Of the Difference between the Ancient and Modern Physicians, touching the Woman’s contributing Seed to the Formation of the Child.

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

Though it is apparent, say the ancients, that the seed of man is the principal efficient and beginning of action, motion, and generation, yet that the woman affords seed, and contributes to the procreation of the child, it is evident from hence, that the woman has seminal vessels, which had been given her in vain if she wanted seminal excrescence; but since nature forms nothing in vain, it must be granted they were made for use of seed and procreation, and fixed in their proper places, to operate, and contribute virtue and efficiency to the seed.

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

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

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

CHAPTER II.
OF CONCEPTION; WHAT IT IS; HOW WOMEN ARE TO ORDER THEMSELVES AFTER CONCEPTION.

Sect. I. What Conception is.

Conception is nothing else but an action of the womb, by which the prolific seed is received and retained, that an infant may be engendered and formed out of it. There are two sorts of conception: the one according to nature, which is followed by the generation of the infant in the womb; the other false, and wholly against nature, in which the seed changes into water, and produces only false conceptions, moles, or other strange matter.

Sect. II. How a Woman ought to order herself after Conception.

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

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

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

Rules for the First Two Months.

As soon as a woman knows (or has reason to believe) she hath conceived, she ought to abstain from all violent motions and exercises; whether she walks on foot, or rides on horseback, or in a coach, it ought to be very gently. Let her beware she lift not her arms too high, nor carry great burdens, nor repose herself on hard and uneasy seats. Let her use moderately good juicy meat, and of easy digestion; and let her wine be neither too strong nor too sharp, but a little mingled with water; or if she be very abstemious, she may use water wherein cinnamon is boiled. Let her avoid fastings, thirst, watchings, mourning, sadness, anger, and all other perturbations of the mind. Let none present any strange or unwholesome thing to her, nor so much as name it, lest she should desire it, and not be able to get it, and so either cause her to miscarry, or the child to have some deformity on that account. Let her bowels be kept loose with prunes, raisins, or manna, in her broth; and let her use the following electuary, to strengthen the womb and the child:—

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

Let her observe the following.

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

Rules for the Third Month.

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

Rules for the Fourth Month.

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

Rules for the Fifth, Sixth, and Seventh Months.

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

Rules for the Eighth Month.

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

Rules for the Ninth Month.

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

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

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

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

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

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

CHAPTER III.
Of the Parts proper to a Child in the Womb. How it is formed there, and the Manner of its Situation therein.

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

Sect. I. Of the Parts proper to a Child in the womb.

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

Of the Umbilicurs, or Navel Vessels.

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

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

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

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

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

Of the Secundine, or After-Birth.

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

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

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

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

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

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

Sect. II. Of the Formation of the Child in the Womb.

The woman having conceived, the first thing which is operative in the conception is the spirit whereof the seed is full, which nature quickening by the heat of the womb, stirs up to action. The internal spirits therefore, separate the parts that are less pure, which are thick, cold and clammy, from those that are more pure and noble. The less pure are cast to the outside, and with these the seed is circled round, and the membranes made, in which that seed which is most pure is wrapped round, and kept close together, that it may be defended from cold and other accidents, and operate the better.

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

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

Sect. III. Of the manner of the Child’s lying in the Womb.

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

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

But, in the second place, a woman’s great belly makes different figures, according to the different times of pregnancy; for, when she is young with child, the embryo is always found of a round figure, a little oblong, having the spine moderately turned inwards, the thighs folded, and a little raised, to which the legs are so raised, and her heels touch the buttocks; the arms are bending, and the hands placed upon the knees, towards which the head is inclining forwards, so that the chin toucheth the breast; in which posture it resembles one sitting to ease nature, and stooping down with the head to see what comes from him. The spine of its back is at that time placed towards the mother’s, the head uppermost, the face downwards; and proportionably to its growth, it extends its members by a little and little, which were exactly folded in the first month.

In this posture it usually keeps till the seventh or eighth month; and then by a natural propensity and disposition of the upper part of the body, the head is turned downwards toward the inward orifice of the womb, tumbling as it were over its head, so that then the feet are uppermost, and the face towards the mother’s great gut; and this turning of the infant in this manner, with its head downwards, towards the latter end of a woman’s reckoning, is so ordered by nature, that it may be thereby the better disposed for its passage into the world at the time of its mother’s labour, which is not then far off (and, indeed, some children turn not at all until the very time of birth); for in this posture all its joints are most easily extended in coming forth; for, by this means the arms and legs cannot hinder its birth, because they cannot be bended against the inward orifice of the womb; and the rest of the body being very supple, passeth without any difficulty after the head which is hard and big, being past the birth. It is true, there are divers children that lie in the womb in another posture, and come to birth with their feet downwards, especially if there be twins; for then by the different motions they do disturb one another, that they seldom come both in the same posture at the time of labour, but when one will come with the head, and another with the feet, or perhaps lie across; and sometimes neither of them will come right. But, however the child may be situated in the womb, or in whatever posture it presents itself at the time of birth, if it be not with its head forwards, as I have before described, it is always against nature, and the delivery will occasion the more pain and danger, and require greater care and skill from the midwife, than when the labour is more natural.

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

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

Sect. I. The Signs of the true Time of a Woman’s Labour.

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

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

Sect. II. How a woman ought to be ordered when the Time if her Labour is come.

When it is known that the true time of her labour is come by the signs laid down in the foregoing section, of which those that are most to be relied on are pains and strong throes in the abdomen, forcing downwards towards the womb, and a dilation of the inward orifice, which may be perceived by touching it with the finger, and the gathering of the waters before the head of the child, and thrusting down of the membranes which contain them; through which, between the pains, one may in some manner with the finger discover the part which presents (as we said before), especially if it be the head of the child, by its roundness and hardness; I say, if these things concur and are evident, the midwife may be sure it is the time of the woman’s labour; and care must be taken to get all things necessary to comfort her in that time. And the better to help her, be sure to see she be not strait-laced: you may also give her one strong clyster or more, if there be occasion, provided it be done at the beginning, and before the child be too forward; for it will be difficult for her to receive them afterwards. The benefit accruing thereby will be, that they excite her gut to discharge itself of its excrements, that so, the rectum being emptied, there may be more space for the dilation of the passage; likewise to cause the pains to bear the more downward, through endeavours she makes when she is at stool; and in the meantime, all other necessary things for her labour should be put in order, both for the mother and the child. To this end, some get a midwife’s stool; but a pallet-bed, girded, is much the best way, placed near the fire, if the reason require; which pallet ought to be placed, that there may be easy access to it on every side, that the woman may be more readily assisted as there is occasion.

If the woman abounds with blood, to bleed her a little may not be improper, for thereby she will both breathe better, and have her breasts more at liberty, and likewise the more strength to bear down her pains; and this may be done without danger, because the child being about that time ready to be born, has no more need of the mother’s blood for its nourishment: besides, this evacuation does many times prevent her having a fever after delivery. Also, before her delivery, if her strength will permit, let her walk up and down her chamber; and that she may have strength so to do, it will be necessary to give her some good strengthening things, such as jelly, broth, new-laid eggs, or some spoonfuls of burnt wine; and let her by all means hold out her pains, bearing them down as much as she can at the time when they take her; and let the midwife from time to time touch the inward orifice with her finger, to know whether the waters are ready to break, and whether the birth will follow soon after. Let her also anoint the woman’s privities with emollient oil, hog’s grease, and fresh butter, if she find they are hard to be dilated. Let the midwife likewise be all the time near the labouring woman, and diligently observe her gestures, complaints, and pains; for by this she may guess pretty well how her labour advanceth, because when she changes her ordinary groans into loud cries, it is a sign the child is very near the birth; for at that time her pains are greater and more frequent. Let the woman, likewise, by intervals rest herself on the bed, to regain her strength, but not too long, especially if she be little, short, and thick; for such women have always worse labour, if they lie long on their beds in their travail. It is better, therefore, that she walk about her chamber as much as she can, the woman supporting her under the arms, if it be necessary; for by this means, the weight of the child causeth the inward orifice of the womb to dilate the sooner than in bed; and if her pains be stronger and more frequent, her labour will not be near so long.

Let not the labouring women be concerned at those qualms and vomitings which perhaps she may find come upon her, for they will be much for her advantage in the issue, however uneasy she may be for the time, as they further her throes and pains by provoking downwards.

When the waters of the child are ready and gathered (which may be perceived through the membranes to present themselves to the inward orifice) to the bigness of the whole dilation, the midwife ought to let them break of themselves, and not, like some hasty midwives, who being impatient of the woman’s long labour, break them, intending thereby to hasten their business, when instead thereof they retard it; for, by the too hasty breaking of these waters (which nature designed to cause the infant to slide forth more easy) the passage remains dry, by which means the pains and throes of the labouring woman are less efficacious to bring forth than they would otherwise have been. It is therefore much the better way to let the waters break of themselves; after which the midwife may with ease feel the child by that part which first presents, and thereby discerns whether it comes right, that is, with the head foremost, for that is the most proper and natural way of its birth. If the head comes right, she will find it round, big, hard, and equal; but if it be any other part, she will find it unequal, rugged, and soft or hard, according to the nature of the part it is. And this being the true time when a woman ought to be delivered, if nature be not wanting to perform its office; therefore, when the midwife finds the birth thus coming forward, let her hasten to assist and deliver it, for it ordinarily happens soon after, if it be natural.

But if it happens, as sometimes it may, that the waters break away too long before the birth, in such a case those things that hasten nature may be safely administered. For which purpose, make use of pennyroyal, dittany, juniper-berries, betony, and feverfew, boiled in white wine, and give a draught of it; or it would be much better to take the juice of it when it is in its prime, which is in May, and having clarified it, make it into syrup, with double its weight of sugar, and keep it all the year, to use when occasion calls for it: mugwort used in the same manner, is also good in this case; also, a drachm of cinnamon powder, given inwardly, profits much in this case; and so does tansey, boiled, and applied to the privities; or an oil of it, so made and used, as you were taught before. The following prescriptions are very good to speedy deliverance to women in travail.

1. A decoction of white wine made in savory, and drank.

2. Take wild tansey, or silver weed, bruise it, and apply it to the woman’s nostrils.

3. Take date stones, and beat them to powder, and let her take half a drachm of them in white wine at a time.

4. Take parsley and bruise it, and press out the juice, and dip a linen cloth in it, and put it up so dipped into the mouth of the womb: it will presently cause the child to come away, though it be dead, and will bring away the after-burden. Also, the juice of parsley is a thing of so great virtue (especially stone parsley) that being drunk by a pregnant woman it cleanseth not only the womb, but also the child in the womb, of all gross humours.

5. A scruple of castorum in powder, in any convenient liquor, is very good to be taken in such a case; and so also is two or three drops of spirit of castorum in any convenient liquor; also eight or nine drops of spirit of myrrh, given in any convenient liquor, gives speedy deliverance.

6. Give a woman in such a case another woman’s milk to drink: it will cause speedy delivery, and almost without pain.

7. The juice of leeks, being drunk with warm water, highly operates to cause speedy delivery.

8. Take peony seeds, and beat them into powder, and mix the powder with oil, with which oil anoint the loins and privities of the woman and child; it will give her deliverance speedily, and with less pain than can be imagined.

9. Take a swallow’s nest, and dissolve it in water, strain it, and drink it warm; it gives delivery with great speed and much ease.

Note this also in general, that all things that move the terms, are good for making the delivery easy; such as myrrh, white amber in white wine, or lily-water, two scruples or a drachm; or cassia lignea, dittany, each a drachm; cinnamon half a drachm, saffron a scruple; give a drachm: or take borax mineral a drachm; and give it in sack: or take cassia lignea a drachm: dittany, amber, of each a drachm; cinnamon, borax, of each a drachm and a half; saffron a scruple; and give her half a drachm: or give her some drops of oil of hazel in convenient liquor; or two or three drops of oil of cinnamon in vervain water. Some prepare the secundine thus:—Take the navel-string and dry it in an oven, take two drachms of the powder, cinnamon a drachm, saffron half a scruple, with juice of savin make trochisks; give two drachms: or wash the secundine in wine, and bake it in a pot; then wash it in endive water and wine; take half a drachm of it: long pepper, galangal, of each half a drachm: plantain and endive seed, of each half a drachm; lavender seed four scruples; make a powder: or take laudanum two drachms; storax, calamile, benzoin, of each half a drachm; musk ambergris, each six grains; make a powder, or trochisks for a fume. Or use pessaries to provoke the birth; take galbanum dissolved in vinegar, an ounce; myrrh two drachms; with oil of oats make a pessary.

An Ointment for the Navel.

Take oil of keir two ounces, juice of savin an ounce, of leeks and mercury each half an ounce; boil them to the consumption of the juice; add galbanum dissolved in vinegar half an ounce; myrrh two drachms, storax liquid a drachm; round bistort, sowbread, cinnamon, saffron a drachm; with wax make an ointment, and apply it.

If the birth be retarded through the weakness of the mother, refresh her by applying wine and soap to the nose; confect. alkermas diamarg.

These things may be applied to help nature in her delivery, when the child comes to the birth the right way, and yet the birth be retarded: but if she finds the child comes the wrong way, and is not able to deliver the woman as she ought to be, by helping nature, and saving both mother and child (for it is not enough to lay a woman, if it might be done any other way with more safety and ease, and less hazard both to woman and child), then let her send speedily for better and more able help; and not as I once knew a midwife do, who, when a woman she was to deliver had hard labour, rather than a man-midwife should be sent for, undertook to deliver the woman herself (though told it was a man’s business), and in her attempting it brought away the child but left the head in the mother’s womb; and had not a man-midwife been presently sent for, the mother had lost her life as well as the child: such persons may rather be termed butchers than midwives. But supposing the woman’s labour be natural, I will next show what the midwife ought to do, in order to her delivery.

CHAPTER V.
OF NATURAL LABOUR; WHAT IT IS; AND WHAT THE MIDWIFE IS TO DO IN SUCH A LABOUR.

Sect. I. What Natural Labour is.

There are four things which denominate a woman’s natural labour; the first, that it be at the full time; for, if a woman comes before her time, it cannot be termed natural labour; neither will it be easy as though she had completed her nine months. The second thing is, that it be speedy and without any ill accident: for, when the time of her birth is come, nature is not dilatory in the bringing of it forth, without some ill accident intervene which renders it unnatural. The third is, that the child be alive; for all will grant that the being delivered of a dead child is very unnatural. The fourth thing requisite to a natural birth is, that the child come right: for if the position of the child in the womb be contrary to what is natural, the event will prove it so, by making that which should be a time of life, the death of both the mother and the child.

Having thus told you what I mean by natural labour, I shall next show how the midwife is to proceed therein, in order to the woman’s delivery. When all the foregoing requisites concur, and after the waters be broke of themselves, let there rather be a quilt upon the pallet bedstead than a feather bed, having thereon linen, and cloths in many folds, with other such things as are necessary, and that may be changed according to the exigency requiring it, so that the woman may not be incommoded with the blood, waters, and other filth which are voided in labour. The bed ought so to be ordered, that the woman, being ready to be delivered, should lie on her back upon it, having her body in a convenient posture; that is, her head and breast a little raised, so that she be between lying and sitting; for being so placed, she is best capable of breathing, and likewise will have more strength to bear her pains than if she lays otherwise, or sunk down in bed. Being so placed, she must spread her thighs abroad, folding her legs a little towards her loins, somewhat raised by a small pillow underneath, to the end her groin should have more liberty to retire back; and let her feet be stayed against some firm thing: besides this, let her take hold of some of the good women attending her with her hands, that she may the better stay herself during her pains. She being thus placed at the side of her bed, having her midwife at hand the better to assist as nature requires, let her take courage, and help her pains the best she can, bearing them down when they take her, which she must do by holding her breath, and forcing them as much as possible, in like manner as when she goes to stool; for by such straining, the diaphragm, or midriff, being strongly thrust downwards, necessarily forces down the womb and the child in it. In the meantime, let the midwife endeavour to comfort her all she can, exhorting her to bear her labour courageously, telling her it will be quickly over, and that there is no fear but she will have a speedy delivery. Let her midwife also, having no rings on her fingers, anoint them with oil of fresh butter, and thereby dilate gently the inward orifice of the womb, putting her finger ends into the entry thereof, and then stretch them one from the other, when her pains take her; by this means endeavouring to help forward the child, and thrusting, by little and little, the sides of the orifice towards the hinder part of the child’s head, anointing it with fresh butter, if it be necessary.

When the head of the infant is a little advanced into the inward orifice, the midwife’s phrase is, “It is crowned;” because it girds and surrounds it just as a crown; but when it is so far that the extremities begin to appear without the privy parts, then they say, “The child is in the passage;” and at this time the woman feels herself as it were scratched, or pricked with pins, and is ready to imagine that the midwife hurts her, when it is occasioned by the violent distention of those parts, and the laceration which the sometimes bigness of the child’s head causeth there. When things are in this posture, let the midwife seat herself conveniently to receive the child, which will come quickly, and with her finger ends (which she must be sure to keep close pared) let her endeavour to thrust the crowning of the womb (of which I have spoken before) back over the head of the child; and as soon as it is advanced as far as the ears, or thereabouts, let her take hold of the two sides with her two hands, that when a good pain comes she may quickly draw forth the child, taking care that the navel-string be not entangled about the neck, or any other part, as sometimes it is, lest thereby the after-burden be pulled with violence, and perhaps the womb also, to which it is fastened, and so either cause her to flood, or else break the strings, both which are of bad consequence to the woman, whose delivery may thereby be rendered the more difficult. It must also be carefully observed, that the head should not be drawn forth straight, but shaking it a little from one side to the other, that the shoulders may sooner and easier take their place immediately after it is past, without losing any time, lest the head being past, the child be stopped there by the largeness of the shoulders, and so come in danger of being suffocated and strangled in the passage, as it sometimes happens, for the want of care therein. But as soon as the head is born, if there be need, she may slide her fingers under the arm-pits, and the rest of the body will follow without any difficulty.

As soon as the midwife hath in this manner drawn forth the child, let her put it on one side, lest the blood and water which follow immediately, should do it an injury, by running into its mouth and nose, as they would do if it lay on its back, and so endanger the choaking of it. The child being thus born, the next thing requisite is, to bring away the after-burden: but before that, let the midwife be very careful to examine whether there be more children in the womb; for sometimes a woman may have twins that expected it not; which the midwife may easily know, by the continuance of the pains after the child is born, and the bigness of the mother’s abdomen. But the midwife may be sure of it, if she puts her hand up the entry of the womb, and finds there another watery gathering, and a child in it presenting to the passage; and if she finds it so, she must have a care of going to fetch the after-birth, till the woman be delivered of all the children she is pregnant with. Wherefore the first string must be cut, being first tied with a thread three or four double, and fasten the other end with a string to the woman’s thighs; and then removing the child already born, she must take care to deliver her of the rest, observing all the circumstances as with the first; after which it will be necessary to fetch away the after-birth or births. But of that I shall treat in another section; and first show what is to be done to the new-born infant.

Sect. II. Of the Cutting of the Child’s Navel-String.

Though this is accounted by many but a trifle, yet great care is to be taken about it; and it shows none of the least art and skill of a midwife to do it as it should be; and that it may be so done, the midwife ought to observe, 1. The time. 2. The place. 3. The manner. 4. The event.

1. The time is, as soon as ever the infant comes out of the womb, whether it brings part of the after-burden with it or not; for sometimes the child brings into the world a piece of the amnios upon its head, and is what midwives call the caul, and ignorantly, attribute some extraordinary virtue to the child that is so born: but this opinion is only the effect of their ignorance; for when the child is born with such a crown (as some call it) upon its brows, it generally betokens weakness, and denotes a short life. But to proceed to the matter in hand. As soon as the child is come into the world, it should be considered whether it is weak or strong; and if it be weak, let the midwife gently put back part of the vital and natural blood into the body of the child by its navel; for that recruits a weak child (the vital and natural spirits being communicated by the mother to the child by its navel-string); but if the child be strong, the operation is needless. Only let me advise you, that many children that are born seemingly dead, may be soon brought to life again, if you squeeze six or seven drops of blood out of that part of the navel-string which is cut off, and give it to the child inwardly.

2. As to the place in which it should be cut, that is, whether it should be cut long or short, it is that which authors can scarcely agree in, and which many midwives quarrel about; some prescribing it to be cut at four fingers’ breadth, which is, at best, but an uncertain rule, unless all fingers were of one size.

3. As to the manner in which it must be cut, let the midwife take a brown thread, four or five times double, of an ell long or thereabouts, tied with a single knot at each of the ends, to prevent their entangling; and with this thread so accommodated (which the midwife must have in readiness before the woman’s labour, as also a good pair of scissors, that no time may be lost) let her tie the string within an inch of the abdomen with a double knot, and, turning about the end of the thread, let her tie two more on the other side of the string, reiterating it again, if it be necessary; then let her cut off the navel another inch below the ligatures, towards the after-birth, so that there only remains but two inches of the string, in the midst of which will be the knot we speak of, which must be so close knit as not to suffer a drop of blood to squeeze out of the vessels; but care must be taken, not to knit it so strait as to cut it in two, and therefore, the thread must be pretty thick, and pretty strait cut, it being better too strait than too loose; for some children have miserably lost their lives, with all their blood, before it was discovered, because the navel-string was not well tied; therefore great care must be taken that no blood squeeze through; for if there do, a new knot must be made with the rest of the string. You need not fear to bind the navel-string very hard, because it is void of sense, and that part which you leave falls off in a very few days, sometimes in six or seven, or sooner, but never tarries longer than eight or nine.

4. The last thing I mentioned was the event or consequence, or what follows cutting the navel-string. As soon as the navel-string is cut off, apply a little cotton or lint to the place to keep it warm, lest the cold enter into the body of the child, which it most certainly will do, if you have not bound it hard enough. If the lint or cotton you apply to it be dipped in the oil of roses, it will be the better; and then put another small rag three or four times double upon the abdomen: upon the top of all, put another small bolster; and then swathe it with a linen swathe, four fingers broad, to keep it steady, lest by moving too much, or by being continually stirred from side to side, it comes to fall off before the navel-string which you left remaining is falling off. It is the usual custom of midwives to put a piece of burnt rag to it, which we commonly call tinder; but I would advise them to put a little ammoniac to it, because of its drying quality.

Sect. III. How to bring away the After-burden.

A woman cannot be said to be fairly delivered, though the child be born, till the after-burden be also taken from her; herein differing from most animals, who, when they have brought forth their young cast forth nothing else but some water, and the membranes which contained them. But women have an after-labour, which sometimes proves more dangerous than the first: and how to bring it safely away, without prejudice to her, shall be my business to show in this section.

As soon as the child is born, before the midwife either ties or cuts the navel-string, lest the womb should close, let her take the string and wind it once or twice about one or two of the fingers of her left hand joined together, the better to hold it, with which she may draw it moderately, and with the right hand she may only take a single hold of it above the left near the privities, drawing likewise with that very gently, resting the while the fore-finger of the string towards the same hand, extended and stretched forth along the entrance of the vagina, always observing, for greater facility, to draw it from the side where the burden cleaves least; for, in so doing, the rest will separate the better: and special care must be taken that it be not drawn forth with too much violence, lest by breaking the string near the burden the midwife be obliged to put the whole hand into the womb to deliver the woman; and she need to be a very skilful person that undertakes it, lest the womb, to which this burden is sometimes very strongly fastened, be drawn away with it, as it has sometimes happened. It is, therefore, best to use such remedies as may assist nature. And here take notice, that what brings away the birth, will also bring away the after-birth. And therefore, for affecting this work, I will lay down the following rules.

1. Use the same means in bringing away the after-birth that you made use of to bring away the birth; for the same care and circumspection are needful now that were then.

2. Considering the labouring woman cannot but be much spent by what she has already undergone in bringing forth the infant; be therefore sure to give her something to comfort her. And in this case good jelly broths, also a little wine and toast in it, and other comforting things, will be very necessary.

3. A little hellebore in powder, to make her sneeze, is in this case very proper.

4. Tansey and the stone ætites, applied as before directed, are also of good use in this case.

5. If you take the herb vervain, and either boil it in wine, or make a syrup with the juice of it, which you may do by adding to it double its weight of sugar, (having clarified the juice before you boil it), a spoonful of that given to the woman is very efficacious to bring away the secundine; and featherfew and mugwort have the same operation, taken as the former.

6. Alexander boiled in wine, and the wine drank, also sweet servile, sweet cicily, angelica roots, and muster-wort, are excellent remedies in this case.

7. Or, if this fail, the smoke of marigolds, received up a woman’s privities by a funnel, has been known to bring away the after-birth, even when the midwife let go her hand.

8. Boil mugwort in water till it be very soft; then take it out, and apply it in the manner of a poultice to the navel of the labouring woman, and it instantly brings away the birth and after-birth. But special care must be taken to remove it as soon as they come away, lest by its longer tarrying it should draw away the womb also.

Sect. IV. Of Laborious and Difficult Labours, and how the Midwife is to proceed therein.

There are three sorts of bad labours, all painful and difficult, but not all properly unnatural. It will be necessary therefore to distinguish these.

The first of these labours is that wherein the mother and child suffer very much by extreme pain and difficulty, even though the child come right; and this is distinguishably called the laborious labour.

The second is that which is difficult, and differs not much from the former, except that, besides those extraordinary pains, it is generally attended with some unhappy accident, which by retarding the birth, causes the difficulty: but these difficulties being removed, it accelerates the birth, and hastens the delivery.

Some have asked, what is the reason that women bring forth their children with so much pain? I answer, the sense of feeling is distributed to the whole body by the nerves; and the mouth of the womb being so strait that it must of necessity be dilated at the time of the woman’s delivery, the dilating thereof stretches the nerves, and from thence comes the pain. And therefore the reason why some women have more pain in their labour than others, proceeds from their having the mouth of the matrix more full of nerves than others. The best way to remove those difficulties that occasion hard pains and labour, is to show first from whence they proceed. Now the difficulty of labour proceeds either from the mother, or child, or both.

From the mother, by reason of the indisposition of the body, or from some particular part only, and chiefly the womb, as when the woman is weak, and the mother is not active to expel the burden, or from weakness or disease, or want of spirits; or it may be from some strong passion of the mind with which she was once possessed; she may be too young, and so may have the passage too strait; or too old, and then, if it be her first child, because her pains are too dry and hard, and cannot easily be dilated, as happens also to them which are too lean; likewise those who are either small, short or deformed, as crooked women, who have not breath enough to help their pains, and to bear them down, and persons that are crooked having sometimes the bones of the passage not well shaped. The cholic also hinders labour, by preventing the true pains; and all great and active pains, as when the woman is taken with a violent fever, a great flooding, frequent convulsions, bloody flux, or any other great distemper. Also, excrements retained cause much difficulty, and so does a stone in the bladder or when the bladder is full of urine, without being able to void it; or when the woman is troubled with great and painful piles. It may also be from the passages, when the membranes are thick, the orifice too strait, and the neck of the womb not sufficiently open, the passages pressed and strained by tumours in the adjacent parts, or when the bones are too firm, and will not open, which very much endangers the mother and child; or when the passages are not slippery, by reason of the waters being broke too soon, or the membranes being too thin. The womb may also be out of order with respect to its bad situation, or conformation, having its neck too strait, hard, and callous, which may easily be so naturally, or may come by accident, being many times caused by a tumor, an imposthume, ulcer, or superfluous flesh.

As to hard labour occasioned by the child it is when the child happens to stick to a mole, or when it is so weak it cannot break the membranes; or if it be too big all over, or at the head only, or if the natural vessels are twisted about its neck; when the belly is hydropical; or when it is monstrous, having two heads, or joined to another child; also, when the child is dead, or so weak that it can contribute nothing to its birth; likewise when it comes wrong; or when there are two or more. And to all these various difficulties there is oftentimes one more, and that is, the ignorance of the midwife, who, for want of understanding in her business, hinders nature in her work instead of helping her.

Having thus looked into the cases of hard labour, I will now show the industrious midwife how she may minister some relief to the labouring woman under these difficult circumstances. But it will require judgment and understanding in the midwife, when she finds a woman in difficult labour, to know the particular obstruction, or cause thereof, that so a suitable remedy may be applied; as, for instance, when it happens by the mother’s being too young or too strait, she must be gently treated, and the passages anointed with oil, hog’s lard, or fresh butter, to relax and dilate them the easier, lest there should happen a rupture of any part when the child is born; for sometimes the peritoneum breaks, with the skin from the privities of the fundament.

But if the woman be in years with her first child, let her lower parts be anointed to mollify the inward orifice, which, in such a case being more hard and callous, does not easily yield to the distention of labour, which is the true cause why such women are longer in labour, and also why their children, being forced against the inward orifice of the womb (which, as I have said, is a little callous) are born with great humps and bruises on their heads.

Those women that are very small and misshapen, should not be put to bed, at least, till their waters are broke, but rather kept upright, and assisted to walk about the chamber, by being supported under the arms; for, by that means, they will breathe more freely, and mend their pains better than on the bed, because there they lie on a heap. As for those that are very lean, and have hard labour from that cause, let them moisten the parts with oil and ointments, to make them more smooth and slippery, that the head of the infant and the womb be not so compressed and bruised by the hardness of the mother’s bones which forms the passage. If the cause be weakness, she ought to be strengthened, the better to support her pains; to which end give her good jelly broths, and a little wine with a toast in it. If she fears her pains, let her be comforted, assuring her that she will not endure many more, but be delivered in a little time. But if her pains be slow and small, or none at all, they must be provoked by frequent and pretty strong clysters; let her walk about the chamber, that so the weight of child may help them forwards. If she flood, or have strong convulsions, she must be then helped by a speedy delivery; the operation I shall relate in the section of unnatural labours. If she be costive, let her use clysters which may also help to dispel the cholic, at those times very injurious, because attended with useless pains, and because such bear not downward, and so help not to forward the birth. If she find an obstruction or stoppage of the urine, by reason the womb bears too much on the bladder, let her lift up her abdomen a little with her hand, and try if she receives any benefit; if she finds she does not, it will be necessary to introduce a catheter into her bladder, and thereby draw forth her urine. If the difficulty be from the ill posture of the woman, let her be placed otherwise, in a posture more suitable and convenient for her; also if it proceed from the indisposition of the womb, as from its oblique situation, &c. it must be remedied, as well as it can, by placing her body accordingly; or, if it be a vicious conformation, having the neck too hard, too callous, and too strait, it must be anointed with oils and ointments, as before directed. If the membranes be so strong as that the waters do not break in due time, they may be broken with the fingers, if the midwife be first well assured that the child is forward in the passage, or else, by breaking the waters too soon, the child may remain in danger of remaining dry a long time; to supply which defect, you may moisten the parts with fomentations, decoctions, and emollient oils: which yet is not half so well as when nature does her work in her own time, with the ordinary slime and water. These membranes sometimes do press forth with the waters three or four fingers’ breadth out of the body before the child, resembling a bladder full of water; but there is then no great danger to break them, if they be not already broken; for when the case is so, the child is always in readiness to follow, being in the passage; but let the midwife be very careful not to pull it with her hand, lest the after-burden be thereby loosened before its time, for it adheres thereto very strongly. If the navel-string happen to come first, it must presently be put in again, and kept so, if possible, or otherwise the woman must be immediately delivered. But if the after-burden should come first, it must not be put up again by any means; for the infant having no further occasion for it, it would be but an obstacle if it were put up; in this case it must be cut off, having tied the navel-string, and afterwards draw forth the child with all the speed that may be, lest it be suffocated.

Sect. V. Of Women labouring with a dead Child.

When the difficulty of labour arises from a dead child, it is a case of great danger to the mother, and great care ought to be taken therein; but before any thing be done, the midwife ought to be well assured the child is dead indeed, which may be known by these signs.

1. The breast suddenly slacks, or falls flat, or bags down. 2. A great coldness, possesses the abdomen of the mother, especially about the navel. 3. Her urine is thick, and a filthy stinking settles at the bottom. 4. No motion of the child can be perceived; for the trial whereof, let the midwife put her hand in warm water, and lay it upon the abdomen; for that, if it is alive, will make it stir. 5. She is very subject to dream of dead men, and be affrighted therewith. 6. She has extravagant longings to eat such things as are contrary to nature. 7. Her breath stinks, though not used so to do. 8. When she turns herself in bed, the child sways that way like a lump of lead.

These things being carefully observed, the midwife may make a judgment whether the child be alive or dead, especially if the woman take the following prescription: “Take half a pint of white wine and burn it, and add thereto half an ounce of cinnamon, but no other spice whatever; and when she has drank it, if her travailing pains come upon her the child is certainly dead; but if not, the child may possibly be either weak or sick, but not dead; this will bring her pains upon her, if it be dead, and will refresh the child, if it be living; for cinnamon refresheth and strengtheneth the child.”

Now, if upon trial, it be found that the child is dead, let the mother do all she can to forward the delivery, because a dead child can be nowise helpful therein. It will be necessary, therefore, that she make some comfortable things to prevent her fainting, by reason of the putrid vapours ascending from the dead child. And in order to her delivery, let her take the following herbs boiled in white wine, (or at least as many of them as you can get), viz. dittany, betony, pennyroyal, sage, featherfew, centuary, ivy leaves, and berries. Let her also take sweet basil, in powder, and half a drachm at a time, in white wine; let her privities be also anointed with the juice of the garden-tansey. Or take the tansey in the summer, when it can be most plentifully had, and before it runs up to the flower, and having bruised it well, boil it in oil till the juice of it be consumed. If you set it in the sun, after you have mixed it with oil, it will be more effectual. This an industrious midwife, who would be prepared against all events, ought to have always by her. As to the manner of her delivery, the same methods must be used as are mentioned in the section of natural labour. And here again I cannot but commend the stone ætites, held near the privities, whose magnetic virtue renders it exceedingly necessary on this occasion, for it draws the child any way, with the same facility that the loadstone draws iron.

Let the midwife also make a strong decoction of hyssop with water, and let the woman drink it very hot, and it will in a little time bring away the dead child.

If, as soon as she is delivered of the dead child, you are in doubt that part of the after-birth is left behind in the body (for in such cases as these, many times, it rots, and comes away piecemeal), let her continue drinking the same decoction till her body be cleansed.

A decoction made of the herb muster-wort, used as you did the decoction of hyssop, works the same effect. Let the midwife also take roots of pollodum, and stamp them well; warm them a little, and bind them on the soles of her feet, and it will soon bring away the child, either dead or alive.

The following medicines likewise are such as stir up the expulsive faculty; but in this case they must be stronger, because the motion of the child ceaseth.

Take savin, round birthwort, trochisks of myrrh, afaran roots, cinnamon, saffron, each half a drachm; make a powder, give a drachm.

Or she may purge first, and then apply an emollient, anointing her about the womb with oil of lilies, sweet almonds, camomile, hen and goose grease. Also foment, to get out the child with a decoction of mercury, orris, wild cucumbers, sæcus, broom flowers. Then anoint the privities and loins with ointment of sowbread. Or, take coloquintida, birthwort, of each a drachm; make a powder; add ammoniacum dissolved in wine, ox-gall, each two drachms; with oil of keir make an ointment. Or this pessary:

Take birthwort, orris, black hellebore, coloquintida, myrrh, each a drachm; powdered ammoniacum dissolved in wine, ox-gall, each two drachms. Or make a fume with an ass’s hoof burnt, or gallianum, or castor, and let it be taken in with a funnel.

To take away pains, and strengthen the parts, foment with the decoction of mugwort, mallows, rosemary, with wood myrtle, St. John’s wort, each half an ounce, spermatic two drachms; deer’s suet an ounce; with wax make anointment. Or,

Take wax six ounces, spermaceti an ounce; melt them, dip flax therein, and lay it all over her abdomen.

If none of these things will do, the last remedy is to use surgery, and then the midwife ought without delay to send for an expert and able man-midwife, to deliver her by manual operation; of which I shall treat more in the next chapter.

CHAPTER VI.
Of unnatural Labour.

In showing the duty of a midwife, when the child-bearing woman’s labour is unnatural, it will be requisite to show, in the first place, what I mean by unnatural labour; for that women do bring forth children in pain and sorrow is natural and common to all. Therefore that which I call unnatural is, when the child comes to the birth in a contrary posture to that which nature ordained, and in which the generality of children come into the world.

The right and natural birth is, when the child comes with its head first; and yet this is too short a definition of a natural birth: for if any part of the head but the crown comes first, so that the body follows not in a straight line, it is a wrong and difficult birth, even though the head comes first. Therefore, if the child comes with its feet first, or with the side across, it is quite contrary to nature, or, to speak more plainly, that which I call unnatural.

Now, there are four general ways a child may come wrong. 1. When any of the fore parts of the body first present themselves. 2. When, by an unhappy transportation, any of the hinder parts of the body first present themselves. 3. When either of the sides, or, 4. the feet present themselves first. To these the different wrong postures that a child can present itself may be reduced.

Sect. I. How to deliver a Woman of a Dead Child, by Manual Operation.

When manual operation is necessary, let the operator acquaint the woman of the absolute necessity there is for such an operation; and that, as the child has already lost its life, there is no other way left for the saving of hers. Let him also inform her, for her encouragement, that he doubts not, with the divine blessing, to deliver her safely; and that the pain arising thereby will not to be so great as she fears. Then let him stir up the woman’s pains by giving her some sharp clyster, to excite her throes to bear down and bring forth the child. And if this prevail not, let him proceed with the manual operation.

First, therefore, let her be placed across the bed that he may operate the easier, and let her lie on her back, with her hips a little higher than her head, or at least the body equally placed, when it is necessary to put back or turn the infant to give it a better posture. Being thus situated, she must fold her legs so as her heels be towards her body, and her thighs spread, and held so by a couple of strong persons: there must be others also to support her under her arms, that the body may not slide down when the child is drawn forth; for which, sometimes, a great strength is required. Let the sheets and blankets cover her thighs, for decency’s sake, and with respect to the assistance, and also to prevent her catching cold; the operator herein governing himself as well with respect to his convenience, and the facility and surety of the operation, as to other things. Then let him anoint the entrance of the womb with oil or fresh butter, if necessary, that so with more ease he may introduce his hand, which must also be anointed; and having, by the signs before-mentioned, received satisfaction that the child is dead, he must do his endeavours to fetch it away as soon as he possibly can. If the child offer the head first, he must gently put it back, until he hath liberty to introduce his hand quite into the womb; then sliding it along to find the feet, let him draw it forth by them, being very careful to keep the head from being locked into the passage, and that it be not separated from the body; which may be effected the more easily, because the child being very rotten and putrefied, the operator needs not be so mindful to keep the breast and face downwards as he is in living births. But if, notwithstanding all these precautions, by reason of the child’s putrefaction, the head should be separated and left behind in the womb, it must be drawn forth according to the directions which have been given in the third section of this chapter. But when the head, coming first, is so far advanced that it cannot well be put back, it is better to draw it forth so, than to torment the woman too much by putting it back to turn it and bring it by the feet: but the head being a part round and slippery, it may so happen that the operator cannot take hold of it by reason of its moisture, nor put them up to the side of it, because of its bigness; he must therefore take a proper instrument, and put it up as far as he can, without violence, between the womb and the child’s head, observing to keep the point of it towards the head (for the child being dead before, there can be no danger in the operation,) and let him fasten it there, giving it hold of the bones of the skull, that it may not slide; and after it is well fixed in the head, he may therewith draw it forth, keeping the ends of his left hand flat upon the opposite side, the better to help to disengage it, and by wagging it a little, to conduct it directly out of the passage, until the head be quite born; and then taking hold of it with the hands only, the shoulders may be drawn into the passage, and so sliding the fingers of both hands under the arm-pits, the child may be quite delivered; and then the after-burden fetched, to finish the operation, being careful not to pluck the navel-string too hard, lest it break, as often happens, when it is corrupt.

If the dead child comes with the arms up to the shoulder so extremely swelled that the woman must suffer too great violence to have it put back, it is then (being first well assured that the child is dead) best to take it off by the shoulder points, by twisting three or four times about, which is very easily done by reason of the softness and tenderness of the body. After the arm is so separated, and no longer possesses the passage, the operator will have more room to put up his hand into the womb, to fetch the child by the feet and bring it away.

But although the operator be sure the child is dead in the womb, yet he must not therefore presently use instruments, because they are never to be used but when hands are not sufficient, and there is no other remedy to prevent the woman’s danger, or to bring forth the child any other way; and the judicious operator will choose that way which is the least hazardous and most safe.

Sect. II. How a Woman must be Delivered, when the Child’s Feet come first.

There is nothing more obvious to those whose business it is to assist labouring women, than that the several unnatural postures in which children present themselves at their birth, are the occasion of most of the bad labour and ill accidents that happen unto them in that condition.

And since midwives are very often obliged, because of the unnatural situations, to draw the children forth by the feet, I conceive it to be most proper first to show how a child must be brought forth that presents itself in that posture, because it will be a guide to several of the rest.

I know indeed in this case it is the advice of several authors to change the figure, and place the head so that it may present to the birth; and this counsel I should be very inclinable to follow, could they but also show how it may be done. But it will appear very difficult, if not impossible, to be performed, if we would avoid the danger that by such violent agitations both the mother and the child must be put into; and therefore my opinion is, that it is better to draw forth by the feet, when it presents itself in that posture, than to venture a worse accident by turning it.

As soon, therefore, as the waters are broken, and it is known that the child comes thus, and that the womb is open enough to admit the midwife’s or operator’s hand into it, or else by anointing the passage with oil or hog’s grease, to endeavour to dilate it by degrees, using her fingers to this purpose, spreading them one from the other, after they are together entered, and continuing to do so till they be sufficiently dilated, then, taking care that her nails be well pared, no rings on her fingers, and her hands well anointed with oil or fresh butter, and the woman placed in the manner directed in the former section, let her gently introduce her hand into the entrance of the womb, where, finding the child’s feet, let her draw it forth in the manner I shall presently direct; only let her first see whether it presents one foot or both; and if but one foot, she ought to consider whether it be the right foot or left, and also in what fashion it comes: for, by that means, she will soon come to know where to find the other, which, as soon as she knows and finds, let her gently draw it forth with the other; but of this she must be especially careful, viz. that the second be not the foot of another child; for, if so, it may be of the utmost consequence, for she may sooner split both mother and child, than draw them forth: but this may be easily prevented, if she but slide the hand up by the first leg and thigh to the twist, and there find both thighs joined together, and descending from one and the same body. And this is also the best means to find the other foot, when it comes but with one.

As soon as the midwife has found both the child’s feet, she may draw them forth, and holding them together, may bring them by little in this manner; taking afterwards hold of the arms and thighs, as soon as she can come at them, drawing them so till the hips come forth. While this is doing, let her observe to wrap the parts in a single cloth, that so her hands, being always greasy, slide not on the infant’s body, which is very slippery, because of the vicious humours which are all over it; which being done, she may take hold under the hips, so as to draw it forth to the beginning of the breast; and let her on both sides with her hand bring down the child’s hand along its body, which she may easily find; and then let her take care that the belly and face of the child be downwards: for, if they should be upwards, there would be some danger of its being stopped by the chin, over the share-bone; and therefore, if it be not so, she must turn it to the posture; which may easily be done, if she takes proper hold of the body when the breast and arms are forth, in the manner as we have said, and draws it, turning it in proportion on that side which it most inclines to, till it be turned with the face downwards; and so, having brought it to the shoulders, let her lose no time, desiring the woman at the same time to bear down, that so drawing the head at that instant may take its place, and not be stopped in the passage. Some children there are whose heads are so big, that when the whole body is born, yet that stops the passage, though the midwife takes all possible care to prevent it. And when this happens, she must endeavour to draw forth the child by the shoulders, taking care that she separate not the body from the head, (as I have known it done by the midwife,) discharging it by little and little from the bones in the passage with the fingers of each hand, sliding them on each side opposite the other, sometimes above and sometimes under, till the work be ended; endeavouring to despatch it as soon as possible, lest the child be suffocated, as it will unavoidably be, if it remain long in that posture; and this being well and carefully effected, she may soon after fetch away the after-birth, as I have before directed.

Sect. III. How to bring away the Head of the Child, when separated from the Body, and left behind in the Womb.

Though the utmost care be taken in bringing away the child by the feet, yet if it happen to be dead, it is sometimes so putrefied and corrupt, that with the least pull the head separates from the body, and remains alone in the womb, and cannot be brought away but with a manual operation and great difficulty, it being extremely slippery, by reason of the place where it is, and from the roundness of its figure, on which no hold can be taken; and so very great is the difficulty in this case, that sometimes two or three able practitioners of midwifery have, one after the other, left the operation unfinished, as not able to effect it, after the utmost industry, skill and strength; so that the woman, not being able to be delivered, perished. To prevent which fatal accident, let the following operation be observed.

When the infant’s head separates from the body, and is left alone behind, whether through putrefaction or otherwise, let the operator immediately, without any delay, whilst the womb is still open, direct up his right hand to the mouth of the head (for no other hole can there be had), and having found it, let him put one or two of his fingers into it, and the thumb under its chin; then let him draw it by little and little, holding it by the jaws: but if that fails, as sometimes it will, when putrefied, then let him pull out the right hand, and slide up his left with which he must support the head, and with the right let him take a narrow instrument called a crotchet, but let it be strong, and with a single branch, which he must guide along the inside of his hand, with the point of it towards it, for fear of hurting the womb; and having thus introduced it, let him turn it towards the head, to strike either in an eye-hole, or the hole of an ear, or behind the head, or else between the sutures, as he finds it most convenient and easy; and then draw forth the head so fastened with the said instrument, still helping to conduct it with his left hand; but when he hath it brought near the passage, being strongly fastened to the instrument, let him remember to draw forth his hand, that the passage, not being filled with it, may be larger and easier, keeping still a finger or two on the side of the head, the better to disengage it.

There is also another method, with more ease and less hardship than the former: let the operator take a soft fillet or linen slip, of about four fingers’ breadth, and the length of three quarters of an ell, or thereabouts, taking the two ends with the left hand, and the middle with the right, and let him so put it up with his right as that it may be beyond the head, to embrace it as a sling doth a stone, and afterwards draw forth the fillet by the two ends together; it will thus be easily drawn forth, the fillet not hindering the least passage, because it takes up little or no space.

When the head is fetched out of the womb, care must be taken that not the least part of it be left behind, and likewise to cleanse the womb of the after-burden, if yet remaining. If the burden be wholly separated from the side of the womb, that ought to be first brought away, because it may also hinder the taking hold of the head. But if it still adheres to the womb, it must not be meddled with till the head be brought away; for if one should endeavour to separate it from the womb, it might then cause a flooding, which would be augmented by the violence of the operation; the vessels to which it is joined remaining for the most part open as long as the womb is distended, which the head causeth while it is retained in it, and cannot be closed till this strange body be voided, and this it doth by contracting and compressing itself together, as has been more fully before explained. Besides, the after-birth remaining thus cleaving to the womb during the operation prevents it from receiving easily either bruise or hurt.

Sect. IV. How to deliver a Woman when the Child’s Head is presented to the Birth.

Though some may think it a natural labour, when the child’s head comes first; yet, if the child’s head present not the right way, even that is an unnatural labour; and therefore, though the head comes first, yet if it be the side of the head instead of the crown, it is very dangerous both to the mother and child, for the child’s neck would be broken, if born in that manner; and by how much the mother’s pains continue to bear the child, which is impossible unless the head be rightly placed, the more the passages are stopped. Therefore, as soon as the position of the child is known, the woman must be laid with all speed, lest the child should advance further into this vicious posture, and thereby render it more difficult to thrust it back, which must be done, in order to place the head right in the passage, as it ought to be.

To this purpose, therefore, place the woman so that her thighs may be a little higher than her head and shoulders, causing her to lean a little upon the opposite side to the child’s ill posture; then let the operator slide up his hand, well anointed with oil, by the side of the child’s head, to bring it right gently with his fingers between the head and the womb; but if the head be so engaged that it cannot be done that way, he must put his hand up to the shoulders, that so by thrusting them back a little into the womb, sometimes on the one side and sometimes on the other, he may, by little and little, give a natural position. I confess it would be better, if the operator could put back the child by its shoulders with both hands: but the head takes up so much room, that he can only make use of his fingers, with which he must perform this operation, and with the help of the finger ends of the other hand put forward the child’s birth, as in natural labour.

Some children present their face first, having their hands turned back, in which posture it is extremely difficult for a child to be born; and if it continues so long, the face will be swelled, and become black and blue, so that it will at first appear monstrous, which is occasioned as well by the compression of it in that place, as by the midwife’s fingers in handling it, in order to place it in a better posture. But this blackness will wear away in three or four days’ time, by anointing it often with oil of sweet almonds. To deliver the birth, the same operation must be used as in the former, when the child comes first with the side of the head; only let the midwife or operator work very gently, to avoid as much as possible the bruising the face.

Sect. V. How to Deliver a Woman when the Child presents one or both Hands together with the Head.

Sometimes the infant will present some other part together with its head; which if it does, it is usually with one or both its hands; and this hinders the birth, because the hands take up part of that passage which is little enough for the head alone: besides when this happens, they generally cause the head to lean on one side; and therefore this position may be well styled unnatural. When the child presents thus, the first thing to be done, after it is perceived, must be to prevent it from coming down more, or engaging further in the passage; and therefore the operator having placed the woman on the bed, with her head lower than her thighs, must guide and put back the infant’s hand with his own as much as may be, or both of them, if they both come down, to give way to the child’s head; and this being done, if the head be on one side, it must be brought into its natural posture, in the middle of the passage, that it may come in a straight line, and then proceed as directed in the foregoing section.

Sect. VI. How a Woman ought to be delivered, when the Hands and Feet of the Infant come together.

There are none but will readily grant, that when the hands and feet of an infant present together, the labour must be unnatural; because it is possible a child can be born in that manner. In this case therefore, when the midwife guides her hand to the orifice of the womb, she will perceive only many fingers close together; and if it be not sufficiently dilated, it will be a good while before the hands and feet be sufficiently distinguished; for they are sometimes so shut and pressed together, that they seem to be all of one and the same shape: but where the womb is open enough to introduce the hand into it, she will easily know which are the hands and which are the feet; and having taken particular notice thereof, let her slide up her hand, and presently direct it towards the infant’s breast, which she will find very near, and then let her very gently thrust back the body towards the bottom of the womb leaving the feet in the same place where she found them: and then, having placed the woman in a convenient posture, that is to say, her thighs a little raised above her breast, and (which situation ought also to be observed when the child is to be put back into the womb), let the midwife afterwards take hold of the child by the feet, and draw it forth, as is directed in the second section.

This labour, though somewhat troublesome, yet is much better than when the child presents only its hands; for then the child must be quite turned round before it can be drawn forth; but in this they are ready, presenting themselves, and there is little to do but to lift and thrust back the upper part of the body, which is almost done of itself, by drawing by the feet alone.

I confess there are many authors that have written of labours, who would have all wrong births reduced to a natural figure; which is, to turn it that it may come with the head first. But those that have written thus are such as never understood the practical part; for if they had the least experience therein, they would know that it is impossible; at least, if it were to be done, that violence must necessarily be used in doing it, that would very probably be the death of both mother and child in the operation.

I would therefore lay down, as a general rule, that whensoever a child presents itself wrong to the birth, in what posture soever, from the shoulders to the feet, it is the best way, and the soonest done, to draw it out by the feet; and that it is better to search for them, if they do not present themselves, than to try to put them into their natural posture, and place the head foremost; for the great endeavours necessary to be used in turning the child in the womb, do so much weaken both the mother and the child, that there remains not afterwards strength enough to commit the operation to the work of nature; for, usually, the woman hath no more throes or pains fit for labour after she has been so wrought upon: for which reason it would be difficult, and tedious at best; and the child by such an operation made very weak, would be in extreme danger of perishing before it could be born. It is therefore much better in these cases to bring it away immediately by the feet; searching for them, as I have already directed, when they do not present themselves; by which the mother will be prevented a tedious labour, and the child be often brought alive into the world, who otherwise could hardly escape death.

Sect. VII. How a Woman should be delivered that has Twins, which present themselves in different Postures.

We have already spoken something of the birth of twins in the chapter of natural labour; for it is not an unnatural labour barely to have twins, provided they come in a right position to the birth. But when they present themselves in different postures, they come properly under the denomination of unnatural labours; and if when one child presents itself in a wrong figure, it makes the labour dangerous and unnatural, it must needs make it much more so when there are several, and render it not only more painful to the mother and children, but to the operator also; for they often trouble each other, and hinder both their births. Besides which, the womb is so filled with them, that the operator can hardly introduce his hand without much violence, which he must do, if they are to be turned or thrust back to give them a better position.

When a woman is pregnant with two children, they rarely present to the birth together, the one generally being more forward than the other; and that is the reason that but one is felt, and that many times the midwife knows not that there are twins till the first is born, and that she is going to fetch away the after-birth. In the first chapter, wherein I treated of natural labour, I have showed how a woman should be delivered of twins, presenting themselves both right; and therefore, before I close the chapter of unnatural labour, it only remains that I show what ought to be done when they either both come wrong, or one of them only, as for the most part it happens; the first generally coming right, and the second with the feet forward, or in some worse posture. In such a case, the birth of the first must be hastened as much as possible, to make way for the second, which is best brought away by the feet, without endeavouring to place it right, because it has been, as well as its mother, already tired and weakened by the birth of the first, and there would be greater danger of its death than likelihood of its coming out of the womb that way.

But if, when the first is born naturally, the second should likewise offer its head to the birth, it would be then best to leave nature to finish what she has so well begun; and if nature should be too slow in her work, some of those things mentioned in the fourth chapter, to accelerate the birth, may be properly enough applied: and if, after that, the second birth should be yet delayed, let a manual operation be deferred no longer; but the woman being properly placed, as has been before directed, let the operator direct his hand gently into the womb to find the feet, and so draw forth the second child, which will be the more easily effected, because there is a way made sufficiently by the birth of the first; and if the waters of this second child be not broke, as it often happens, yet, intending to bring it by the feet, he need not scruple to break the membranes with his fingers; for though, when the birth of a child is left to the operation of nature, it is necessary that the waters should break of themselves, yet when the child is brought out of the womb by art, there is no danger of breaking them; nay, on the contrary, it becomes necessary; for without the waters are broken, it would be impossible to turn the child.

But herein principally lies the cares of the operator, that he be not deceived, when either the hands or feet of both children offer themselves together to the birth; in this case he ought well to consider the operation, as, whether they be not joined together, or any way monstrous; and which part belongs to one child, and which to the other; that so they may be fetched one after the other, and not both together, as may be, if it were not duly considered; taking the right foot of the one and the left of the other, and so drawing them together, as if they belonged to one body, because there is a left and a right, by which means it would be impossible ever to deliver them. But a skilful operator will easily prevent this, if, having found two or three of several children presenting together in the passage, and taking aside two of the forwardest, a right and a left, and sliding his arm along the legs and thighs up to the wrist, he finds they both belong to one body; of which being thus assured, he may begin to draw forth the nearest, without regarding which is the strongest or weakest, bigger or less, living or dead, having first put aside that part of the other child which offers to have the more way, and so dispatch the first as soon as may be, observing the same rules as if there were but one, that is keeping the breast and face downwards, with every circumstance directed in that section where the child comes with its feet first, and not fetch the burden till the second child is born. And therefore, when the operator hath drawn forth one child, he must separate it from the burden, having tied and cut the navel-string, and then fetch the other by the feet in the same manner, and afterwards bring away the after-burden with the two strings as hath been before showed. If the children present any other part but the feet, the operator may follow the same method as directed in the foregoing section where the several unnatural positions are fully treated of.

CHAPTER VII.
DIRECTIONS FOR CHILD-BEARING WOMEN IN THEIR LYING-IN.

Sect. I. How a Woman newly Delivered ought to be ordered.

As soon as she is laid in her bed, let her be placed in it conveniently for ease and rest, which she stands in great need of, to recover herself of the great fatigue she underwent during her travail; and that she may lie the more easily let her hands and body be a little raised, that she may breathe more freely, and cleanse the better, especially of that blood which then comes away, that so it may not clot, which being restrained causeth great pain.

Having thus placed her in bed, let her take a draught of burnt white wine, having a drachm of spermaceti melted therein. The herb vervain is also singularly good for a woman in this condition, boiling it in what she either eats or drinks, fortifying the womb so exceedingly, that it will do more good in two days, than any other thing does in double that time, having no offensive taste. And this is no more than what she stands in need of; for her lower parts being greatly distended till the birth of the infant, it is good to endeavour the prevention of an inflammation there. Let there also be outwardly applied, all over the bottom of her abdomen and privities, the following anodyne and cataplasm: Take two ounces of oil of sweet almonds, and two or three new-laid eggs, yolks and whites, stirring them together in an earthen pipkin over hot embers, till they come to the consistence of a poultice; which being spread upon a cloth, must be applied to those parts, indifferently warm, having first taken away the closure (which was put to her presently after her delivery,) and likewise such clots of blood as were then left. Let this lie on five or six hours, and then renew it again as you see cause.

Great care ought to be taken at first, that if her body be very weak, she be not kept too hot, for extremity of heat weakens nature and dissolves the strength; and whether she be weak or strong, be sure that no cold air comes near her first; for cold is an enemy to the spermatic parts, and if it get into the womb, it increases the after-pains, causes swelling in the womb, and hurts the nerves. As to her diet, let it be hot, and let her eat but a little at a time. Let her avoid the light for the first three days, and longer if she be weak, for her labour weakens her eyes exceedingly, by a harmony between the womb and them. Let her also avoid great noise, sadness, and trouble of mind.

If the womb be foul, which may be easily perceived by the impurity of the blood (which will then easily come away in clots or stinking, of if you suspect any of the after-burden to be left behind, which may sometimes happen,) make her drink of featherfew, mugwort, pennyroyal, and mother of thyme, boiled in white wine and sweetened with sugar.

Panado and new-laid eggs are the best meat for her at first; of which she may eat often but not too much at a time. And let her nurse use cinnamon in all her meats and drinks, for it generally strengthens the womb.

Let her stir as little as may be, till after the fifth, sixth, or seventh day of her delivery, if she be weak; and let her take as little meat as possible, for that tends to weaken her very much.

If she goes not well to stool, give a clyster made only with the decoction of mallows and a little brown sugar.

When she hath lain-in a week or more, let her use such things as close the womb, of which knot-grass and comfrey are very good; and to them you may add a little polypodium, for it will do her good, both leaves and root being bruised.

Sect. II. How to remedy those Accidents which a Lying-in Woman is subject to.

I. The first common and usual accident that troubles women in their lying-in, is after-pains. They proceed from cold and wind contained in the bowels, with which they are easily filled after labour, because then they have more room to dilate than when the child was in the womb, by which they were compressed; and also because nourishment and matter, contained as well in them as in the stomach, have been so confusedly agitated from side to side during the pains of labour, by the throes which always must compress the belly, that they could not be well digested, whence the wind is afterwards generated, and by consequence the gripes which the woman feels running in her bowels from side to side, according as the wind moves more or less, and sometimes likewise from the womb, because of the compression and commotion which the bowels make. These being generally the case, let us now apply a suitable remedy.

1. Boil an egg soft, and pour out the yolk of it: with which mix a spoonful of cinnamon-water, and let her drink it; and if you mix in it two grains of ambergris, it will be better; and yet vervain taken in any thing she drinks, will be as effectual as the other.

2. Give the lying-in woman, immediately after delivery, oil of sweet almonds and syrup of maiden-hair mixed together. Some prefer oil of walnuts, provided it be made of nuts that are very good; but it tastes worse than the other at best. This will lenify the inside of the intestines by unctuousness, and by that means bring away that which is contained in them more easily.

3. Take and boil onions well in water, then stamp them with oil of cinnamon, spread them on a cloth, and apply them to the region of the womb.

4. Let her be careful to keep her body warm, and not to drink too cold; and if the pain prove violent, hot cloths, from time to time, must be laid on her abdomen, or a pancake fried in walnut oil may be applied to it, without swathing her body too strait. And for the better evacuating the wind out of the intestines, give her a clyster, which may be repeated as often as necessity requires.

5. Take bay-berries, beat them to powder, put the powder upon a chafing-dish of coals, and let her receive the smoke of them up her privities.

6. Take tar and bear’s grease, of each an equal quantity, boil them together, and whilst it is boiling, add a little pigeon’s dung to it. Spread some of this upon a linen cloth, and apply it to the reins of the back of her that is troubled with after-pains, and it will give her speedy ease.

Lastly, Let her take half a drachm of bay-berries beaten into a powder in a draught of muscadel or tent.

II. Another accident to which women in child-bed are subject is the hemorrhoids, or piles, occasioned through the great straining in bringing the child into the world. To cure this,

1. Let her be let blood in the saphæna vein.

2. Let her use polypodium in her meat and drink, bruised and boiled.

3. Take an onion, and having made a hole in the middle of it, fill it full of oil, roast it, and having bruised it all together, apply it to the fundament.

4. Take a dozen of snails, without shells if you can get them, or else so many shell snails, and pull them out, and having bruised them with a little oil, apply them warm as before.

5. If she go not well to stool, let her take an ounce of cassia fistula drawn at night going to bed; she needs no change of diet after.

III. Retention of the menses is another accident happening to women in child-bed; and which is of so dangerous a consequence, that, if not timely remedied, it proves mortal. When this happens,

1. Let the woman take such medicines as strongly provoke the terms, such as dittany, betony, pennyroyal, featherfew, centuary, juniper-berries, peony roots.

2. Let her take two or three spoonfuls of briony water each morning.

3. Gentian roots beaten into a powder, and a drachm of it taken every morning in wine, are an extraordinary remedy.

4. The root of birthwort, either long or round, so used and taken as the former, are very good.

5. Take twelve peony seeds, and beat them into a very fine powder, and let her drink them in a draught of hot cardus posset, and let her sweat after. And if this last medicine do not bring them down the first time she takes it, let her take as much more three hours after, and it seldom fails.

IV. Overflowing of the menses is another accident incidental to child-bearing women. For which,

1. Take shepherd’s purse, either boiled in any convenient liquor, or dried and beaten into a powder, and it will be an admirable remedy to stop them, this being especially appropriated to the privities.

2. The flower and leaves of brambles, or either of them, being dried and beaten into a powder, and a drachm of them taken every morning in a spoonful of red wine, or in a decoction of leaves of the same (which perhaps is much better,) is an admirable remedy for the immoderate flowing of the terms in women.

V. Excoriations, bruises, and rents of the lower part of the womb are often occasioned by that violent distention and separation of the four carbuncles in a woman’s labour. For the healing whereof, as soon as the woman is laid, if there be only simple contusions and excoriations, then let the anodyne cataplasms, formerly directed, be applied to the lower parts to ease the pain, made of the yolks and whites of new-laid egg and oil of roses, boiled a little over warm embers, continually stirring it till it is mixed, and then spread on a fine cloth; it must be applied very warm to the bearing-place for five or six hours, and when it is taken away, lay some fine rags, dipped in oil of St. John’s wort twice or thrice a day; also foment the parts with barley-water and honey of roses, to cleanse them from the excrements which pass.

VI. The curding and clotting of the milk is another accident which happens to women in child-bed; for, in the beginning of child-bed, the woman’s milk is not purified, because of the great commotions her body suffered during her labour, which affected all the parts, and it is then moved with many humours. Now this clotting of the milk does, for the most part, proceed from the breasts not being fully drawn, and that either because she has too much milk, and that the infant is too small and weak to suck all, or because she does not desire to be a nurse; for the milk, in those cases remaining in the breast after concoction, without being drawn, loseth the sweetness and the balsamic quality it had, and by reason of the heat it acquires, and the too long stay it makes there, it sours, curds, and clots, in like manner as we see runnet put into ordinary milk turn it into curds. The curding of the milk may be also caused by having taken a great cold, and not keeping the breast well covered.

But from what cause soever this curding of the milk proceeds, the most certain remedy is, speedily to draw the breasts until it is emitted and dried. But in regard that the infant, by reason of weakness, cannot draw strong enough, the woman being hard marked when her milk is curded, it will be most proper to get another woman to draw her breasts until the milk comes freely, and then she may give her child suck. And that she may not afterwards be troubled with a surplus of milk, she must eat such diet as gives but little nourishment, and keep her body open.

But if the case be such, that the woman neither can nor will be a nurse, it is necessary to apply other remedies for the curing of this distemper: for then it will be best not to draw the breasts: for that will be the way to bring more milk into them. For which purpose, it will be necessary to empty the body, by bleeding the arm: besides which, let the humours be drawn by strong clysters and bleeding in the feet: nor will it be amiss to purge gently; and to digest, dissolve, and dissipate the curded milk, apply a cataplasm of pure honey, or that of the four brains dissolved in a decoction of sage, milk, smallage, and fennel, mixing with it oil of camomile, with which oil let the breasts be well anointed. The following liniment is also good to scatter and dissipate the milk.

A Liniment to Scatter and Dissipate the Milk.

That the milk flowing back to the breast may without offence be dissipated, you must use this ointment; “Take pure wax two ounces, linseed half a pound; when the wax is melted, let the liniment be made, wherein linen cloths must be dipped, and, according to their largeness, be laid upon the breast; and when it shall be dispersed, and pains no more, let other linen cloths be dipped in the distilled water of acorns, and put them upon them.”

Note. That the cloths dipped into distilled water of acorns must be used only by those who cannot nurse their own children: but if a swelling in the breast of her who gives suck do arise from abundance of milk, and threatens an inflammation, let her use the former ointment, but abstain from using the distilled water of acorns.

CHAPTER VIII.
Directions for the Nurses, in ordering Newly-born Children.

When the child’s navel-string hath been cut, according to the rules prescribed, let the midwife presently cleanse it from the excrements and filth it brings with it; of which some are within the body, as the urine in the bladder, and the excrements found in the guts; and others without, which are thick, whitish, and clammy, proceeding from the sliminess of the waters. There are children sometimes covered all over with this, that one would think they were rubbed over with soft cheese; and some women are of so easy a belief, that they really think it so, because they had eaten some while they were enceinte. From these excrements let the child be cleansed with wine and water a little warmed, washing every part therewith, but chiefly the head, because of the hair, also on the folds of the groin, arm-pits, and privities; which parts must be gently cleansed with a linen rag, or a soft sponge, dipped in lukewarm wine. If this clammy or viscous excrement stick so close that it will not easily be washed off from those places, it may be fetched off with oil of sweet almonds, or a little fresh butter melted with wine, and afterwards well dried off; also make tents of fine rags, and wetting them in this liquor, clear the ears and nostrils; but for the eyes, wipe them only with a dry soft rag, and dipping it in the wine, lest it should make them smart.

The child being thus washed, and cleansed from the native blood and impurities which attend it into the world, it must in the next place be searched, to see whether all things be right about it, and that there is no fault or dislocation; whether it has suffered any violence by its birth, in any part of its body; and whether all the parts be well and duly shaped; that suitable remedies may be applied, if any thing be found not right. Nor is it enough to see that all be right without, and that the outside of the body be cleansed, but she must chiefly observe whether it dischargeth the excrements contained within, and whether the passage be open; for some have been born without having been perforated. Therefore, let her examine whether the conduits of the urine and stool be clear, for want of which some have died, not being able to void their excrements, because timely care was not taken at first. As to the urine, all children, as well males as females, do make water as soon as they are born, if they can, especially if they feel the heat of the fire, and sometimes also void the excrements, but not so soon as the urine. If the infant does not ordure the first day, then put up into its fundament a small suppository, to stir it up to be discharged, that it may not cause painful gripes by remaining so long in the belly. A sugar almond may be proper for this purpose, anointed over with a little boiled honey; or else a small piece of Castile-soap rubbed over with fresh butter; also give the child for this purpose a little syrup of roses or violets at the mouth, mixed with some oil of sweet almonds drawn without a fire, anointing the belly also with the same oil or fresh butter.

The midwife having thus washed and cleansed the child, according to the before-mentioned directions, let her begin to swaddle it in swathing clothes, and when she dresses the head, let her put small rags behind the ears to dry up the filth which usually engenders there, and so let her do also in the folds of the arm-pits and groin, and so swathe it; then wrap it up warm in a bed with blankets, which there is scarcely any woman so ignorant but knows well enough how to do: only let me give them this caution, that they swathe not the child too strait in its blankets, especially about the breast and stomach, that it may breathe the more freely, and not be forced to vomit up the milk it sucks, because the stomach cannot be sufficiently extended to contain it; therefore let its arms and legs be wrapped in its bed stretched and straight, and swathed to keep them so, viz, the arms along its sides, and its legs equally both together, with a little of the bed between them, that they may not be galled by rubbing each other; then let the head be kept steady and straight, with a stay fastened on each side of the blanket; and then wrap the child up in a mantle and blankets to keep it warm. Let none think this of swathing the infant is needless to set down, for it is necessary it should be thus swaddled, to give its little body a straight figure, which is most decent and proper for a man, and to accustom him to keep upon his feet, who otherwise would go upon all fours, as most other animals do.