Chapter XVI: LASTLY, Let her State of Health be never so good, she ought to

take proper _Medicines_ to strengthen the WOMB, as well as the FŒTUS, in order to prevent _Accidents_, which may happen to the _strongest Woman_.

BUT as to _Women_ of more _tender Constitutions_, they are not only subject to the _common Symptoms_, but often liable also to _acute Diseases_; such as _Fevers_, _Pleurisies_, _Squincies_, _Inflammations_, _Epilepsies_, _Apoplexies_, _Convulsions_, _Contractions_ of the Limbs, Joints, _&c._ In which _Cases_, I may reasonably recommend the PATIENT to the ablest _Physician_; since none but the most Judicious ought to undertake them in such critical Conjunctures. Because it is no ways SAFE to use the _same Means_ and _Medicines_ with the _Pregnant Woman_ (which those incident _Diseases_ would otherways regularly require;) without a due _Distinction_ and a nice _Regard_ had to her other HABITS of _Body_.

THESE _tender Women_ are also sometimes seiz’d with _Chronical Distempers_; such as _intermitting Fevers_, _lingring Coughs_, &c: But, in those _Cases_, PRESCRIPTIONS are not so Proper or Convenient, unless the _Distemper_ be very severe and extremely prejudicial to the FOETUS, because they commonly wear off before the DELIVERY.

HOWEVER, be the _Constitution_, or Condition, of the _Woman_ as it will, I mean, _Strong_ or _Weak_, _Healthy_ or _Sickly_, all prudent PARENTS, who desire to be bless’d with comely, tractable, and hopeful _Children_, ought not only to perform their _Nuptial Duties_ with great _Serenity of Mind_, but also to take mutual _Care_ to prevent and suppress all _Family-Tumults_ or _Domestick Storms_: For there never ought so much as a _Cloud_ to appear in their _Conjugal Society_; since all such unhappy _Accidents_ strongly affect the growing INFANT, and intail the same _Qualities_ of DISPOSITION almost indelibly imprinted upon it.

CHAP. IV.
_Of the SYMPTOMS of the first three Months._

THE _Prolifick Seed_ being duly coagulated by a gentle _Ebullition_ of its own _vegetative Faculty_, by the Power of the _Plastick Virtue_ of the vital _Spirits_, and by the peculiar innate _Quality_ of the MATRIX; this inlivened Substance produceth an _Organical Body_, of a perfectly form’d, and delineated FOETUS: Which FOETUS, according to the various _Steps_ of its Progression in _Formation_, _Animation_, and _Maturation_, occasions as many various and different _Effects_ upon the BEARING WOMAN; as necessary _Consequences_ of the said three principal ACTS of the _Infant’s_ Constitution.

NOW these consequential _Effects_ may be properly divided into _Three_ CLASSES; which are accordingly call’d SYMPTOMS of the _First_, _Second_, or _Middle_; and of the last _Three Months_.

BUT it is to be observ’d by the Way, that all _Women_ are not alike subjected to them; SOME being more troubled with _Those_ of the _First_; OTHERS also with _Those_ of the _Second_; and OTHERS again with the SYMPTOMS of the _last Three Months_. But there are _some Women_, in fine, that continue to be troubled, in the _Middle Months_, with the SYMPTOMS of the _First_; and in the _Latter_, with some of _Those_ of the _Second_: All which happens according to their various _Regimens_, _Dispositions_ and _Habits_ of Body.

HOWEVER, to proceed methodically, with all Submission, according to what competent _Knowledge_ and _Experience_ I have of the CONCEIV’D WOMAN; the SYMPTOMS most common to _Her_, in the _First Three Months_, may be briefly reduced to the following principal _Eight_ in Number; namely, (1.) _Vomiting or Nauseating_. (2.) _Fastidy_ or _Loathing_. (3.) _Pica_ or _Longing_. (4.) _Painful Cholicks_ or _Gripes_. (5.) _Diarrhea_ or _Looseness_. (6.) _Tooth-Aches_. (7.) _Head-Aches_. And, (8.) _Swimmings of the Head_. Of all which, I shall now separately treat in their Order.

CHAP. V.
_Of VOMITING, or NAUSEATING._

VOMITING is a strong and sudden _Contraction_ of the whole _Stomach_, occasion’d by the _Animal Spirit’s_ being preternaturally _expanded_ in its _orbicular_ as well as _oblong Fibres_, and the too quick and violent _Exertion_ of their _Elastick Power_: Or otherwise, it is a _Convulsive Motion_ of the _Stomach_, whereby, when the _Fibres_, which compose its middle or _muscular Tunick_, are all at once strongly contracted, it endeavours to eject through the _Oesophagus_ and _Mouth_ the Contents of its _Cavity_; to which the _Gullet_ itself (being of a piece with the _Stomach_) and the _Muscles_ of the _Belly_ contribute not a little.

WHICH _Definition_ comprehends the _immediate Cause_ of all _Vomitings_; and tho’ there be many external and internal _mediate Causes_, yet, I think, in the present Case of the _pregnant Woman_, the Cause of this SYMPTOM proceeds chiefly from the _Vapours_ of the exhaled HUMOURS, and the worse Part of the BLOOD; infesting the _Tunicks_ of the _Orifice_ of the VENTRICLE, and flying into the _Cavity_ of the STOMACH.

WHICH, if _slightly_ affected, occasions only a _nauseous Spitting_, or _gentle Vomiting_; but if more _severely_, it excites a far worse _Vomiting_, with a certain grievous _Pain_ and _Torment_ of the Person afflicted. Now if those _Vapours_ be of a _calid Quality_, they commonly occasion a stinking and burning kind of _Belching_; but if _frigid_, perhaps, on the contrary, a troublesome sour, acid, _breaking of Wind_: Both of which promote _frequent Vomiting_, that carries off the _vicious Juices_; so that the SYMPTOM commonly ceases (of itself) in the _second_ or _third Month_. Wherefore this ill _Habit_ need not be industriously restrain’d, unless very _Troublesome_; as in the above-mention’d _Case_, when attended with extreme _Severity of Pain_: For _then_ it is not without _Danger_, and therefore requires immediate _Remedy_ or CURE.

WHICH _Cure_, I humbly conceive, maybe judiciously effected by expelling the _Cause_, and strengthening the _Ventricle_; so that it may be capable to repel those _Vapours_, or _Humours_, ascending from the WOMB; and may either entirely subvert or repress _Those_ previously receiv’d.

CHAP. VI.
_Of FASTIDY, or LOATHING._

THE _Cause_ of this SYMPTOM proceeds from the worse Sort and more ignoble Part of the BLOOD; which, in concert with the _Humours_, perverts the _Temperature_ of the STOMACH, by flowing towards its Orifice: And _This_, upon emitting _Vapours_ to the _same_, strongly impresseth such _vicious Qualities_ upon it, as doth occasion sometimes a LOATHING of _All Meats_, and sometimes only an _Aversion_ to some certain _particular Dishes of Meat_.

WHICH last _Case_ happens most commonly, and especially at the Time of _New_ and _Full-Moon_. Now this LOATHING may be _thus_ distinguished: To wit; if it rises from _bilous_ or _cholerick Humours_, the WOMAN feels a gnawing or biting of the _Ventricle_, and is afflicted with a frequent _great Thirst_: If from _putrid Humours_, she is (at several Times) _feverishly inclined_: And if from _moderate gross Humours_, the only SIGN is a _frequent Spitting_.

THIS _Symptom_ ceases (of itself) in due Progress of Time: For as the FOETUS (which as yet is only _sustain’d_ by the better and nobler Part of the BLOOD) grows _bigger_, it requires the _larger Quantity_, and at last the WHOLE of the _Menstruous_ BLOOD for its _Sustenance_; at which Time also the accumulated _Humours_ likewise are lodg’d in their proper Place: _Both_ which _Causes_ being thus remov’d, the _Effect_ ceases of course by degrees. However it is prudent, to prevent this _Evil_, from the beginning of Conception, by proper _Medicines_; but otherways (whenever it happens) unless the FOETUS be endanger’d for want of sufficient Aliment, Time and Patience are the fitted _Remedies_.

CHAP. VII.
_Of the PICA or LONGING._

WOMEN subject to this SYMPTOM, are indeed desirous of _Meat_ and _Drink_; yet commonly of _such_, as is not only _disagreeable_, but also _offensive_ and _prejudicial_ to NATURE.

THE violent _Excess_ of this _vicious_ or _degenerate Appetite_ is wonderful; as frequently appears by many _unnatural Instances_, which I shall forbear mentioning in this Place, for fear of ill Consequences; so that I can only recommend the _Curious_ to the[59]_Authorities_ of the MARGIN.

THE _Cause_ of this _SYMPTOM_ proceeds from the various _Humours_ of deprav’d _Qualities_, inherent in the _Tunicks_ of the _STOMACH_, vitiating the _Ferment_ of the _VENTRICLE_; and so affecting the _Orifice_, that it becomes the very _Seat_ and _Source_ of this _Evil_: from whence arises the _Variety_ of the _Humours_, exciting a strange and uncommon _Variety_ of APPETITE.

THE _Nature_ and _Quality_ of these _HUMOURS_, have occasion’d many learned _Disputes_, which yet remain undecided. But tho’ _Platerus_ takes upon himself to call them _Malignant_ and _Poisonous_, yet it is the _Opinion_ of many _learned Men_, and as excellent _Authors_, that _They_ are not to be justly accounted for, any farther than that they are of an _occult perverse Quality_, generated in the _STOMACH_, from irregular _Diet_, improper _Food_, and bad _Concoction_, attended with an _erroneous Regimen_ in other Cases.

THIS _Symptom_ begins commonly about the 40th _Day_ from _Conception_, and continues to the 4th _Month_: Against which time, part of the _vitious Humours_ are excreted or thrown up by _Vomiting_, and the Remainder (by degrees) imbib’d by the _growing Infant_; which _Humours_ being so consum’d, the _Distemper_ ceases of Course.

THIS _Effect_ is more extreme and disorderly in bearing a GIRL than a BOY; the _pituitous Humours_ having less _Concoction_, because of the want of requisite _Heat_: Which for the same Reason also occasions disagreeable _Flatulencies_, _Belchings_, and _Fluctuations_.

I have, in the Course of my Experience, observ’d this _Evil_ to be most common in _Holland_; partly because of the _thick_ condensed _Air_ of the Country, and partly because the _Commonalty_ of the _Women_ live but on gross and cold Food, Fruit, Acids, _&c._ and are consequently of a cold humid _Temperature_, very subject to this Evil.

THE _Diagnostick Signs_ of this _SYMPTOM_, are Weakness of _Body_, Dissolution of _Limbs_, Gnawing of _Stomach_, Loathing of _wholesome Food_, (and even _That_ very often which the _Party_ lov’d before) _Anxiety_, _Pensiveness_, frequent _Spittings_, and (at several times) _Vomitings_.

IF the _Ventricle_ or _Stomach_ is only slightly affected with some sort of _viscous_ and _frigid Humours_, the _Party_ generally _longs_ for _sharp_ and _tart Meats_; if with _calid_ and _hot_ ones, she craves for those which are _bitter_ and _biting_: But if more severely affected, with _Humours_ of some perverse _occult Quality_, she longs for _strange unaccountable Matters_; and hence it is that all _monstrous APPETITES_ proceed.

BUT if such _Humours_ become _Connatural_ to the _Woman_, by the _deep Impression_ of Diuturnity, she longs for things _resembling_ the very same _Nature_ of the _Humours_: As for Example, if they be of a _burning_ or _parching Nature_, she covets to eat _COALS_, _CINDERS_, &c. if of a _gross_ and _thick Quality_, _CHALK_, _LIME_, &c. if of a _Saltish_ Kind, _SALT_ itself: if of a _Melancholick_ Temper, _EARTH_, _CLAY_, _DUST_, &c. For because, as the Thing _containing_ changes the _Contents_, so the _Contents_ (in process of time, by Force of _constant Impression_) change the Thing _containing_. In like manner as _deprav’d Wine_ imparts a vitious _Taste_ or _Savour_ to the _CASK_, so those _Humours_ convert the Temperature of the _STOMACH_ into their own _Natural Qualities_.

THE Similitude and Dissimilitude of _Humours_ and _Temperature_, may be thus known and distinguished, _viz._ The APPETITE, longing for things of a _like_ or _resembling Nature_ (as above), remains still _unsatisfy’d_, tho’ plentifully indulg’d with the Thing desir’d: Whereas the APPETITE of _different_ or[60]_discording_ Things, having obtain’d the Thing _long’d_ for, is easily _satiated_, and immediately ceaseth.

THIS _Malicious_ or _Lusting SYMPTOM_, is most _dangerous_; degenerating commonly into a _Cacochymy_, _Dropsy_, _Phthisick_, or some other heavy _Disease_.

BUT the greatest Hardship or Misfortune, after All, is _This_; that, if the _Woman_ doth not indulge her corrupt _APPETITE_, she _languishes_ and _pines_ to such a degree, that her[61]Life is often endanger’d, together with the FOETUS, by the Disappointment: and if she does so gratify herself, _This_ often proves of the worst of Consequences, even sometimes to a mortal Fatality.

HOWEVER, in short, this _SYMPTOM_ is like many _Others_, more easily _prevented_, than _cur’d_: Wherefore all _Women_, as soon as they _conceive_, ought (at repeated Times) to use proper _Anti-kittean Medicines_ (that is, against _PICA_ or _Longing_) and be very careful of their _Regimen_ and _Diet_: But when, perhaps, by neglect of those _Means_, the _Distemper_ appears inordinate, the Method of CURE consists in evacuating the Humours, and in absterging, alterating, and corroborating the STOMACH.

CHAP. VIII.
_Of CHOLICKS and GRIPES._

THO’ the _Cholick_ derives its Name from the Gut _Colon_, I mean by it not precisely that _Pain_ which affects _This_ only, but that also which usually invades other _Guts_, whether thin or thick; because one _Gut_ seems not to be more subject than another to this Pain; the _Contexture_ of all of _them_ being the same every where. So that the _Cholick_ is nothing else than a sorrowful _Sensation_ of a very sharp _Pain_, infesting the _Guts_, or the Nervous _Plexus_, or _Membranes_ in their Neighbourhood, proceeding from wandering _Winds_ and _Flatulencies_ in the ABDOMEN, or lower Belly; arising from the _Humours_ aggregated about the WOMB: which, dissipating themselves, distend the _Intestines_, and excite most severe _Pains_ about the NAVEL.

THESE _Effects_ may also proceed from indurated _Excrements_ in the RECTUM; or from any _other Matter_, which either compresses, obstructs, or erodes the _Intestines_: Hence _Physicians_ commonly take notice of _Three_ different Sorts of _Cholicks_; namely, the _Flatulent_, the _Bilous_, and the _Pituitous_.

NOW _These_ are All thus distinguished: The _Wind-Cholick_ traverses the Belly, and gives an excruciating wandring _Pain_ in the VISCERA, or _Bowels_, &c. The _Bilous_ induces a certain Pain, with a very sensible _Mordacity_; and is generally attended with _Thirst_ and a _Bitterness_ in the MOUTH: The _Pituitous_ gives a most sharp penetrating fixed _Pain_, resembling (as it were) a driven _Stake_, or perforating _Instrument_; attended with a _Nausea_, _Vomiting_, and _Retention_ of Excrements, _&c._ This last Sort _Galen_ calls the most cruel CHOLICK.

HOWEVER I take it to be the _First_ of these, which most commonly afflicts the _Conceiv’d Woman_; generated of improper _Diet_, or proceeding from an irregular _Regimen_: And _This_ is also sometimes so excessive, that I’ve seen the _PATIENT_ fall by its Extremity into a _Lipothymia_, or _Swooning-Fit_, which generally presages _ABORTION_, if not seasonably prevented by proper _Discutients_, and convenient _Diet_, _&c._

CHAP. IX.
_Of a DIARRHEA, or LOOSENESS._

A _Looseness_, in my Sense, is an immoderate, frequent and sudden going to STOOL: in which the _liquid_ and _diluted_, as well as _sharp_ and _peccant_, _Excrements_ are voided, which is commonly preceded by the _Belly-ach_ and _Gripes_.

IT differs from a LIENTERIA, in that the _Excrements_ are not indigested, unaltered, or _Chylous_, nor the STOOLS so quick after Meals: As it also differs from the _bloody Hepatick_, and _Hemorrhoidal Flux_, in that no _Blood_, _Matter_, or _Liquor_ like that, in which Meat may have been wash’d, is voided with the _Excrements_.

SOME _Loosenesses_ are call’d _Bilous_, when so much of the sharp _Gall_ is expell’d as tinges the _Excrements Yellow_, however mix’d with other _serous Matter_: _Others_ are call’d _serous_ and _pituitous_, in which viscous watery _Humours_, less impregnated with GALL, are frequently and copiously voided.

THIS _Symptom_ may proceed from a great Variety of _Causes_: For an _Error_ committed accidentally in _eating_ or _drinking_, or any _Irregularity_ in the way of Living may occasion it. [62] _HIPPOCRATES_ and many _others_, justly observe this _Case_ to be dangerous; because it not only relaxes and debilitates the _Body_ of the WOMAN, and _Ligaments_ of the INFANT; but also necessarily impairs its requisite _Nourishment_, and provokes _Nature_ to an _untimely Expulsion_ of the tender Fruit. Which unhappy _Consequence_ ought (by all means) to be prevented, if possible, and the grievous _Affection_ to be cured without any Loss of Time: Now I presume _That_ may be done _first_, by gentle _Abstergents_ and _Corroborants_; and _Then_ afterwards by proper _Restringents_ and _Strengthners_.

CHAP. X.
_Of the TOOTH-ACH._

THE _Cause_ of this SYMPTOM, proceeds from the sharper part of the _Humours_; which, ascending to the _Head_, vitiates the BLOOD, and thence occasions a _effluxion_ of _Rheum_ upon the TEETH: So that _This_ vitious _Rheum_ fixing itself at some of their _Roots_, affects the _Membranous Parts_ so sensibly, that instead of a small _Ach_, it proves a great _Pain_, and almost intolerable _Torment_ to the SUFFERER.

THIS ill _Affection_ may also proceed from some _Frigid_ or _Calid_, _Serous_ or _Salt-Humour_, falling down upon the _Membrane_ of the JAWS, or _Nerves_ of the TEETH: Where, if it corrupts and lies putrefying, it commonly engenders WORMS.

IN all which _Cases_, I humbly conceive, it may be _cur’d_ by Variety of respective _Means_, according to the different Quality of the CAUSE, whether _Frigid_, _Calid_, _Serous_, _Saltish_, or _Acrimonious_: Otherways it ceases (of itself) in process of Time, by good Conduct and keeping warm, &c.

CHAP. XI.
_Of the HEAD-ACH._

OF all the _Parts_ of the Body, the HEAD is most expos’d to _Pains_; that is, to a troublesome and grievous _Sensation_ of the _Membranous Parts_; proceeding from _Vapours_ of the noxious _Humours_; which ascending to the HEAD, distend and rend, in a manner, the _Membranes_ of the BRAIN.

THE _Parts_ most commonly affected, are the _Hairy Scalp_, the _Pericranium_, and the _Diploe_; That is, the medullous _Duplicature_ of the CRANIUM, otherways call’d the _Meditullium_: For these _Parts_, by a continual _Solution_, when it happens so, are always most severely pain’d. But besides, in a _Woman_ that has conceiv’d, the _Pains_ commonly shift and move from one Place, to another, of the HEAD; and take certain _Intervals_, longer or shorter, betwixt their _Access_ and _Recess_.

BUT as the _Infant_ grows, and exhausts a greater Quantity, or at last the _whole_ of the BLOOD; and as the _Humours_ fix in their proper Place: So this SYMPTOM gradually goes off, and quite ceases.

HOWEVER, in case the _Accesses_ be long and violent, they may be discreetly _cur’d_ by repelling and mitigating _Applications_, or by peculiar _Corroboratives_ and _Discutients_, or proper _Alteratives_, according to the _Nature_ and _Quality_ of the CAUSE. I refer what may be farther added on this Head, to _Sect._ IX. _Chap._ 3.

CHAP. XII.
_Of the MEGRIM, or VERTIGO._

THIS _Symptom_ begins with a _Swimming_, _Giddiness_, or _Dizziness_ of the HEAD, and proceeds (in the _conceiv’d Woman_) from _Vapours_ of the _Humours_; which, ascending partly thro’ the _Veins_ and _Arteries_ tending to the BRAIN, and partly thro’ the OESOPHAGUS or _Gullet_, disturb the Animal Spirits.

NOW This _Distemper_ is _Two-fold_, and distinguished by the Words VERTIGO and TENEBRICOSA; which last the _Arabian Physicians_ have call’d _Scotomia_, I suppose from the _Greek_ Word Σκοτος, _Tenebræ_, Darkness; and is now generally receiv’d by that Name.

BUT because this sad _Affection_ is too common to both _Sexes_, young and old, I shall proceed to a farther Dilucidation of it, for the universal Good and Benefit of All.

FIRST then, the[63]_VERTIGO_ is a deprav’d _Imagination_, attended with the vitiated SENSES of _Hearing_ and _Seeing_; proceeding from the violent Commotion of the _Animal Spirits_. _Secondly_, The _SCOTOMIA_ is also a deprav’d _Imagination_, accompany’d with loss of _Sight_, and sometimes of the _Motion_ of the _Animals_ affected with it, because of some _Interruption_ in their circular Passage. In the _first Case_, the _PATIENT_ imagines his Head only to be turn’d round, or winded about: In the _other_, he thinks that _circular Motion_ to consist in the _external Objects_.

NOW the _VERTIGO_ is attended with the vitiated SENSE of _Hearing_, as well as _Seeing_: Because, as something like a _Cloud_, _Smoak_, or _Web_, seems to appear before the PATIENT’s _Eyes_; so there is a certain _Whistling_, _Hissing_, or Tinkling always in his _Ears_. The SCOTOMIA, in like manner, is attended with Loss of _Sight_, and _Motion_; because of some _Disorder_ of the _Ventricles_ of the BRAIN obstructing or impeding the _Transition_ of the SPIRITS.

IN the VERTIGO, an _Agitation_ happens in the _Membranes_ of the VEINS and ARTERIES, as also in the _Membranes_ of the BRAIN; by which violent _Motion_, the very _Continent Parts_ are vehemently shaken and concuss’d, and at length so disquieted, that the PATIENT thinks his HEAD wheels round about.

IN the SCOTOMIA, the _Animal Spirits_ having in themselves the _Species_ of all Sensibles, and those _Species_ being presented to the _Imagination_: As such _Images_ of external _Objects_ are moved in it, so the _Party_ thinks the same _real Objects_ to be moved. For, according to _Avicen_, it is the same thing, whether that which is _seen_, or that by which we _see_, is moved: As seeing _Land_ from on board a _Ship_, in a smooth Sea, being insensible of the _Ship’s Way_, we imagine (and sometimes very strongly too) that the LAND is in _Motion_.

THAT by which we _see_, is the _visible Species_ reserved in the _Spirit_: Hence when this _Species_ is moved, the _external Object_ seems also to be _moved_.

BUT in explaining the _Circular Motion_ of the _Animal Spirits_, we must consider it to be _twofold_; namely, _Natural_ and _Preternatural_: The _Natural Motion_ is that which begins in the _Carotide Arteries_, thence tending to the _Plexus Choroideus_, or the _anteriour Ventricles_ of the BRAIN; from _These_ to the _middle_; from the _middle_ to the _Posteriours_; and from the _posteriour Ventricles_ of the BRAIN, the _Spirits_ are imparted to the NERVES. The _Preternatural Motion_ is just the _Reverse_ of this Case.

THE _Causes_ of both these Cases and Conditions are either _immediate_ or _mediate_. The _immediate Causes_ may be reduced to _Three Classes_; to wit, _Causes_ of an _inordinate Motion_ of the Animal Spirits, _Causes_ of the _Circular Motions_, and _Causes_ of lost _Sense_, _Sight_, and _Motion_.

THE _Causes_ of the _Spirits_[64] moving inordinately, are either _External_ or _Internal_. The _Externals_ are the _Sun_, _Hot Baths_, _Frictions_, and _Concussions of the_ HEAD; or a _Fall_, _Blow_, _Contusion_, and all inordinate and immoderate _Motions_ of the whole Body: such as _Running_, _Leaping_, _Riding_, _Dancing_, too much _Venery_, or hard _Drinking_; as also the Use of _Acids_, or acrimonious Things, and all Things replenishing or stuffing the HEAD; such as _Garlick_, _Mustard_, _Anise_, _Parsley_, _Leeks_, _Onions_, _Radish_, strong _Snuffs_, _Drinks_, &c.

THE _internal immediate Causes_ are the _Imagination_ of the PATIENT, _Vapours_ of the whole Body, frigid _Flatulencies_, and[65]a sudden _Fluxion_ of the _vital Spirits_ into the HEAD.

THE _mediate Causes_ are _Material_; and this _Matter_[66] (almost all _Physicians_ agree) is _frigid_. From hence it is certain, that the _Distemper_ proceeds from _Crudities_, and _Victuals_ of a crude Juice; such as _Pulses_, _Cheese_, _Tarts_, _Fish_, and all _other Sorts_ of the like frigid and humid _Qualities_: But _these_ are only to be reckon’d _concurring_, not _efficient Causes_.

THE most common _material Cause_ is, according to _Galen_[67], the BILE; which, seeking for Vent at the _Mouth of the Stomach_, is the _Cause_ of these _Symptoms_, and is[68]properly to be educed or evacuated by a due _Vomit_.

BUT in Case of VAPOURS, _Heat_ is always the _efficient Cause_, elevating them from the peccant _Matter_; since a _Cold_, or a refrigerated _Body_, can never engender VAPOURS or _Wind_ from any Material Cause.

I shall not now enter upon the particular _Diagnosticks_ of this _Distemper_, because they are as _Various_, as the _Causes_, and affected _Places_ are different. Let me observe only, that the _simple_ VERTIGO is easily known by the _Imagination_ of the _Circular Motion_ of the _Patient’s_ HEAD, or That of _external Objects_, or by vitiated _Seeing_ and _Hearing_.

BUT the SCOTOMIA differs from the VERTIGO, in that besides the _Imagination_ of the _circular Motion_, the PATIENT often loses his _Sight_, staggers, tumbles, or falls to the Ground. And yet the _same_ is distinguished from the _Epilepsy_, in that the PATIENT retains his principal _Functions_, and neither _Foams_ at Mouth, nor is _Convulsive_.

HOWEVER, as to the _Distinction_ of Causes, if the _internal Cause_ proceeds from _Calidity_, it is known by the _hot Temperament_ of the whole Body, as well as by a _Swelling_ and _Pulsation_ of the ARTERIES about the _Throat_: Besides that this VERTIGO easily _accedes_ and _recedes_, it is always attended with _Calidity_ and _Redness_ of Face and Eyes; with _Watchings_, _Deliriums_, &c: And it commonly follows _Fevers_, _Watchings_, _Anger_, the _Use of Calids_, hot Things, _&c._ In which _Cases_, it is always to be helped by the _Use of Frigids_, or Coolers.

IF it arises from _frigid Flatulencies_, the _Paroxysms_ or Fits are preceded by a _Hissing_ or _Tingling_ in the EARS; the PATIENT turns _pale_ and _wan_, and is taken with an odd extensive _Pain_ of the HEAD: And if these _Flatulencies_ generate in the HEAD, the _Party_ feels it _ponderous_, _lumpish_, and _heavy_; and is consequently much inclin’d to _Sleep_, _Stupidity_, _Dullness_, and _Inactivity_.

IF the _Distemper_ is derived from a _flatulent Stomach_, the _PATIENT_ is troubled with _Rifting_ and _Rumbling_ of the Belly; with _Sobbing_ and _Sighing_, with _Hickups_, _Yawnings_, _Extensions_, _Inflations_, and frequent _Spittings_.

IF it comes from a _Mordacity_ of the _Mouth of the Stomach_, the _Party_ is infested with a _Nausea_, _Loathing_ and _Fastidy_; with a Dejection of _Appetite_, a lasting or frequent _Thirst_, and a _Bitterness_ of the Mouth. But this _Affection_ also very often proceeds from the WOMB, and that either because of the suppress’d _Menstrua_, or longretain’d _Seed_; as will hereafter more fully appear in _Sect._ ix. _Chap. 8_.

AS to the _Prognosticks_ of this _Distemper_, it does not always seem _Dangerous_, much less _Lethal_, at first; but its _Consequences_ are (however) very _Fatal_[69], if not timely prevented: For it often turns to _Inflammations_[70] of the HEAD, or _Convulsions_; sometimes to _Melancholy_ or _Madness_; and sometimes to _Epilepsies_ or _Apoplexies_.

NOW because this _Affection_ observes _Lunar Periods_, and in extreme Cases, is near a-kin to the _Falling-Sickness_;[71] _Cœlius Aurelianus_ informs us, That it was call’d by the _Ancients_ the _little Epilepsy_: And as it admits of _periodical Accessions_ and _Circulations_ (I mean coming and going _Fits_) which depend chiefly upon the Power and Influence of the _New_ and _Full-Moon_; so it is to be treated with respect to _Cure_, in a different manner; one way in the _Access_, another in the _Interval_.

BUT this _Cure_ is as different, as the Causes and Degrees of the _Distemper_ are various; wherefore I can, by no means, enter upon it in this place, for Brevity-sake.

CHAP. XIII.
_Of the SYMPTOMS of the middle Three Months._

THE FOETUS having receiv’d a distinct FORM, constituted of various _Organical Members_, and produced of divers _substantial Matters_, takes a various _Situation_; the different _Members_ possessing different _Places_, according to the _Institution of NATURE_.

AFTER an absolute and compleat _Conformation_ of ORGANS, the rational _Soul_ is infus’d and adapted; which is the ultimate Perfection of the _Human_ FOETUS: By which it becomes MAN and receives _Life_, living and subsisting henceforward by its own vivacious _Faculties_, distinct from those of the MOTHER. Now the Great and All-wise CREATOR undoubtedly is the only _Supream_, _Efficient_, and Immediate _Author_ and _Finisher_ of this noble _Work_; which, according to the nicest _Calculation_ of the greatest _Masters_ of _Nature_, is most commonly accomplished about the _Beginning_ of these _Middle Months_: At which time, the usual _Turn of Nature_ necessarily occasions different _Effects_ to the _Child-bearing Woman_; which are call’d _SYMPTOMS_ of the _Middle Months_.

AND these _SYMPTOMS_, in short, I reduce to the following _Seven_ in Number; _viz._ 1. _Coughs_; 2. _Palpitations_ or _Heart-Beatings_; 3. _Swoonings_ or _Syncopes_; 4. _Watchings_; 5. _Pains_ in the _Hips_ and _Loins_; 6. _Hemorrhages_ or _Bleedings_; and, 7. _Fluxes_ of _Blood_. Of which, in their due Order.

CHAP. XIV.
_Of COUGHS._

COUGHS are either _Humid_ or _Siccid_: They are call’d _Humid_, when the _Humours_ contain’d in the _Aspera Arteria_, of whatsoever Nature, are expell’d by its own Force thro’ the _Mouth_. And _Siccid_, or dry COUGHS, when, notwithstanding great Pains and Trouble, nothing is _excreted_, only the whole Body fatigued by a continual irritated Endeavour to _Cough_ and _spit-out_; whence arise Pains of the _Head_, _Hypochondriacks_, and other Parts.

THE _Cause_ of which _SYMPTOM_ is _Four-fold_, and proceeds either from the sharp acid _Vapours_ of the _Humours_ flying towards the _Lungs_, _Wind-pipe_, and _Jaws_; irritating the natural Faculty to _Expulsion_: Or, from the finer Part of the _Blood_, converting itself to the _pectoral Veins_: Or, from the _Humours_ themselves ascending to the _Head_, and relapsing upon the _Breast_: Or, in fine, from the suppressed _Albedines_ or WHITES, and whatsoever may vellicate the _Aspera Arteria_, or in any respect oppress or irritate the _same_.

THIS _Symptom_ (however slighted or lightly esteem’d) is very Dangerous; forasmuch as it attenuates and weakens the _whole Body_, enervates or destroys its _Strength_ and _Vigour_, causes difficult _Respiration_, excites _Head-Aches_, hinders _natural Rest_, occasions _Watchings_, promotes Defluxions, and finally gives _Origin_ to _Fevers_, as well as most other _Diseases_: Besides that, it continually exagitates and distresses the _Muscles_ of the ABDOMEN, or lower Belly; and thereby too commonly provokes _Miscarriage_.

FOR these Reasons this _SYMPTOM_ ought to be carefully _mitigated_, if not _cur’d_, without any loss of Time: But the CURE itself, in my humble Opinion, may be easily effected, by evacuating the _peccant Humours_, by purging and corroborating the _Head_, and by the right _Use_ of proper _Thoracick Medicines_.

CHAP. XV.
_Of HEART-BEATINGS and SWOONING-FITS._

THESE Beatings or _Palpitations_ are nothing else but a sudden Loss of all the Strength, with an immoderate _Concussion_, by a vehement _Diastole_, and molestous _Systole_ of the _HEART_: From hence this _SYMPTOM_ easily turns to a _Cardialgia_, _Lipothymia_, or _Syncope_; which are _All_ of near _Affinity_, in the Case of the _Pregnant Woman_, so that I shall treat of them _conjunctly_, and first observe; that

THE _Cause_ of all such _SYMPTOMS_ are but _Two-fold_, and proceed either from a _flatulent_ Substance of the _Humours_, ascending, thro’ the _Arteries_, or the _Vena Cava_, to the _HEART_: Or from the _Abundance_ of BLOOD, which (not finding passage by the WOMB) seeks to the _superiour Parts_, and thence oppresses the _HEART_ and _vital Faculty_.

THIS _Last_ is the most dangerous _Condition_, being (in such _Plethorick Women_) the certain _Prognostick_ of imminent _ABORTION_: To prevent which unhappy _Accident_, the principal Part of the CURE, depends very much on cautious _Venæ-Sections_, or letting Blood, proper _Diet_, &c: Whereas, in the _First Case_, proper _Discutients_, _Cordials_, and _Corroborants_, are the most convenient and successful.

CHAP. XVI.
_Of WATCHINGS._

THIS _Symptom_ is nothing else, more than an immoderate _Exercitation_ of the SENSES, from too great a _Motion_ of the _Animal Spirits_: Proceeding from some acrimonious and siccid _Vapours_ of the _Humours_, ascending to the BRAIN, and there disturbing the _Spirits_, by exciting their vehement Motion; which so exagitates the SENSES, that the vigilant restless _Woman_ gets either none at all, or but very _short Sleep_.

THIS watchful _Affection_ is distinguished by a _siccid_, or _calid_ and _siccid Intemperature_; attended sometimes with a _Melancholick_, _Bilous_, or _Pituitous_, _Saltish_ Matter; which is either essentially lodg’d in the HEAD, or communicated to it from the _Mouth of the Stomach_, or the Veins of the whole Body.

SOME have been so overtaken with this _SYMPTOM_, that they have not only continued _Awake_ for some Days and Nights, but also Weeks and Months: Insomuch that _Hercules Saxon_[72] relates of his own _Father_, that He, being melancholick, suffer’d such like WATCHINGS, without the least SLEEP, _seven Months long_.

HOWEVER in the _Child-bearing Woman_, the least Degree of such immoderate _WATCHING_[73] is dangerous; insomuch that it often occasions _Deliriums_, and _Convulsions_, by the continual Stretch and _Tension_ of the FIBRES.

HOWEVER the CURE of this _SYMPTOM_ may (I hope) be well perform’d both by _external_ and _internal Means_; externally, by proper _Lotions_, _Inunctions_, and _Frictions_; internally, by proper Soporiferous _Medicines_ adapted to the Quality of the Intemperature.

CHAP. XVII.
_Of PAINS in the Hips, Loins_, &c.

ALTHOUGH these _PAINS_ (in general Terms) are the _Effects_ of the _Compression_ of the extended WOMB, hanging on, and bearing too much upon the neighbouring _Parts_, by its Gravity and Weight: Yet the particular _Cause_ of such _SYMPTOMS_ (in my Opinion) is _Two-fold_; and proceeds either from the Abundance of BLOOD lodging in the _Veins_ of those Parts; or from the growing FOETUS, so extending the _Ligaments_ of the WOMB, as to oblige the neighbouring Parts to sympathize. From hence the _broad Ligaments_ cause the _PAINS_ of the _Back_ and _Loins_, answering to the _Reins_, to which _Parts_ they are strongly fixed; as the _round Ones_ affect the _Groins_, _Hips_, and _Thighs_, where they terminate. Which _Ligaments_ are sometimes so violently extended, especially in the first Time of _Pregnancy_, that (by the Concurrence of any slight _procatarctick Cause_) they have been often known to break.

THE _Cure_ of these _SYMPTOMS_, in the _first Case_ above-mentioned, depends chiefly upon cautious _Phlebotomy_, and good _Repose_ in Bed; and in the _Second_, upon proper _Swathes_, _Unguents_, &c.

CHAP. XVIII.
_Of HÆMORRHAGIES, or BLEEDINGS._

THESE _Symptoms_ are to be understood to happen only from the superiour Parts; as _Nostrils_, _Mouth_, or _Ears_: And the _Cause_ seems to be _Three-fold_: proceeding either from a more than ordinary _Plenty_ of BLOOD; or from a gross Mixture of _Humours_ and BLOOD, prompting Nature to _Excretion_; or, lastly, from a _Debility_ and _Weakness_ of the INFANT, when not able to attract the due Quantity of BLOOD to its _Subsistence_.

IN the _first Case_, the _Woman_ usually looks _sanguine_ and well-colour’d, and hath more _Plethorick Marks_ upon her; which, if it happens, without any great _Inconvenience_, as it is without _Danger_, the _Woman_ may easily bear and dispense with it.

IN the _second Case_, the BLOOD so lost falls dropping away, and with _Pain_; it is ugly and _ill-colour’d_, of an _acid Quality_, and _stinking Smell_: And the PATIENT hath more _Cacochymic Signs_ upon her, whereby she is threatned with _Abortion_ and imminent Danger.

IN the _third Case_, the SIGNS of a _Debilitated Fœtus_, and instant _Abortion_, are evidently presented; as mention’d in Chap. 29, and 30, of this _Section_: When, if she chance to escape _Miscarriage_, (which most commonly happens in this _Condition_, if not timely and artfully prevented) a difficult and laborious BIRTH is the certain _Consequence_; and sometimes a protracted Time of BEARING to the _Close_ of the 10th, or (as I have observ’d) to the _Beginning_ of the 11th _Month_.

THIS _Symptom_ is to be judg’d of, and _cur’d_ according to the above-mention’d, and what other concomitating _Diagnostick Signs_ appear.

CHAP. XIX.
_Of FLUXES of BLOOD._

THIS _Symptom_ is to be understood to happen from the _inferiour Parts_; namely, by way of the _Hæmorrhoidal Veins_, or by the _Passage_ of the WOMB, but most commonly by the _Last_.

THE _Cause_ then of this _SYMPTOM_, happening by the _Hæmorrhoids_, is _Three-fold_; and proceeds, either from too great a _Quantity_ of BLOOD abounding; or from the disorder’d and deprav’d _Quality_ of that BLOOD; or from _Both_ these _Indispositions_ jointly: And this sanguine _Affection_ is commonly without any great Danger (tho’ not without some Trouble) to the _Woman_; ceasing gradually (of itself) after a safe and successful _DELIVERY_.

THIS _Symptom_ from the WOMB, happens _Four_ different Ways; to wit, either by the _Vessels_, which run to the _Neck_ of the WOMB; or by _Those_, which tend to the _Body_ and _Cavity_ of the SAME; or by _Those_, that adhere to the _Membrane_ call’d CHORION, and to the _Infant_, by which it attracts its _Nutriment_; or by _Those_, that _Nature_ hath reserv’d for a _Superfœtation_, or the _Necessity_ of expurging this BLOOD when it chances to be Superfluous.

WHATEVER way this FLUX happens, its _Cause_ is _Three-fold_; and proceeds, either from an _Apertion_ of some of the mentioned _Uterine Vessels_; or from their _Dilatation_; or from a _Rupture_ of those Vessels.

THEY are _open’d_ by a _Redundancy_ or _Superfluity_ of BLOOD; which _Wise Nature_ takes this _Method_ of fiercing and throwing-off, the _Natural Evacuation_ being stopped. They are _dilated_ by the _Acrimony_ of the _Humours_, or by their own rarefy’d and thin _Contexture_, And, in fine, they may be _bursten_ or _broken_, by a great Variety of _Accidents_; such as _Running_, _Leaping_, _Falling_, _Striking_, _Lifting_ a heavy Weight, violent _Motion_, _Coughs_, great _Pains_, _Vapours_, _Costiveness_, _Looseness_, immoderate _Heat_, or _Cold_; as also by any violent _Perturbation_ of Mind.

THE _First Case_ (being the Work of _Nature_) happens with great Ease, and without any Pain or Trouble; it _flows_ moderately and regularly, is of _short Continuance_, and not attended with any immediate _Danger_, so long as the _Woman_ enjoys her _Health_, and continues well-colour’d in _Complexion_.

THE _Second Case_ is called an ANASTOMOSIS; and what happens by such irregular _Dilatations_, falls _Drop_ by _Drop_ away; and is All _Acid_, _Ill-colour’d_, _Stinking_, _Thin_, _Pale_, _Serous Stuff_.

THE _Third Case_ is known by an immoderate and irregular _Flooding_, as it were in _Heaps_; attended with PAINS of the _Groins_, _Loins_, &c: And at last aggravated with _Faintings_ and _Convulsions_. The true STATE of which _Case_ is particularly noted in Sect. V. Chap. 7. Only give me leave to add here, that the _Procatarctick Cause_, is always sufficiently known, from the _Relation_ of the PATIENT.

BUT however, it is also proper to know in all the above-mention’d _Cases_, from what _Place_, and by what _Vessels_ this _Flux_ happens: Which may be rightly thus distinguished; for if from the _Neck_ of the WOMB, it flows orderly and moderately; as it likewise does, if it comes from _Vessels_ no ways adhering to the INFANT: but if it arises from the _Bottom_ of the WOMB, it flows in less _Order_, and greater _Quantity_; and if it happens, in fine, from the _Vessels_ fixed to the INFANT, and the CHORION, then it does _flow_ most irregularly of all, and in very great _Quantities_.

THE _Prognosticks_ of this _SYMPTOM_ are, either a[74] weak debilitated INFANT, or an approaching _Abortion_: But besides also, it sometimes portends a _hard_, _laborious_, and _protracted BIRTH_, perhaps even to the 11th _Month_.

WHICH _Prognosticks_ are indeed founded upon sufficient relative _Reasons_: The _First_, because the _INFANT_ is not able to convert the _whole_ of the _superabundant_ BLOOD, to its _Aliment_: The _Second_, because the _INFANT_ (tho’ perhaps Strong and Able enough) is depriv’d of its requisite _Sustenance_: The _Third_, because (according to _Hippocrates_, &c.) a _sickly Gestation_ always indicates a difficult and laborious _BIRTH_: And besides the reason of a _protracted Birth_ (beyond the _ordinary Time_) is very plain and perspicuous; because, if a _strong healthy CHILD_ requires _two Months_, to recover itself after the first _Onset_ or _Attempt_ of the _7th Month_, (as is more amply explain’d in _Chap._ 34. of this Section) it is but highly reasonable to think, that a _weak sickly One_, requires a _longer Time_ of Gestation.

THE _first Case_ of this _SYMPTOM_, seems to be the most favourable of the _Three_; yet I would advise such _Sanguine_ or _Plethorick Women_, to guard against _one ill Consequence_, which I have known sometimes to happen in the same burthensome _Condition_: Namely, that from too great a _Plenty_ or _Superfluity_ of BLOOD, it sometimes runs through the _interiour Veins_ into the _Cavity_ of the WOMB, which renders the _Case_ by far the most dangerous; because this BLOOD[75] (being out of its proper _Canal_ or _Center_) irregularly extravas’d, immediately _corrupts_ and _suppurates_; which corrupted BLOOD, in Concert with the _INFANT_, (whose _Aliment_ is thereby impair’d) always obliges the WOMB, to dilate and yield up its _Contents_: So that, in short, this particular _SYMPTOM_[76] is, in all its different Cases or Conditions, the most Pernicious and Dangerous.

WHEREFORE it is, that the respective CURES of these sundry _Cases_, belong only to the Ablest _Physician_, and _That_ (most properly) to _Him_ who professes and practices MIDWIFERY: Because, when _Medicinal Helps_ fail, and cannot prevent _Misfortunes_, HE will at least know best then, how to _Compose_, and _Mitigate_ them, by delivering the Woman, if Necessity so require.

CHAP. XX.
_Of the SYMPTOMS of the last three Months_.

TWO _third Parts_ of the common Duration and Conjuncture of CHILD-BEARING, being, by this time faithfully, if not so fully, accounted for; it remains now, that we also more particularly consider the MOTHER and her INFANT throughout the last _Three Months-Travail_. These are the _Finishing Maturating Months_ of the _INFANT_: I mean peculiarly, as to its _Strength_ and _Vigour_; since in other respects, the _Middle Months_ have duly _perfected_ the Ornaments of the _particular Members_, and gracefully compleated the SHAPE and FORM of the whole Body.

WHEREFORE, as, in these _latter Months_, the _CHILD_ encreases in _Bulk_, _Vigour_, and _Activity_, it then affords the tender MOTHER incredible _Uneasinesses_, and grows sometimes almost _Obstreperous_: Which _Augmentation_ of the FOETUS (of natural Consequence) occasions in her Constitution of Body various different _Effects_; call’d _SYMPTOMS_ of the last _Three Months_.

NOW these _SYMPTOMS_, I hope I may pertinently reduce to the following _Nine_, in Number; namely, 1. _Dysuries_; 2. _Ischuries_; 3. _Stranguries_; 4. _Costiveness_; 5. _Tenesms_; 6. _Varices_; 7. _Inflations_ of the _Legs_; 8. _Fissures_ of the Belly; and 9. and lastly, _Water-Fluxes_. Of which I shall take leave to treat separately, in their proper Order.

CHAP. XXI.
_Of DYSURIES, ISCHURIES, and STRANGURIES._

THE _Dysuria_ is a painful and difficult _Excretion_ of _Urine_; as the _Ischuria_ is an entire _Suppression_ of the SAME: And the _Stranguria_ nothing but an _Effect_ of the other TWO; being an _Excretion_ made Drop by Drop, with a continual _Stimulation_ or _Propensity_ to make Water, however without any acute _Pain_, tho’ not without some _Uneasiness_.

NOW these _three SYMPTOMS_ have all their respective _Causes_, which I shall not particularly enter upon here at large; but only, take notice by the By, that in the _Pregnant Woman_, they most commonly proceed from _One_ and the same _Original_: Wherefore I shall in this Place discourse of them _conjunctly_; and observe that all three _SYMPTOMS_ may proceed from the _ponderous_ WOMB, lying upon, and depressing the _Neck of the Bladder_; and _that_ the more heavily, the nearer the _Woman_ is to her TIME. The _pungent Acrimony_ of the URINE sometimes also occasions _Incontinence_, or want of _Retention_; as its _Inflammatory Heat_ causeth almost a total _Suppression_. However, in short, such _SYMPTOMS_ may likewise proceed from some _crude_ and _unconcocted Matter_, obstructing and oppressing the _Sphincter-Muscles_.

BE _That_ as it will, in the present _Case_, the CURE is but very seldom of great _Difficulty_; being frequently effected, by lifting up the _Bottom of her Belly_ with both Hands when she is about to _make Water_: Or, by wearing a convenient large SWATHE. But if Need require, the _Region_ of the BLADDER may be cherished with proper _emollient Fomentations_, _Injections_, or _Cataplasms_; as (upon any _Extremity_ at last) a CATHETER may be prudently used.

IF the _SYMPTOM_ however proceeds from any _Inflammatory_, or _Acrimonious Quality_ of the URINE; it may be sufficiently helped by a proper, regular, cooling _Diet_: As, if it arises from any _undigested_, _crude Matter_; it may be assisted or reliev’d by a good _Draught_[77] of _warm_ generous _WINE_; which not only helps _Concoction_, but also facilitates and promotes _URINE_: But in case of absolute _Necessity_, after all, gentle PHLEBOTOMY ought to be carefully used.

CHAP. XXII.
_Of COSTIVENESS._

THE _Belly_ discharges it self sometimes more _seldom_ or infrequently; sometimes with more _Pain_ and _Difficulty_; and sometimes in less _Quantity_ than is convenient for _Nature_.

THERE have been many _Instances_ given of this _Disorder_, by[78]Learned Men, where some PATIENTS have gone to _Stool_ but once in _Eight_, once in _Fourteen_, and once in _Twenty_ or more _Days_.

YEA,[79]_Dominicus Panarolus_ relates of a certain Friend of his, whose _Belly_ was so exsiccated, that he sometimes liv’d three _Months_ without going to _Stool_.

BUT what I mean by _Costiveness_, is not that Distemper, where there is a total Suppression, for that rather belongs to the _Iliack Passion_; but that only, where the _Excrements_ lodging longer than their due natural _Time_, perhaps three or four Days more or less, are at last voided hard and dry with some small Straining.

Which irregular _Accident_ may proceed from many different _Causes_. Although in the _pregnant Woman_, I take the following to be the most _Common_: That is to say, the _Calidity_ and _Siccity_ of the _LIVER_, or _SPLEEN_; occasion’d by the _Lusty Child’s_ attracting too much of the _Radical_ and Succid _Moisture_ of the _MOTHER_, and compressing the _Intestines_.

THIS _Symptom_ proves often of dangerous _Consequence_: For by the pressing _Force_, commonly us’d in such a _Case_ to ease the BELLY, some _Vessels_ or _Ligaments_ may be easily and readily _broken_. And not only so, but the retain’d _Fæces_ always affect the HEAD, and contaminate the BLOOD with noxious _Vapours_; and thereby impede or hinder the _Concoction_ of the _Ventricle_, and the Separation of the better and purer, from the grosser and impurer part of the _Chyle_: Whence proceed many other various _Disorders_ to the whole _Body_, from the long Retention of the _Excrements_.

THE _Cure_ consists in temperating the _Calidity_ of the _VISCERA_, and relaxing the _BELLY_ by proper _Diet_, _Dissolvents_, &c. And in _Case_ of any sudden _VOMITING_, which sometimes happens upon _Costiveness_, humectant and emollient _Clysters_ may be most properly and cautiously used, to restrain and prevent all such _Revulsions_.

CHAP. XXIII.
_Of TENESMS._

A TENESMS is an irregular _Retention_ of NATURE, and nothing else but a continual _Desire_ or _Inclination_ of going to _STOOL_; attended with _Pain_, without voiding any thing but _Slime_, or an indigested MUCOSITY: And this is in the ANUS, what a _Strangury_ is in the BLADDER; being _Both_ a violent _Contraction_ of the FIBRES, or _Disorder_ of the SPHINCTER-MUSCLES.

WHICH tenacious _Symptom_ proceeds from a great Variety of _Causes_, occasionally provoking the _expulsive Faculty_ of the _strait Gut_, call’d the RECTUM, without a _Power_ to expel; such as may happen to be an unusual _Exulceration_, or _Constriction_ of, or an _Acid-Salt-Humour_ in the same INTESTINE: So likewise a _Stone_ in the Neck of the BLADDER, a _Tumour_ of the adjacent _Parts_, or seminal _Vessels_, a frigid _Intemperature_, the _Hemorrhoides_, a _Dysenteria_, _Dysuria_, _Ischuria_ or _Stranguria_, &c. may very shrewdly occasion the TENESMUS.

WHICH binding _SYMPTOM_ is of the same dangerous _Nature_ and[80]_Consequence_ with the preceding _Case_; both having an equal _Effect_ of Power, if not prevented, to expel and dislodge the INFANT. Which _Notion_ cannot be otherways better maintain’d; for the WOMB being situated upon the _Intestinum Rectum_, must suffer great _Commotions_ by continual _Needings_ and _Strainings_ in both Cases.

BUT the safest CURE, in short, in my humble Opinion, is to be perform’d by proper _Decoctions_, _Fomentations_, and absterging _Clysters_.

CHAP. XXIV.
_Of the VARICES, or Vein-Tumours._

THIS _Symptom_ is nothing else, than a _Distention_ or _Dilatation_ of the HIP, THIGH, and LEG-VEINS: Which however chiefly appears about the HAM; and it happens most commonly to _Plethorick Women_, who walk much, or exercise themselves more freely upon any Occasion.

THE _Cause_ proceeds only from a _Plenty_, or _Superfluity_ of the suppressed BLOOD, more than the _Infant_ can consume: which being carry’d by the _Arteries_ to the _lower Parts_, is thence received by the _Crural_ and _Saphene_ or _Ankle-Veins_. Insomuch that the WOMB, being (by this time) both _Ponderous_ and _Bulky_, so presseth the ILIAC-VEINS, that it hinders the BLOOD in its _Course_, and obstructs its free _Motion_ and _Circulation_; whereby (of consequence) these _inferiour Veins_ must swell and distend themselves proportionably.

HOWEVER, the _Danger_ of the _SYMPTOM_ is not great; because after a safe _BIRTH_, when the super-abounding BLOOD and _Humours_ are evacuated, these preternatural _Tumours_ settle, and the VEINS return to their _Pristine State_.

WHEREFORE the only necessary _Relief_ of this Malady, consists chiefly in the _Woman’s_ abstaining from too much _Walking_, and all other extravagant _Exercises_; upon indulging her _inferiour Limbs_, by keeping them rais’d upon a _Couch_ or _Stool_, that the BLOOD may not settle too much to these _lower Parts_: Or (which is far better) let her prudently keep her _Bed_; in which _Posture_, the BLOOD can meet with no such _Difficulty_ in returning by these _Veins_ to the HEART, as it will find when it must ascend by the _Woman’s SITTING_ or _STANDING_ upright; so that consequently it must needs _circulate_ the more readily and with more _Ease_. Hence in short, it is, that from this more Free and Easy CIRCULATION in _Bed_, such _Women_ are always more easy, or better dispos’d, and far less _pain’d_ or troubled in the _Mornings_, than at _Nights_, in This Condition.

BUT if, after All, the _PATIENT’s_ Convenience will not permit such _Indulgences_, Then a proper _Swathe_ of three or four Fingers Breadth, is most adviseable; beginning to _swathe_ this _Varicose_, or _Swelling Part_, from the _Bottom upwards_, as far as the _Varices_ or _Tumours_ extend. But in Case of more _Plethorick Marks_, at last, in the _other Parts_ of the Body, _Phlebotomy_ may be most safely made Use of.

CHAP. XXV.
_Of the INFLATIONS and TUMOURS of the LEGS._

THESE bloating _Symptoms_ not only happen to some _Women_ before, but also after _BIRTH_; especially when the LOCHIA, or Child-bed Cleansings, do not flow in a regular _Measure_ or sufficient _Quantity_.

THE _Cause_ of the present disorder’d _Case_, proceeds either from the Suppression of some _Aqueous Flux_ of the WOMB; or from some such _watery serous_ BLOOD descending to the LEGS; or from the Abundance of retain’d _Menstruous_ BLOOD, more than the INFANT can dispense with: which, being of no Service either to _MOTHER_ or _CHILD_, settles downwards to these aggriev’d _Parts_. But _these Things_ are to be considered with this Distinction and Difference, that if the _LIVER_ be debilitated, and the BLOOD becom’s _Pituitous_ or _Aqueous_, the _Woman_’s LEGS are so _Oedematous_ or _Tumid_, that when pressed with the Finger, it leaves the Impression of a _Dent_ and _Hollowness_: But if the BLOOD grows _corrupted_ and _bilous_, her LEGS are _inflam’d_, and sometimes occasionally _exulcerated_, as in _Scorbutick Cases_: And if none of _These_ happen, then a gross thick BLOOD only abounds, tending vitiously downwards. Upon which there are only some _Livid_ or _Blueish Marks_[81] to be discover’d with those _Tumours_, such as the _VARICES_ or _Swellings_ occasion in the preceeding _Case_.

IN fine, the _Woman_ troubled with these _Symptoms_, commonly bears a _Female_; as all _Women_, having sickly times of _GESTATION_, generally do. However yet, tho’ this swelling _Affection_ is very troublesome, its _Danger_ is not great; because it ordinarily ceases of it self with good Care after the _BIRTH_. Wherefore in this Condition a _CURE_ is not always to be attempted, lest the _Humours_ recoiling upwards, affect some _nobler Part_. Nevertheless, if the _SWELLING_ be too considerably Painful or Troublesome, proper _Digerents_ and _Discutients_ may be apply’d, and the LEGS fomented with a convenient _Lixivy_, _Decoction_, or _Cataplasm_.

CHAP. XXVI.
_Of FISSURES or CHOPS of the BELLY._

THIS _Symptom_ only happens to _Women_ bearing their _first_ or _second CHILD_; whole _lower BELLIES_ have not yet been sufficiently _extended_ by frequent _CONCEPTION_.

THE _Cause_ proceeds only from the _natural Lenitude_ and _Constriction_ of the Skin of the _ABDOMEN_ or _lower Belly_; which (in proportion to the _Growth_ of the _INFANT_) must dilate and distend itself: So far as that towards the _latter Months_, it gives way to such a large degree, that it appears not otherways than as if the _SKIN_ was to be divided, and almost crack or break by its thin _Attenuation_.

HOWEVER it occasions also very often great _Pain_, as well as a _permanent wrinkled_ DEFORMITY of that _Part_. Wherefore _Laxative Liniments_, and proper _Unguents_, are pertinently to be made use of by way of _Precaution_, from the _fourth Month_, until the Time of Delivery.

CHAP. XXVII.
_Of WATER-FLUXES._

THE _Water_ which is gather’d in the Time of _GESTATION_, between the _Membranes_ involving the _INFANT_, is at last upon the approaching _BIRTH_ effus’d: For the _CHILD_ having broke the AMNION, feels these _WATERS_ troublesome, and consequently obliges the CHORION also to give way. From whence proceeds naturally a _copious Effusion_ of the same WATERS.

BUT of this natural _Flooding_, I am not properly to treat in this Place; only of _that_ preposterous FLUX, which happens before the due time of _BIRTH_, the _immediate Cause_ of which proceeds from some _Procatarctick Accident_: Such as a _Perturbation of Mind_, an unlucky _Fall_, a _Leap_, a _Stroke_, or any other Violence.

THIS _Symptom_ happens _Two ways_, either by a _Disruption_, or _Dilatation_ of the _MEMBRANES_: the _first_ by _external_, the other commonly by _internal Causes_. In the _first Case_, the FLUX comes suddenly, irregularly, and in a great _Quantity_; in the _second_, by little and little, or by degrees, and less in _Quantity_.

THE _first Case_ is most dangerous, being the infallible _PROGNOSTICK_ of instant _Abortion_, if not timely and judiciously prevented. The _second Case_ is of the following bad _Consequence_, that this WATER, which has hitherto defended the INFANT from the _Rigidity_ of the circumjacent _Parts_, being at last (how leisurely soever) exhausted and spent; the CHILD is soon sensible of its _Loss_, and finding its wonted SEAT become uneasy, it thereupon being restless or discontented, endeavours to move and seek for a _Better_: By which means (if _Abortion_ does not presently ensue) it falls into a _preternatural Situation_, which (of course) occasions a _preternatural BIRTH_. But abstracting from _This_, the bare _Deficiency_ of the WATERS, for moistening the _Passages_ in time of _LABOUR_, is enough to effect the same Unhappiness.

HOWEVER, the _Cure_ of this _SYMPTOM_ depends chiefly upon a good _Regimen_ of _DIET_, and _external_, as well as _internal Corroboratives_.

IN short, having thus discuss’d the several _SYMPTOMS_ of the Nine _Months_, and such as are most common and familiar to the _Woman_ during her FOETURA, or the whole Time of her _CHILD-BEARING_; I shall proceed now in the next Place with all due _Method_ and peculiar _Regard_ for her GOOD.

CHAP. XXVIII.
_Of Acute DISEASES incident to the CHILD-BEARING WOMAN._

IT sometimes, and more than too often, happens, that besides the common _SYMPTOMS_ of the _Months_, the _conceiv’d Woman_ is also suddenly taken with some _acute DISEASE_ or other; upon which I shall offer my sincere _Opinion_, and according to the best of my Judgment, give a brief _Account_ of _Those_ several _Maladies_, with their _Definition_ and _Cause_, _Nature_ and _Quality_, _Danger_ and CURE.

FIRST then, the great _Galen_ defines _acute DISEASES_ to be such, whose _Motion is swift_, attended with sudden and immediate _Danger_.

THE learned _Brassavole_ calls such _DISEASES Acute_, as come _suddenly_, continue a _short Time_, and have very severe or violent _SYMPTOMS_.

THE ingenious _Blancard_ calls those _DISEASES Acute_, which are _over in a little Time_, but not without _imminent Danger_. Now _Those_ are deem’d either _very Acute_, or _most Acute_; the _latter_ is meant when the _Distemper_ is over the 4th _Day_; but the _former_ is that which continues till the 7th _Day_: For the more _acute_ the _DISEASE_ is, the sooner follows its _Determination_, either for Life or Death. Again, a Disease is call’d _simply acute_, when it lasts 14 or 21 _Days_; or lastly, it is term’d _Acute ex decidentiâ_, which lasts 42 Days at least.

AND according to the diligent Dr. _Sydenham_[82], the _Despumation_ of _Acute DISEASES_ happens in 336 _Hours_; which he also justly applies to _intermitting FEVERS_, reckoning 5 Hours and a half for a _Paroxysm_: Because what we call DAYS in _Acute Fevers_, are so many PERIODS in _intermitting Fevers_: The only difference of _Those_ consisting in that the _one_ perfects its _Fermentation_ at _once_, which the _other_ accomplishes at reiterated _Times_, and divers _Turns_, by the same Duct of _Nature_. He farther still, observes that _Autumnal Quartan Fevers_ continue six Months; in which Time, if the Number of the recurrent _Paroxysms_ be summed up, they will exactly amount to the aforesaid 336 Hours, or 14 Days, which is the _Term_ or _End_ of the regular and _continual Fevers_ of that Season.

AND the wise HIPPOCRATES observes[83] that as an exquisite _continual Fever_ ceases within the 7th Day, so an exquisite _Tertian_ has seven _periodical Circuits_; because every _Access_ in the latter, makes up a _Day_ in the former Case. Hence it is manifest that all _Epidemick Diseases_ have their due and regular _Times_[84] of encreasing, continuing, and decreasing; and that These _Laws_ of _Nature_ are so constant and permanent, that however _Fevers_ differ in other Circumstances, they are equal as to the Duration of _Time_; counting according to the _Periods_ or Fits of the _intermitting_, and the continued Number of _Days_ of the never _intermitting Fever_.

GALEN[85] further explains _Acute DISEASES_, and calls them _Two-fold_: The _one_ attended with a continual FEVER; such as are _burning Fevers_, _Frenzies_, _Lethargies_, _Pleurisies_, _Squincies_, _Inflammations_, &c. The _other_ without any Fever, such as _Epilepsies_, _Apoplexies_, _Convulsions_, _Palsies_, _Contraction of LIMBS_, _JOINTS_, &c. Now the[86] _Accesses_ and _Crises_ of all _These_ proceed from the _Influence_ of the MOON; which in over-ruling terrestrial Things, surpasses all the other PLANETS and STARS, not so much because of her _Power_, as by her _Approximation_ or _Vicinity_.

THE _Cause_ of both the _one_ and the _other_ seems to be the _same_; tho’ it _affecteth differently_, according to the various _Regimen_ and _Disposition_ of the Woman: And it most probably proceeds either from the _vitious Humours_, which have abounded in the Body before _Conception_; or from such _Humours_ as have been congested afterwards by the _suppressed_ MENSES, or _Months_: Which being irritated by improper or depraved _Food_, by bad or negligent _Regimen_, either before or after _Conception_; those _Humours_ (like _Yest_ in _Ale_) ferment the BLOOD, to such a Degree, that (all on a sudden) the PATIENT is violently taken with one or other of those _Acute_ DISEASES, which are determined by a certain _Lunary_ CRISIS; that is to say, by a certain _Motion_ of NATURE, accelerated by the _Power_ of the MOON, to a gradual _Expulsion_ of the _peccant Matter_ thro’ the PORES of the Body. But this CRISIS, in short, happens always with most Ease and Safety upon the _New_ or _Full-Moon_, because the ambient _Air_ does not at that time so much affect the _Superficies_ of the Body, nor so violently repress the _Motion_ of the FLUIDS.

HOWEVER, this melancholy _Accident_ can never happen worse than to the _Conceiv’d Woman_; and the _farther_ she is gone in her Time, the more _Danger_ still. And that because of the _Scarcity_ or _Want_ of _pure_ BLOOD, which ought to be imbibed by the _Infant_, either in part or in whole, according to its Age and Strength: Or, because of the _Plenty_ of _vitious_ BLOOD, which tends to no other end, than to _imbecilitate_ the Woman, and render her _incapable_ of suffering the _Insults_ of such _acute_ DISEASES. For _Nature_ may (perhaps) be able to bear up against _one simple Effect_, but when it is joined and aggravated by _another_, the PATIENT is too often obliged to _succumb_, and yield herself up to be _overpower’d_ in the Struggle of Life.

BUT, after all yet, _acute_ DISEASES are not always _mortal_ to the _Conceived Woman_; for, as Experience teaches, SOME have the good Fortune to _escape_, tho’ indeed the Odds[87] are very great on the other Side. But of such sharp MALADIES, _those_ without any _Fever_ are reckoned most _dangerous_; because they are not only _Acute_, but also _most Acute_: And by _those_ the MOTHER is more immediately endangered than the INFANT; whereas by _those_ which come with a _Fever_, the tender INFANT is first and chiefly endangered, because of the MOTHER’s internal _Calidity_ and _Depravation_, which easily affects, and soon suffocates or stifles it in a short time.

HOWEVER, it is very observable, that a _Woman_[88], bearing a FEMALE, is more readily seized, and more easily freed or cured of _acute_ DISEASES, than _she_ who bears a MALE: And that because FEMALES are naturally more obnoxious to _Distempers_, proceeding from the _Retention_ of the MENSTRUA, and consequently more _favourably affected_, because of the _natural Affinity_ and _Familiarity_ of the Case.

AND this is the Reason that FEMALES, after the _first Months_, do bear and sustain more _Pains_ than the MALES; as daily Experience confirms, in that a _Female Miscarriage_[89] seldom happens after the _first Months_: whereas the _Male Abortion_ is most of all to be feared, after the TIME of _Motion_ or _Animation_, because the ACETABULA, or _Cavities_, being then more _siccid_, are the more easily broken by its _stronger Motion_.

IN Cases of _Acute_ DISEASES, the worst is, that the necessary _Helps_, which such incident _Distempers_ otherways absolutely require, are not always safe and convenient for the _Child-bearing Woman_: which Condition, (with respect to the CURE) renders the CASE one of the _nicest Points_ in the ART of _Physick_. Wherefore I would, with Submission, advise, that _none_ but the ablest and well-qualified _Physician_ should undertake either the _Care_ or the CURE of such a PATIENT. To whom I am not to prescribe _Rules_, and therefore I shall only refer him to his own more _Acute Judgment_, and the _Curious Solutions_ of (that most learned PHYSICIAN) _Daniel Senertus_[90], upon the _six following Questions_, thus stated by himself, _viz._

I. HOW _far slender Diet is convenient for the Child-bearing Woman_, _labouring under an acute Disease?_

II. HOW _far it is convenient to open a Vein or bleed this Woman upon such an Occasion?_

III. HOW _far it may be proper to purge her on the same Occasion?_

IV. WHETHER _Venæ-Sections or Purges are most dangerous in such a Case?_

V. WHETHER _it is practicable_ (_in such a dangerous Case_) _to excite Abortion_, _for the Woman’s Health and Recovery?_