BUT supposing by the way, that the INFANT offers its Buttocks first, they being neither so round nor hard as the HEAD, I would then intrude all my Fingers into the Womb more easily; some of which (or sometimes All) I would pass into the Orifice of the Womb under the Buttocks as before into the VAGINA. Now my HAND being placed there, I intently observe the PAINS as they come on; then inviting the Woman to Labour, I gradually press backwards as hard as I can conveniently, drawing my HAND downwards as before: But if in attracting it so, the HAND should slide too much out of the Womb, (which however I endeavour to prevent) while the PAINS are yet upon her; then as soon as they are over, I pass it up again, that I may be ready against their Return. And this I would reiterate upon every PAIN, so that the Child (guided by my HAND) may slide down at every Turn, until at last the Passage is so dilated, that it may advance gradually with ease into the World.
BY these judicious Means; forcing back the OS COCCYGIS by the Pressure of the HAND, as the PAINS come on, I may not only dilate the Passage, and enlarge the Orifice of the Womb; but also upon retracting the HAND by degrees, I can gradually attract the CHILD out of the Womb, through the Narrowness of the PELVIS: And thus, by this curious Art, (which I take to be one of the chief Points belonging to Midwifery) I do fairly deliver the Woman, who by no other Means whatsoever, could be preserved, together with her INFANT, in all Probability.
HOWEVER, tho’ I have candidly laid down this Method, (conformable to the Doctrine of the most excellent and ingenious Instructers) yet I would not advise every coarse Clumsy HAND to undertake it, nor such as are not thoroughly acquainted with the Parts of Generation: For this Performance requires Judgment and Prudence, as well as Art and Experience. But however yet in Case of Necessity, where no Extraordinary Person’s Assistance can be had, as it often happens in the Country, the Ordinary MIDWIFE ought not to neglect her Duty: nevertheless, before she offers to attempt this piece of extraordinary Skill, she ought to be very certain that these BONES are the great Impediment and Difficulty of the Delivery.
CHAP. X.
Of Difficult BIRTHS, proceeding from Causes of the BLADDER and RECTUM.
DIFFICULTY in BIRTH may also proceed from the BLADDER, as (in like manner) it may from the RECTUM or Strait Gut.
I. FROM the BLADDER, when affected with Tumours, Ulcers, or Glands, obstructing the Passages; which however is more frequently occasioned by Stones lodged in the BLADDER, or in its Neck: In either of which Conditions, the Midwife, by dilating the Passage with a subtile HAND, must repel the OS COCCYGIS according to Art (as taught in the preceeding Chapter) that the HEAD in falling down, may the less offend the BLADDER.
II. THE same Difficulty may arise from the RECTUM, when it happens in the same Manner, to be affected with such obdurated Glands, Tumours, &c. for the Consequence is the same in shutting up the Passages: In which Case the MIDWIFE is to depress gently such Excrescences, of what kind soever, with her cautious HAND, and consequently to dilate the Passages by degrees (how much soever obstructed) for receiving the Head of the INFANT; always having a respect to the affected Parts, and bearing no harder upon them than Necessity requires.
MOREOVER sometimes it happens, that the only Difficulty in LABOUR proceeds from hardened Excrements in this Gut, which may as effectually stop or shut up the Passage, as any thing else, until duly voided and evacuated by one or more proper CLYSTERS, as Occasion directs.
BUT sometimes it also happens, that such Difficulties arise from the falling out of the Fundament by the strong and violent THROWS that the Woman Suffers in Labour: In which Condition, if the CHILD is very forward in the Passage, before it happens, it may be prevented by dissuading or hindering the Woman from Labouring so vehemently; but if it happen’d before that time, it must be left so until the BIRTH be accomplished; after which time, it is to be put up exactly, and reduced to its proper Place, in the same manner as the Womb might be (in Case of its Prolapse, as mentioned in the following Chapter) after duly fomenting and bathing it with proper Applicatives: advertising always to use no CLYSTERS, in time of Child-Bed; because such Means would readily excite it again to a slippery Relapse.