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

THE DIAGNOSTICKS however of this Distemper are manifest; for either no BLOOD is voided at all, or too small a Quantity, in respect to the Size, Temperament, and Constitution of the PATIENT: But besides, it may be also known by the following Symptoms; viz. a SWELLING of the BELLY, upon the Retention of the Humours that ought to be evacuated; a Difficulty of Breathing arises; Pains seize the Abdomen, as also the Loins and the Groins; a Fever and Tremblings follow; as Faintings do upon a weak, quick and unequal Pulse; something fuliginous appears in the Urine; and a livid, black, grumous, or nauseous Matter is excreted.

HENCE proceed various PROGNOSTICKS; viz. Fevers, Spitting or Vomiting of Blood, Melancholy, Inflammations of the Liver, Quincy, Pleurisy, Frenzy, Dropsy, Apoplexy, and Madness itself: The least of which may prove of fatal Consequence, wherefore Delays in this Condition are most dangerous; because when any of these heavy Symptoms has befallen the Woman, there is scarce any Hope left for her Recovery; whereas before, they may be artfully prevented, and the Cure duly perfected by convenient DIET, Venæsections, Revulsive Medicines, &c.

BUT more particularly the Cure ought to vary, according to the difference of the co-incident Symptoms: For since continual Fevers and Inflammatory Diseases most commonly follow upon this Suppression or Diminution of the Lochia, we must take great Care that, endeavouring to promote the FLUX, and to open the Uterine Vessels, we do not augment the FEVER and Inflammation; which will certainly happen, (if without distinction) we use the hot Medicines prescribed by many Authors.

WHEREFORE in this Case repeated Venæsections sometimes in the Ancle, and sometimes in the Arm; and cupping Glasses applied to the Thighs and Shins; as also Rubbing of the Legs and Thighs well, are generally sufficient Remedies; especially if followed with one or more Cleansing, or partly opening, partly cooling, and Emollient CLYSTERS, of a Decoction of Mallows, Pellitory, or the like; in which strain’d Liquor, the Pulp of CASSIA with a Dram of Nitre, and Sugar, and Honey may be dissolved: As also Fomentations and Fumigations of Emollient and Aperient Medicines that are not sharp, may be very pertinently used. Finally, the Infusion of Jesuits-Bark in Water, may be properly given three or four Times a day; and purging PTISANS, after the first days, are of good Service in the present Case.

CHAP. IV.
Of the immoderate Flux of the LOCHIA.

THE too copious and long lasting, or immoderate Flux of the Child-Bed Purgations, is no less Preternatural, than the former Case of their being altogether suppressed, or in part diminished. Tho’ it is however to be observ’d, that there can be no certain Quantity of flowing Blood, nor any certain Time of Duration of this Flux prefix’d or determined to the Puerperial Woman, as aforesaid: Wherefore the Excess of this Evacuation is best known by the Loss of Strength, sinking of the Spirits, and the great Uneasiness of the Patient.

THE Cause of this Distemper is, either 1st, a too great Plenty of the abounding Blood; or 2dly, its Tenuity and Acrimony stimulating Nature to Excretion; or 3dly, too great an Apertion of the Uterine Vessels; or 4thly and lastly, a violent Extraction of the AFTER-BIRTH: For the Flux of the LOCHIA proceeding meerly from the Separation of the Placenta from the Womb, the more strong and violent this Separation or Divulsion is, the more the Vessels in the Concave Part of the Womb are torn or dilacerated; and so being either too much opened, or too difficult to reconsolidate, they discharge Blood immoderately.

HENCE, I say, this immoderate FLOODING, is not only known by the great Quantities of BLOOD voided, by its Continuance, or by coming away in Clods, and much at a time; but also by the Loss of Strength, and a Defect of SPIRITS; upon which follows a low, debilitated and frequent PULSE; Loathing of VICTUALS; PAINS in the Hypochondriacks, with a Twisting of the GUTS, and Griping of the BELLY; a Dimness of SIGHT; a Hissing of the EARS; and at last Swoonings or Convulsions, proceeding from the Depauperation of the BLOOD: Which after an immoderate FLUX always disorders the SPIRITS, because when the Mass of it is much lessened, it cannot keep its due Mixture and Disposition.

IN this Case the true Prognostick is, that, if all immoderate Hæmorrhagies are dangerous; because by them, the Treasure of LIFE (the natural Heat) is exhausted: Then, without Controversy, the immoderate Flux of the Lochia, whether after Labour, or after a MISCARRIAGE, is full of Danger; as coming upon the PATIENT at a most unseasonable time, when her Strength is already spent.