The Female Physician / Containing all the diseases incident to that sex, in virgins, wives, and widows; together with their causes and symptoms, their degrees of danger, and respective methods of prevention and cure: to which is added, the whole art of new improv'd midwifery; comprehending the necessary qualifications of a midwife, and particular directions for laying women, in all cases of difficult and preternatural births; together with the diet and regimen of both the mother and child.

by John Maubray

IN short, I shall here only add, that if the INFANT offers itself well turn’d, in this less oblique Womb; the MIDWIFE, having restored the Womb to its right Place and natural Posture, will find nothing more to do, but to take Care to facilitate and enlarge the Passage, and receive the CHILD tenderly with the Head foremost. Whereas in Case the INFANT presents itself ill-turn’d in this Womb, it is to be very circumspectly extracted by the Feet; as by and by will more amply appear from what ensues, Viz.——

CHAP. XXIII.
Of Preternatural BIRTHS, proceeding from complicated Causes, of both the INFANT and the WOMB.

BY this sort of BIRTHS, I mean such as are Preternatural, both in respect of the Situation of the CHILD, and of the Womb. Which complicated Preternatural BIRTH is (of all others) the most dangerous; because of an Indefinity of Accidents and Difficulties with which it is always attended, according to the many various Postures in which both the INFANT and the Womb are found: All which to enumerate here, and to guard particularly against them, as I have done in the preceeding Cases, would not only augment the Bulk and Charge of this WORK, but also be in some respect altogether Needless: Because if I was to content my self to treat this Chapter in general (without descending to particular) TERMS, I would not doubt but that the ingenious Reader would even thence readily form a clear IDEA of all such BIRTHS, from the many different Cases already stated and discussed; which if thoroughly well understood, the Rest cannot but be easily comprehended.

HOWEVER, that I may not leave the weaker Capacity, or the doubtful MIDWIFE to the Uncertainties of her own scrupulous Judgement, I shall propose and resolve some of the most difficult and dangerous Cases belonging to this preternatural Subject, and that as far as is really requisite, in manner following; viz.——

I. WE Shall suppose that the INFANT is ill-turned, and presents itself preternaturally, with Face, Chin, Hand, Elbow, Shoulder, Breast, Back, Belly, Side, Buttock, Knee, Foot, or any other Part or Member first, in a Womb tending obliquely forwards. In this Condition, I shall first show the MIDWIFE how, and by what Signs, she may know and discover such perverse Postures; and secondly how, and by what Means, These may be rectify’d, the CHILD extricated, and the MOTHER reliev’d in Life.

THEN as to the First Point, I would have it minded, that the Touch is the only Expedient, by which the Situation of the INFANT in any Womb, whether Oblique or Direct, is to be discover’d and perfectly known. Which when the MIDWIFE finds to be preternatural, she needs not much trouble herself about what precise Part offers or comes first in the PASSAGE: Because of this short Rule, which I would not have her to forget; namely, That, when the Head does not present itself first in this complicated Case, the CHILD is to be drawn out by the FEET. For in this ill Position of both the INFANT and the WOMB, the Version of the CHILD succeeds more easily than if the Head was foremost: Wherefore I would lose no Time, but as Soon as I had discover’d all Circumstances aright, I would commence my Business upon this Occasion, before either the MOTHER or the INFANT are much spent, that I may perform my Work, while they both can mutually concur with me towards their own Relief; That is, while the Womb is yet suspended in the upper Part of the Pelvis, and the Membrane not yet broken.

IN order to this Second Point, the Woman being commodiously placed, the MIDWIFE is to pass up her Hand into the VAGINA, and dispose the Orifice of the Womb to open, which is now sooner done than if the Head came first: This being done dextrously, she is to put first one or two Fingers, then all of them successively into the Aperture; and when that is sufficiently enlarged, she is to penetrate into the Womb, and either break the MEMBRANE, or wait its spontaneous Breaking, as she judges best by occurring Circumstances. In the next place, she is to look for and find the FEET; and, the TOES being always turn’d towards the Rectum, they are to be forthwith brought into the Passage: proceeding still farther in the due and regular Method of extracting the Child, as already taught[^[178]] and dilucidated.

II. WE will suppose moreover, that the Infant is ill-seated, and presents itself preternaturally with any of the aforementioned Members first, in a Womb hanging obliquely to either Side. In this Case, I would sincerely advise the MIDWIFE, to lose no Time in opening the Womb, breaking the Membrane, turning the Child, and extracting it by the Feet: Because in this Posture of both the BIRTH and the WOMB, Experience has taught me that nothing can be safer and less dangerous than this Method, when ingeniously and presently perform’d with Dexterity.

IT is true indeed it may be objected, that I dissent in this Matter, from most (if not from all) Authors: To which I answer, in short, that Those from whom I do differ, were never acquainted with this complicated preternatural Condition, but always supposed the WOMB to continue in its proper Place, never dreaming of its various Motion, nor suspecting its oblique Situation; erroneously imagining all preternatural BIRTHS to proceed merely from the ill Version of the Infant: In which Circumstance however, when it happens so, I confess they are so far in the right, that the Head is to be first brought into the Passage, and the Child excluded by it with all possible Expedition.