Chapter VIII: THE EIGHTH and last Function of the WOMB, is Birth, which I

shall remember to speak more particularly of in its proper Place.

FROM all which we may easily collect the sundry proper _Uses_ of the WOMB, and readily comprehend that it is not only destin’d by _Nature_ to admit the SEED, and receive the _impregnated_ EGG from the OVARIUM and the _Fallopian Tube_; but also to contain the _Organizing Matter_, and all necessary _Principles_ (_Active_ and _Passive_) for constituting the _Conception_; fomenting the receiv’d SEEDS, by its natural _Calidity_, preserving the same, and preparing the _Maternal Blood_ by its inherent _Temperament_, for the Use of the FOETUS: Which FOETUS it surrounds and defends from external _Accidents_, by its Substantial _Corpulency_; containing and nourishing the INFANT, about the Space of 9 or 10 _Months_, by its Faculties of _Extension_ and _Attraction_; and at last forcing it into the World, by _that_ of _Expulsion_.

UPON which Occasion, that the _MIDWIFE_ may the better discharge her _Duty_, and assist the _Labouring Woman_ more effectually, without Fear or Danger, and without committing any Blunder or Mistake; as I have already taught her in what _Place_ the WOMB is seated, to what _Parts_ it tends, and how it is _annexed_, &c; so I shall now proceed to describe its _Qualities_ and _Faculties_, so far as is necessary, and absolutely requisite in the _Practice_ of _MIDWIFERY_. And, FIRST, then——

CHAP. X.
_Of the Extensive Faculty of the WOMB._

NATURE has endued the WOMB with this _Faculty_, to the end that it may (in _Pregnancy_) extend and dilate itself Day by Day, in _Proportion_ to the _Growth_ of the INFANT, _Secundine_, and _Humours_.

NOW the WOMB in its _lower Part_ being straitly tied to the _Intestinum Rectum_ and _Bladder_; it is to be understood that the _Distention_ happens mostly in its superiour Part or _Bottom_: Which is not only most _Free_ and at greatest _Liberty_, but also _Thickest_ and aptest for _Dilatation_.

THIS will appear more evident, when we consider how the INFANT adheres to that Part, the _Bottom_, by means of the _Secundine_: How the INFANT also as it grows, begins to separate the _Humours_ in the _Secundine_, which (of consequence) encrease as the _Infant_ does: And how again the Encrease of the _Humours_ fill up the _Chinks_ and VACUUMS, as I may call them, which the INFANT cannot possess. From hence it is that the WOMB extends itself in the _Form_ of a PEAR, only a little _Plainer_ at Both Ends.

THUS the _Secundine_ adhering[155] to the _Bottom_ of the WOMB, by its _thicker Part_ (call’d the PLACENTA,) thence it is that the WOMB encreases and extends itself more in its _Bottom_, than in any _inferiour Part_.

WHEREFORE the WOMB being most extended in its upper Part, call’d the _Bottom_; and both the _Bladder_ and RECTUM below being soft loose _Parts_, it necessarily follows, that the WOMB may freely _ascend_ and _descend_ upon Occasion, as we often find it in the _Cavity_ of the _Belly_; which, however, does not happen to All _Women_ alike.

BUT, in short, these _extensive_ and _ascensive Faculties_ of the WOMB, chiefly residing in its _Bottom_; I would have it laid down for a certain _Maxim_ of Truth, that _These_ exert themselves, without any the least _Extenuation_ to the _Uterine Substance_: Which Position leads me directly to consider——

CHAP. XI.
_Of the Substantial Density of the WOMB._

TOUCHING the _Thickness_ of the _Pregnant_ WOMB, _Authors_ have differ’d extremely: _Some_ thinking, that as the WOMB grows _Larger_, it grows _Thicker_; and _Others_ the _Reverse_, that as it _extends_, it grows _Thinner_.

NOW these _Opinions_ being both diametrically opposite _One_ to the _Other_, as _Both_ (perhaps) may be contrary to _Truth_, I shall freely and ingenuously offer my _Sentiments_ in a few Words; not that I vainly desire to engage myself in any _Controversy_: Save only, because the true _Knowledge_ of this Point, is so Material and Consequential for all _MIDWIVES_, especially in _Cases_ of difficult and preternatural BIRTHS, that I cannot well excuse myself, should I pass it by with _Silence_ in this Place.

MR. _MAURICEAU_, in his _Book_ of the _Diseases_ of Women, contradicting the Authority of _Riolanus_, _Bartholinus_, and the whole Body of the most Renown’d and Ingenious _Anatomists_, both _Ancient_ and _Modern_, is at great Pains to make us believe, that the _impregnated_ WOMB is (like the _Bladder_) in this Case; _the more it is extended, the thinner it grows_.

BUT as his quoted Authority of _Galen_ and _Carol_. _Stephanus_ cannot be sufficient against so many good _Authors_ of the _contrary Opinion_; so neither will his _Demonstrations_ of WAX, nor _Comparisons with the_ WOMBS of _Animals_, be sufficient to make out his _Argument_, against confirm’d _Experience_, common _Sense_, and current _Reason_. Which Point of _Experience_ I judge this _Author_ to have been deficient in, otherwise he would certainly have given us some _particular Instance_ or other of it, and not had _Recourse_ to _Inconsistencies_ for supporting his new-fashion’d unreceiv’d _Notion_. For what _Comparison_ can there be betwixt an _Animate_ and _Inanimate Body_? Or what _Affinity_ betwixt the _WOMB_ of _Animals_ and that of _Women_, who are form’d after the _Image_ of GOD, and (by a _Prerogative_ above all other _Creatures_) are furnished with a _WOMB_ very _different_ from them?

I ingenuously acknowledge, when I first met with this _Author’s Works_, not daring then to be too _Positive_ in this _Point_, I was put into some _Suspence_ of Judgment; which made me not only consult with the best of _Authors_ and _Professors_ of ANATOMY, but also induc’d me to embrace every Opportunity of satisfying myself otherways to a full _Conviction_.

WHEREFORE at all _Dissections_ of _pregnant Women_, where I have been present, I carefully observed and took notice of this particular _Point_; upon which I must needs affirm, that I always found the _WOMB_ (however _Big_ or _Little_) of its _natural Thickness_, and rather _thicker_ than _thinner_: For tho’ _It_ is expanded by the _growing Infant_, &c. yet _it_ may (most probably) be equally condensed, by the Imbibition of the _fluent Humours_, which consolidate into _itself_ by the _Pores_ of its _Plexus Body_. Nay, I have not only satisfy’d myself in _dead_, but also in _living Bodies_, with respect to this Matter; for by passing _One Hand_ into the _WOMB_ to take away the _Secundine_, when the _Other_ laid upon the BELLY, I clearly discerned the _Truth_ by SENSE, and have sometimes found the _WOMB_ not only incredibly _Thick_, but also RIGID withal: And in this Matter, I have not been singular; for I find the _ingenious Daventer_ writes to the same purpose, upon this _Head_, in his Book of _Midwifery_. Having therefore thus, in short, perceiv’d the _Thickness_ of the _WOMB_, both with my _Hands_ and _Eyes_, I must trust my SENSES, and prefer my _Experience_ before any _Man’s bare Conjecture_; for tho’ I often _see not_ those Things which I _believe_, yet I must still _believe_ those Things which I _see_.

WHENCE I conclude, that the _WOMB_, tho’ of a different _Bigness_ from the _Conception_ to the BIRTH, is always, at least, of one _Thickness_ with the _unconceiv’d_ WOMB: Which the _Divine Wisdom_ (no doubt) has so ordered for the _Preservation_ of the MOTHER and INFANT; for if the _WOMB_ in Time of _Pregnancy_ did grow _Thinner_, according to its _Extension_, it must of Consequence grow _Weaker_, and, in that _Case_ the INFANT would be liable to perforate it with _Foot_ or _Hand_, which would infallibly terminate in the _Loss_ of both their LIVES.

BUT besides, if the _WOMB_ was so _Thin_ and _Weak_ as Mr. _Mauriceau_ imagines; as the _Pregnant Woman_ would be liable to imminent _Danger_ every Moment _Before_, as well as _In Time_ of LABOUR; so the MIDWIFE would be expos’d to the greatest of _Difficulties_: For who then durst, without _Horror_, offer to turn the INFANT, so closely compress’d in those _thin Membranes_ of the _WOMB_? Or who could have _Resolution_ enough to separate and pull away the AFTER-BIRTH?

HOWEVER, I could produce innumerable _Instances_ of most Learned and Ingenious _Men_ to support my above-mentioned _Opinion_; but I shall content myself now with ONE, who (I think) is of sufficient Authority: For hearing lately that Mr. _Mauriceau_’s mention’d Book (which I had only read before in its _Original French_) was translated by Dr. _Chamberlain_, I doubted not but I should fully discover that Eminent TRANSLATOR’S _Sentiment_ upon this single _Point_; whereupon this most famous _Physician_ and _Boethogynist_ marks by way of Observation or a _Bene Notandum_, that his _Charity_ for his _Author_ makes him believe that _French-Women_ differ in this _Point_ from _Our English_, with whom it is apparently otherwise order’d. And in the farther Explication of his _Author’s Opinion_ on this _Head_, he adds, That _Experience_ will convince any inquisitive Person of the _Contrary_.

TO which I reply, in short, with all due Submission, that the _French-Women_ do not differ one Jot in this respect from _Ours_, nor _Ours_ from any _Others_: Which (no doubt) the worthy _Doctor_ was very sensible of, notwithstanding his great _Complaisance_ to his _Author_.

CHAP. XII.
_Of the various Local Motion of the WOMB._

ALTHOUGH the _Ligaments_ are fixed to the _WOMB_ on each side, under the _Tubes_, near the _Bottom_, on purpose to keep it duly in the _Middle_, from falling to either _Side_; yet we may easily perceive, FIRST, That the _Pregnant WOMB_, as it dilates and extends itself most (in the _Bottom_) above the _Ligaments_, so it rises _Highest_ and becomes _Heaviest_ in that Part; by which means it cannot always be contained in the _narrow Compass_ of the PELVIS, and the _Larger_ the _INFANT_ is, the _Higher_ the _WOMB_ rises (above the _Ligaments_) in the BELLY. Insomuch that when the _Cavity_ of the PELVIS is not sufficient to contain a large _WOMB_, fill’d with _One_ or _more_ well-grown _INFANTS_, together with the _Secundines_ and _Humours_, it must (of necessity) ascend into the _Cavity_ of the BELLY; as is evident from _Chap. 10_.

SECONDLY, The _WOMB_ being in Form of a PEAR, much larger _above_ than _below_ the _Ligaments_, and that _superiour Bulk_ being only sustain’d at the _lower Part_ by subtile _Ligaments_ apt to extend, as well as supported near the _Orifice_ by the _Bladder_ and RECTUM, which are soft, loose, and _extensive Parts_: Hence, I say, we may easily conceive, that as _These_ are not sufficient to hinder a large WOMB from ascending above the Borders of the PELVIS into the _Cavity_ of the BELLY; so neither are _they_ able to keep it from leaning or inclining _this_ or _that way_, by reason of its _Weight_ in the _Bottom_, which is always the farther distant from the _Ligaments_, the more it is _extended_: And the _extended_ WOMB being not of the same _Firmness_ and _Solidity_ with THAT in a _natural State_, is the more apt and ready to move _aside_, either on the Right or the Left Hand.

NOW this various _Motion_ of the WOMB, in short, will appear more manifestly _Probable_, when we consider how variously _Women_ with CHILD move their _Bodies_, bending them every way for _Relief_, when oppress’d with _Pain_; both _sitting_ and _lying_ in different _Postures_: All which may easily give the WOMB a _Tendency_ this or that way, sliding either _Forwards_ or _Backwards_, to the right or the left _Side_ of the Person.

CHAP. XIII.
_Of the Oblique Situation of the WOMB._

I Doubt not in the least but among the _Many_, some will reject _this_ THESIS as _False_ or _New-fangled_; but _They_ who are _Ignorant_ of it, are meer blind _Novices_ in the _Art_ of MIDWIFERY: For repeated _Experience_ has taught _Myself_ and many _Others_ the Certainty of this _Truth_; as will more amply appear from the following Discourse.

THE _Womb_ having then ascended into the _Cavity_ of the BELLY, if its _pointed Parts_ tend perpendicularly into the PELVIS, so as that its _Orifice_ may be easily touch’d on every _Side_ with the Fingers, its _Bottom_ is placed about the NAVEL; and _This_ I call a right or _natural Situation_: But when otherways, the _Posture_ is changed, inclining _this_ or _that way_, and the _Orifice_ suspended so _High_, that it can scarce or not at all be touch’d, I call _That_ a wrong and _preternatural Position_, or _oblique Situation_ of the WOMB; which may not only be occasion’d (as is said) by the _Weight_ and _Bulk_ of its _Bottom_, above the extended and relaxed _Ligaments_, but also by many other different _Causes_; such as an obdurated _Gland_, a _Cicatrix_, an _Ulcer_, an _Obstruction_ of the _Vessels_ in the _Ligaments_ or adjacent _Parts_, &c.

HENCE it is that the _wrong Positions_ of the _WOMB_ are manifold, which would be very tedious to enumerate exactly here; but only, that I may not pass by what is so _material_, I shall reduce them to a _Four-fold Difference_; as the _Ancients_ did the _Winds_, because of the _Four Regions_ or _Limits_ of the Heavens. And _Those Four_ will (I hope) comprehend all other _wrong Situations_ of the _WOMB_, not very improperly or _mal-à-propos_, as _Ovid_[156] has comprehended _These_ in the following elegant _Verses_, viz.

_“Eurus ad Auroram Nabathæáq; regna recessit,
“Persidáq; & radiis Juga subdita matutinis.
“Vesper & Occiduo quæ littora sole tepescunt,
“Proxima sunt Zephyro, Scythiam septémque triones
“Horrifer invasit Boreas. Contraria Tellus
“Nubibus assiduis, pluvióq; madescit ab Austro._

THE _first_ bad _Position_ of which is, when the _Bottom_ of the _WOMB_ is placed on the _left Side_ of the Woman, a little raised or depress’d; the _Orifice_ being turn’d towards the SPINE of the right OS ILIUM or OS PUBIS, against which the INFANT in time of BIRTH commonly pushes its _Head_, beats out its Brains, and sticks there to Death: Or else passing the said SPINE, it lies _a-thwart_ the PELVIS.

THE _Second_ ill _Position_ of the _WOMB_ is, when the _Bottom_ is seated on the _right Side_; the _Orifice_ being turn’d towards the _left Part_ of the PELVIS, directly opposite to the _other Position_, and attended with the same _Inconveniencies_.

THE _Third_ is, when, in _Women_ having large _Bellies_, the _WOMB_ hangs too much _Forwards_; the _Orifice_ being turn’d towards the OS SACRUM: So that the INFANT falls down by the _Head_ into the Bent, or crooked _Cavity_ of the OS COCCYGIS, where it fatally sticks fast.

THE _fourth Oblique Situation_ of the _WOMB_ is, when its _Bottom_ is press’d too near the DIAPHRAGMA, and its _Body_ too near the VERTEBRÆ of the _Loins_; the _Orifice_ being elevated, is thereby turned too near the _OS PUBIS_, where the INFANT striking its _Head_ against these _Bones_, remains immoveable and perishes: Or, (which is worse) sliding with its _Head_ upon the _OSSA PUBIS_, it is turn’d on one or other _Side_ or _Backwards_; when (commonly with _Hand_ or _Arm_ out of the Body) it lies _a-thwart_ the Passage, and infallibly occasions its OWN or its MOTHER’S _Death_, or _Both_; unless (as in the _three_ preceding _Cases_) it be in due time prevented by the _Assistance_ of some very skilful HAND.

THOSE are the _Four_ most difficult and principal wrong, or chief _preternatural Situations_, of the _WOMB_; from whence we may easily frame a competent Conjecture of the _Rest_; to wit, when the _Bottom_ of the _WOMB_ is more or less turn’d to the _right_, or the _left Side_, or _forwards_, or _backwards_: Since as _that_ differs more or less from the _natural Position_, so the BIRTH in like manner is (of consequence) the more or less _Difficult_, as will hereafter manifestly appear.

CHAP. XIV.
_Of TOUCHING or HANDLING the Woman._

THE _Midwife_ ought to have a special _Knowledge_ in _This_ Matter, since a Thing of so much Moment as LIFE itself often depends upon it; yea, and _this Knowledge_ is of absolute Necessity to all Persons practising MIDWIFERY, because many different Points of the greatest _Importance_, are thereby plainly discover’d: But before I enter upon these Things, I would have it rightly understood, that nothing else is meant here by the _Performance_ of the TOUCH, than (upon having first pared the _Nails_ short, equal, and smooth) _passing the two Fore-fingers of either Hand, (previously well anointed with Fat or Butter, when proper Oils are not to be had) through the_ VULVA _into the_ VAGINA, _in order to reach the Orifice of the WOMB_, and to discern its FORM, by feeling it on each Side.

AND it is not only requisite that the Woman in LABOUR be _touched_, before her _Pains_ come on, because then the _Membrane_ containing the _Humours_ being loose, the INFANT’s _Posture_ may be the better distinguish’d; but the same TOUCH also is to be continued during the _Force_ of the _Pains_, the better to know their _Nature_ and _Effects_; whether the INFANT continues still at the _Passage_ or not; and whether the _Humours_ are contracted _length-ways_, or press’d into a _Flat Form_, and the like. For after the _Pains_ are over, it is easily to be perceiv’d, whether they have _promoted_ the BIRTH or _Not_.

BUT during this _Performance_ of the TOUCH, great Care must be taken not to handle the _Membranes_ containing the _Humours_ too roughly, lest they should break in the Action.

NOW that the MIDWIFE may the more readily perform her TOUCH, she must take good Heed to what is said of the _Cavity_ of the[157] PELVIS: for as it rises from the _Bottom_ obliquely, ascending forwards; so, upon this Occasion, in seeking for the _Orifice_ of the WOMB, she must not thrust her _Fingers_ streight along according to the _Length_ of the Body, towards the bending of the OS SACRUM; but guide them _upwards_ from the _Bottom_, as if thro’ the VAGINA, she would touch the _Navel_: For Thus her _Hand_ being turn’d inward, and her _Fingers_ tending towards the _Navel_, the _Orifice_ of the WOMB lying directly in the way, she meets with it readily at first. Whereas they who go otherways to work, seek it in vain, and find it with Difficulty.

THIS Observation I thought the more requisite in this Place, because _MIDWIVES_ not accurately understanding the _Situation_ of the _Bones_ of the PELVIS, think that the WOMB and its _Neck_ or VAGINA reach according to the _Length_ of the Woman, and make use of their _Hands_ accordingly: First hurting the VAGINA and RECTUM in the Bending of the SACRUM; and then finding no farther _Passage_ for their _Fingers_; but being altogether ignorant of the above-mentioned Method of finding the said _Orifice_, they are very often surpriz’d, fall into great _Confusion_ for want of better _Instruction_. Whence I proceed to——

CHAP. XV.
_Of the various Uses and Advantages of the TOUCH._

BY the TOUCH then, to be brief, the _MIDWIFE_ gains the certain _Knowledge_ of the following important _Heads_: viz.

FIRST, Whether a _Woman_ be with _CHILD_ or not: For I must needs own, that some of the most certain _Signs_ of _Pregnancy_ are discover’d by the _TOUCH_; since the WOMB shuts itself close up, immediately after CONCEPTION, and its _Orifice_ becomes more _pointed_, _hard_, and _solid_, resembling (according to _Mauriceau’s_ just Comparison) the _Mouth_ of a _Puppy_ newly pupp’d.

BUT in time of the _INFANT_’s ripening, this _Orifice_ begins to _swell_, and becomes _softer_, _smoother_, and _thinner_ than it was Before.

SECONDLY, The _MIDWIFE_ discovers by the _TOUCH_, whether the Time of BIRTH is near at hand, and how near it is. However, in speaking to this Point, I desire to be rightly understood, not meaning _Miscarriages_, or _Illegitimate BIRTHS_, but only such as are intirely _Legitimate_.

AS then the _INFANT_ advances in _Maturation_, so the _Orifice_ of the WOMB from the _Third Month_, grows _smoother_, _thinner_, and _softer_; and consequently the more _smooth_, _thin_, and _soft_ it appears at any time afterwards to the _TOUCH_, so much the _nearer_ draws on the _Time_ of BIRTH.

IN _some Women_, this _ORIFICE_ begins to open two or three _Months_ before BIRTH; and this _Aperture_ enlarging itself by degrees, becomes soon as wide as a _Shilling-Piece_, when the _Motion_ of the _INFANT_ may be distinctly perceiv’d: And in _others_ it is so much more enlarged, that one single _Pain_ or two accomplishes the BIRTH.

BUT as all _Women_ are not _alike_, so this _RULE_ will admit of sundry _Exceptions_; for _strong-body’d_ Women, Women of their _First Child_, and those somewhat in Years, their WOMBS continue generally shut up to the last, and open not without the severest _Pains_: And not only so, but the _Orifice_ of the WOMB differs also, in all difficult and _Preternatural Cases_, as well by reason of its own _oblique Situation_, as of the _INFANT_’s ill Posture. For this Reason it is, that an Experienced and Judicious _Hand_ is most requisite upon such Occasions; since such an _One_ can clearly distinguish, what _Another_ cannot so much as guess at.

THIRDLY, The _MIDWIFE_ immediately knows by the _TOUCH_, whether the Woman be taken with the real and genuine LABOUR-PAINS or _Not_. Which is a Point of the _greatest Moment_; since as it is of bad Consequence to _delay_ the BIRTH, when the Woman is so taken, especially if the _WOMB_ and _INFANT_ be _Both_ well situated, lest the _Pains_ should vanish, and the Opportunity of DELIVERY should thereby be lost: so, on the other hand, to force a Woman to LABOUR, unseasonably, when but seiz’d with _Bastard-Pains_, is a most pernicious Thing.

BUT both these _Cases_ too often happen, even to the _Hazard_, if not the _Loss_ also of both LIVES; especially the _Latter_, when the _MIDWIFE_ does not know how to distinguish these _False Pains_, either the _Cholick_, or other _Gripes_, from the _genuine Pains_ by the _TOUCH_: As will be more fully and amply explain’d in the next following _Chapter_.

GIVE me Leave to say then, that BIRTH is not to be provok’d by any Means, until the _MIDWIFE_, by touching the _Orifice_ of the WOMB, is certain, that the Woman labours under the _True Pains_; which is not to be judiciously suppos’d to happen before the _Seventh Month_ at soonest.

_BIRTH_ at that Time approaching, the Woman is afflicted with great PAINS in her _Groin_, _Loins_, and about the _Navel_, tending downwards with a depressing Force upon the WOMB and other _Private Parts_. But these PAINS are not continual, for they only go-off and come-on by _turns_; at which Time, by their violent _Depressure_, the _MIDWIFE_ finds the _Orifice_ of the WOMB _open_, or at least _opening_, and upon Renewal of the PAIN, she finds it more and more dilated and relaxed: whereas, on the other hand, when the PAINS are _Spurious_, they disperse themselves through the whole _Body_, as well as the _Abdomen_; and then the WOMB (as if it were securing itself) is found more closely _contracted_.

FOURTHLY, It is likewise well known by the _TOUCH_, whether the BIRTH will be _Easy_ and _Speedy_, or _Difficult_ and _Lingring_, on several Occasions: 1. When the _MIDWIFE_ finds the _Head_ of the INFANT and the lower Part of the WOMB fallen into the _Cavity_ of the PELVIS, so that _She_ can touch it in the Confines of the VAGINA: 2. When the _Orifice_ of the WOMB is very soft, thin, and wide-open, so that (through it) she finds the _Head_ of the INFANT foremost, without any Obstruction by the _Arms_ or _Umbilical Vessels_ in the way, between the _Head_ of the INFANT, and _Orifice_ of the WOMB; as often happens: And, 3. When the _Humours_, by the _right Situation_ of the WOMB and the INFANT, are found compressed into a _Flat Form_. I say, when Matters are found so (by the _TOUCH_) in this _Natural Posture_, there is no great doubt (under GOD) of a _Speedy_ and _Easy_ DELIVERY.

WHEREAS, on the contrary, when the _Orifice_ is found by Experience _higher_, _little_ or not at all _open_; _sharp_, _hard_, and _thick_, with the _Humours_ pressed up length-ways: _Then_ the _Case_ is quite revers’d, and the _MIDWIFE_, if she _understands_ her Business, must resolve to _sweat at her Work_.

NOW the Reason of such _Difficult_ BIRTHS commonly proceeds, either from the _wrong Situation_ of the INFANT, or _That_ of the WOMB; the _latter_ of which always occasions the greater _Difficulty_, especially when it is accidentally join’d with the _First_, to a vast Degree of _Aggravation_: Of which, as follows of course.

FIFTHLY, Another _Advantage_ of the _TOUCH_, is the truly Knowing whether the INFANT be in a _Natural_, or _Preternatural Posture_. For the _MIDWIFE_ finding the _Orifice_ of the WOMB so _open_, that it admits one or two _Fingers_, she may distinctly feel the _Chin_ of the INFANT in a _Natural Position_, lying forwards on its _Breast_, and the _Neck_ in the _Middle_ of the _Orifice_, or streight _Before_ it; so that the _Head_ being foremost and lowest within the Borders of the _Orifice_, the _Fingers_ cannot pass any _Farther_.

HOWEVER, supposing the _Clunes_, _Knee_, or _Elbow_, to present themselves _First_ in the _ORIFICE_; It is true, they have their _Roundness_, but then they are easily distinguished from the _Head_: For the _Globular Part_ of it is much _broader_ and _smoother_, than either _Knee_ or _Elbow_, and _harder_ than the _Buttocks_; which _Fleshy Part_ is soon distinguished from the _Bones_, or the _soft Membrane_ betwixt the _Bones_ of the HEAD.

BUT as a capable _MIDWIFE_ can hereby distinguish all _These_ with Facility, even before the _Waters_ begin to flow; so I need not mention the _Hands_, which distinguish themselves by the _Fingers_, as the _Feet_ do, by the _Toes_ or _Heels_; and the _Navel-string_ discovers itself by its _Softness_, _Thinness_, and _Roundness_: All which, however yet, are more easily known when the _Membrane_ is broke, and the _Waters_ have actually flown. For the _Parts_, which were before covered with this _Membrane_, lie now naked in the _ORIFICE_: Hence it often unluckily happens, that _few MIDWIVES_ make an exact _Scrutiny_, about the _Situation_ of the INFANT, till this Time of FLOODING; erroneously thinking they are then _soon_ enough, which is an unaccountable Mistake; as will hereafter abundantly appear.

SIXTHLY, It is perfectly known by the TOUCH, whether the WOMB be in a _Natural_ or _Preternatural Posture_, as is plainly taught more at large in the foregoing _Chapter_.

FINALLY, in short, we most assuredly know by the TOUCH, what is proper to be done in all _Preternatural Cases_, upon giving _Assistance_ both to the MOTHER and INFANT; as hereafter will fully appear by a more copious _Dissertation_ to that Purpose.

CHAP. XVI.
_Of the Genuine and Spurious LABOUR-PAINS._

THE sole Reason I add this _Chapter_, is, because our common _MIDWIVES_ are so often mistaken, and do so frequently err in this _Point_, having no thorough-pac’d _Knowledge_ of either sort of these _PAINS_: For when she comes to a Woman, taken ill with severe _PAINS_ in the _Belly_ or _Loins_, being ignorant of the accurate Nicety of the TOUCH, she presently concludes _These_ to be the true _labouring PAINS_, because they indeed often resemble them very much; and she farther finding perhaps the _ORIFICE_ a little _relax’d_ and _open_, expects it to enlarge to her Satisfaction. Which, however, not answering her Hopes, nor the _PAINS_ encreasing; she endeavours by _stimulating Medicines_ and other sinistrous _Means_, conformable to the perverse _Rules_ of her PRACTICE, to raise and provoke _Them_: So that this, in short, is the _Cause_, not only of many an _untimely BIRTH_, but also too commonly of many an _untimely DEATH_.

NOW the _Wind-Cholick_, either in the Lower or Upper Part of the _Belly_, occasions frequent racking _PAINS_, as do also the HUMOURS by Virtue of their _Acidity_, corroding the _Intestines_; and these _Mordacious PAINS_ are generally attended with a subsequent _Looseness_. In which _Cases_, I always use proper _mitigating_ and _repelling_ MEANS, (such as a _Carminative_ and _Emollient Clyster_, &c: upon extreme Occasions); which proper _Means_ infallibly answer my Ends in either Condition. For if the _PAINS_ that afflict the Woman are _Spurious_, They are thereby suddenly _laid_ and repressed; and if _Genuine_, These very self-same _Means_ most effectually promote and advance _them_ to _BIRTH_.

BUT again, _some Women_ are taken with a mix’d Complication of _Genuine_ and _Spurious_, or _Real_ and _False PAINS_, that are properly called _Tergiversant_; which one Moment seem to _depress_ the _BIRTH_, and _encourage_ the Woman to LABOUR; and the next convert themselves into scatter’d CRAMPS, and other contracting _PAINS_: And these dispersed _Bastard-Pains_ are always more pernicious to the Woman, than the most severe _natural_ LABOUR-PAINS: _This Case_ is also easily distinguished by the TOUCH; which done, the _false wandring Pains_ are first to be assuag’d or carry’d off, before the _BIRTH_ can well succeed.

NOW, as to the real _Natural_ and _Genuine Pains_, They are, (methinks) in short, easily to be judged of by the _Manner_ in which they always seize the _Woman_; viz.

I. FROM the _Navel_ downwards to the _Groin_, reflecting towards the _Loins_, with a depressing and bearing down upon the WOMB and PRIVITIES, as occasionally mentioned in the preceding _Chapter_: And tho’ _These_ are intermitting (not _continual_) _PAINS_, yet their Severity and Violence extenuate the _Umbilical_, and protuberate the _Genital Parts_, opening and distending the _Passages_. But besides, as the _Blood_ is exagitated and fermented, it excites a Velocity of PULSE, and a _Redness of Face_; whilst the BELLY waxes _Fiery-hot_, and a _Feverish Shivering_ or _Trembling-Fit_ invades the _whole Woman_, especially the inferiour LIMBS, but without any _Frigidity_.

II. THE _Membranes_, with their _Contents_, which _MIDWIVES_ commonly call the _Gathering of the Waters_, now present themselves at the _Orifice_ before the _Head_ of the INFANT, resembling (to the TOUCH) _Abortive Eggs_ without any SHELL: upon _These_ breaking, the _Waters_ begin to flow; at first more _Sparingly_, but by and by more _profusely_, and at last a _waterish Blood_ follows, when a _GIRL_ is to be born; or a _pure-colour’d Blood_, when a _BOY_: But I also farther distinguish the _BIRTH_ of an approaching _BOY_ from _that_ of a _GIRL_, by the _Labour-Pains_; for in the _first Case_, these are far more severe and penetrating, and accordingly the _BIRTH_ much more expeditious, than in _Case_ of a _GIRL_: In which (however) the _PAINS_ are more constant and regular.