Chapter V: WHEN the WOMAN is taken with any Acute Disease, the BIRTH is to

be prompted by all safe _Means_; and if a _Natural DELIVERY_ does not presently succeed, an _Artificial_ one must (without Loss of _Time_) be undertaken. As in the _Case_ of immoderate and continual _Floodings_, with concomitant _Convulsions_, which always proceed from the Separation of the _SECUNDINE_ (either in whole or in part) from the WOMB, and happen many different ways, as already mentioned at large[165].

IN these _Cases_, especially if the SECUNDINE is found (by the TOUCH) at the _Orifice_, there is no Hope of _Stopping_ them by any other _Means_, than by _delivering_ the WOMAN; which now the _sooner_ done, the _better_ (for saving two _Lives_) and _that_ whether at full time of _Reckoning_ or not. But this _Operation_, I conceive, is to be most discreetly _Undertaken_ in the manner following, _viz._

THE _Woman_ is to be placed in BED, with the _Upper_ and _Lower_ Part of her Body almost _equal_, then the MIDWIFE is gently and gradually to introduce her _Fingers_ into the _Orifice_, dilating it cautiously with _one_ or _two_, until she can enter them _All_; when opening the MATRIX by Degrees, she gets in her _Whole Hand_, and thereby _first_ carefully tears the _Membrane_ with her _Nails_, if the _WATERS_ are not previously broke: Then she puts her _Hand_ in the same _Membrane_ to the INFANT’s _Feet_, seeking them in their _Place_, where they are to be found, when they don’t present themselves at _First_: Because, the _Hold_ by the _FEET_ being _Better_, it is more easy to _deliver_ by _Them_, in this Case, than by the _HEAD_, or any _other Part_. After _this_ the _FEET_ being found, the CHILD is easily _turn’d_, as long as the WOMB is loose and slippery, and the _Humours_ not quite flown off; which being nicely done, the _FEET_ are to be drawn out _both together_, if possible; but if otherways, _they_ must be drawn down _separately_, with _great_ Caution: And so being conjoin’d or held fast together, they are to be drawn forward with _one Hand_, whilst the _other_ is circumspectly thrust towards the _Knees_ or _Buttocks_ of the CHILD, in order thereby to turn also the whole Body of the INFANT, so that its _Face_, _Belly_, and _Toes_ may tend downwards towards the _RECTUM_.

IN this _Posture_ the CHILD may be gently and gradually extracted with Ease; next the _SECUNDINE_ must be fetch’d away in its Turn, and lastly the WOMB is to be thoroughly cleans’d of all _heterogeneous_ Bodies, as formerly directed[166]. And thus the WOMB (having yielded up its _Contents_) immediately contracts, by which _MEANS_ of divine Appointment, the Vessels close and shut firmly, and consequently the _FLUX_ ceases, together with all the concomitant _SYMPTOMS_.

BUT it is to be well remembred, that this _Operation_ ought to be _timely_ perform’d; that is, before the WOMAN has lost too much _Blood_, or is too much spent; in which _Condition_ such a painful Attempt would but accelerate her _Death_. As to her _Regimen_ next, upon this melancholy Occasion, _She_ must be duly provided for _beforehand_, that she may be able to undergo and stand out such an extream difficult _DELIVERY_; and afterwards, that she may recruit her _Spirits_, and retrieve her exhausted _Strength_: For which Purposes, she ought to be supplied from time to time with some good _Broths_, _Jellys_, and a little generous _Wine_, smelling continually _Rose-Vinegar_, and applying repeated warm _Toasts_ dipt in _Wine_ (in which _Cinnamon_ has been infus’d or boil’d) to the _Region_ of her HEART, as also _Napkins_ dipt in a Mixture of _Water_ and _Vinegar_ about her REINS, in order for turning the _Course_ of the FLUX.

THESE Things being all duly and artfully perform’d, the PATIENT (under God) will soon _recover_ and be _in Statu quo_. Now _These_, in short, are all the _principal_ and most common _Causes_ of _difficult_ BIRTHS proceeding from the part of the MOTHER; which being thus discussed with all Brevity, I go on to——

CHAP. VI.
_Of Difficult BIRTHS proceeding from Causes of the INFANT._

IT sometimes also happens, that the _Difficulty_ in LABOUR arises from the INFANT: And _that FIRST_ when _Two_ or _More_ strive for _Priority_ in _BIRTH_.

NOW this _Condition_ the MIDWIFE can no otherways distinguish or discover, but by the TOUCH; and when the _one_ is more _forward_ than the _other_, ’tis not to be done or known, until she has even _touch’d_ the very _Fund_ of the WOMB: Because sometimes it so happens, that _One_ CHILD has its _Hands_ and _Feet_ so intermix’d, that whatever way _She_ turns her _Hand_, she finds _Legs_ or _Arms_, _Hands_ or _Feet_, which often deceives MIDWIVES, believing there are _TWINS_. But in this perplex’d _Case_ the most sure and only certain _Sign_, is, when she feels _two Heads_ or _two Backs_; for then she cannot be Mistaken, since _one Body_ cannot have _two Heads_, unless it be a MONSTER, which may be soon discover’d by feeling if the _double Head_ be fix’d to _one_ and the _same Body_.

BUT in the _Case_ of _TWINS_ or _more Children_ (as long as they come right) the DELIVERY is perform’d, as if the _Woman_ had but ONE, in the _Natural Case_ already Stated; so that I shall repeat or recapitulate Nothing of what I have said, only that the AFTER-BIRTH, or BIRTHS are not to be _touch’d_, until all the _CHILDREN_ are Born: Upon which drawing gently the _Navel Strings_ (in their Turns) with the _One Hand_, the _Other_ brings them forth easily and orderly; as is set forth more fully in SECT. IV. _Chap._ 18.

A SECOND _difficult LABOUR_ may proceed from the _Weakness_ and _Debility_ of the INFANT, or from its being too _Small-grown_; in which _Case_, both the WOMAN and the MIDWIFE are to use their best mutual _Endeavours_ to promote the _BIRTH_, since the _CHILD_ can do little or nothing for itself, and the _Less_ it is, the less it is affected with the _THROWS_ of the _Mother_, and the less _Impression_ her Impulses make upon it: Whereupon _Nature_ is to be assisted in this weak _Condition_ by all convenient _Means_, whereof _THAT_ of the _Agile_ or _Nimble Hand_ is the most effectual.

A THIRD _difficult BIRTH_ may proceed from the INFANT’s being too _Big_; In which Place I must previously apprize the _READER_, that I no ways mean a _MONSTER_ or _Hydropical CHILD_, but only _One full_, _well_, or _Big-grown_, which is only reckoned too _Big_ in regard of the _Maternal Passages_, which may be too _Small_ in Proportion.

IN this _Case_, there is an absolute Necessity for _Manual Assistance_, since the PAINS (however penetrating or forcible) cannot effect the _Work_. But and if the _INFANT_ is fallen down (well turn’d) into the PELVIS, the MIDWIFE using her best and most skilful Endeavours to _dilate_ the _Passages_ below near the OS COCCYGIS, the CHILD may be easily brought forth (without any dangerous _Instrument_) by her dextrous _Hand_ only accomplishing the _Work_. In the mean Time, however, it is to be minded always, that _This_ is still more safely and commodiously done by the FEET, than by the HEAD, after carefully dilating the OS COCCYGIS, taking this Opportunity in the beginning of the LABOUR, before the _INFANT_ is too much press’d down into the PELVIS.

NOW _these_ are, in fine, the most common _Causes_ on the Part of the _INFANT_, whence I come to touch upon _difficult BIRTHS_, proceeding from _Causes_ of the _Passages_; which, because they are various, I subdivide into a _Fivefold Diversity_; viz. _Difficult BIRTHS_, proceeding from _Causes_ of the MEMBRANES, from _Causes_ of the PELVIS, from _Causes_ of the BONES of the PELVIS, from _Causes_ of the BLADDER and RECTUM, and from _Causes_ of the VAGINA: And because all these require to be singularly explain’d, and particularly insisted upon, I shall assign them as many respective _Chapters_. And _First_——

CHAP. VII.
_Of Difficult BIRTHS, proceeding from Causes of the MEMBRANES._

SUCH _Difficulties_ as These, in _BIRTH_, may arise, _FIRST_ from the _Strength_ and _Firmness_ of the MEMBRANES; when they happen to be so _gross_, _callous_, or _thick_, that the _INFANT_ cannot easily break through them.

In this _Case_, when the _MIDWIFE_ finds the _Orifice_ of the WOMB sufficiently dilated, for the _Circumference_ of the HEAD, and the CHILD so forward in the _Passage_, that it is ready for _BIRTH_, and only impeded by the rigid or stiff MEMBRANE; then _she_ has just Authority to break it gently with her _Nails_ and _Fingers_; taking Care in the ACT not to draw the MEMBRANE towards _her_, because thereby the SECUNDINE (of which the MEMBRANE, tho’ distinguish’d from the PLACENTA, is in Effect, but the _Thinner Part_) would be untimely separated from the WOMB, and the _INFANT undone_, unless presently _Born_.

BUT the _MIDWIFE_, after All, must always remember, not to attempt _This_, before these mentioned _Signs_ are obvious to her TOUCH; otherways the WATERS being too soon discharged, the _CHILD_ is left behind, the _Passages_ grow dry, and _that_ which might have been an _Easy_ and _Speedy_, proves a _Difficult_ and _Lingring BIRTH_.

AND the self-same _Consequences_ arise from the _Weakness_ and _Tenuity_ of the _MEMBRANES_; when they are so _thin_ and _soft_, that they break, and the WATERS (which are destin’d to lubricate and moisten the _Passages_) flow before their Time: In both which _Cases_, the _Office_ of the WATERS must be supply’d by proper _Fomentations_, and _Oils_, which (however costly) falls far short of the _Effect_ of what is so _Natural_. However, in short, neither of these _Conditions_, under the diligent _Hand_ of the expert MIDWIFE, can differ far from the _Case_ of an _Easy BIRTH_, as already defin’d; wherefore I proceed regularly to——

CHAP. VIII.
_Of Difficult BIRTHS, proceeding from the Causes of the PELVIS._

DIFFICULT _BIRTHS_ on part of the _Passages_, happen frequently, because of some perverse _Form_ of the _PELVIS_, in these Respects; as by its being either too _Large_, too _Narrow_, or too _Smooth_. But that I may be the better understood in this Matter: _FIRST_, by a _PELVIS_ too _large_, I mean such an _One_, as is so in comparison with the WOMB or INFANT; in which _Condition_, as the Womb can neither be firmly _fix’d_, compactly _inclos’d_, or duly supported, so neither can the HEAD of the _Infant_ and the _WATERS_ be exactly depressed upon the _Orifice_: Hence it often happens, that (besides the MIDWIFE’S careful _Hand_) the _Privities_ are the best, if not the only _Defence_, against both the WOMB and the CHILD’S falling out of the Body.

SECONDLY, By a _PELVIS_ too _small_, I mean, _such_ an _One_ as is so, in Consideration of the SIZE of the whole Body; in which _Condition_, the _INFANT_ commonly answering to that _Proportion_, its _Head_ can by no Possibility pass thro’ the _PELVIS_, in a WOMB well seated, without great _Force_, by which Means the WOMB may be easily turn’d _obliquely_: And thus consequently the _Smallness_ of the _PELVIS_, may sometimes prove the _Cause_ of a _Preternatural_, as well as of a _Difficult BIRTH_; and not only so, but also the _Death_ of both the _MOTHER_ and _CHILD_ may ensue thereupon, unless timely deliver’d by an _Artful Hand_.

THIRDLY, By a _PELVIS_ too _smooth_, I mean such an _One_, whose _Distance_ betwixt the _OSSA PUBIS_ and the prominent Part of the _OS SACRUM_ is too _narrow_; in which _Condition_, tho’ the WOMB be well placed, it cannot admit the _Head_ (especially if large and well-grown) without great _Difficulty_: And this _smooth PELVIS_ may also very easily turn the WOMB (either way) _obliquely_, and consequently prove of the same dangerous consequential _Effect_ with the preceeding _Case_.

HENCE (I think) it evidently appears, how necessary it is that all _MIDWIVES_ should not only know the _Form_ and _Size_ of the _PELVIS_, but also the _Situation_ and _Connexion_ of its BONES, as already describ’d at large[167], that _she_ may thereby the better distinguish the _Circumstances_ by plainly discerning the _Causes_, and judge accurately of the _Position_ of both the _WOMB_ and the _INFANT_; so that in the beginning of the LABOUR, she may immediately discover how the PELVIS and its _Entrance_ is form’d, whether _Large_ or _Narrow_, _Smooth_ or _Round_.

FOR this Reason, the _first Thing_ that the _MIDWIFE_ ought to do, when she comes to a _Woman_ in LABOUR, is to try by the TOUCH, how all is circumstantiated, with respect to these Things; and _This_ is to be done before the _WOMB_ and the _CHILD_ are fallen down into the PELVIS, that she may contrive her _Work_ accordingly. Because sometimes the _Exclusion_ of the _INFANT_, is to be hoped for, from the PAINS only; sometimes _Nature_ is to be prudently assisted; sometimes there is an absolute Necessity for _extracting_ the CHILD (without loss of Time) by an _Artful Hand_, as will hereafter more clearly appear; and sometimes again the same Necessity obliges us to _protract_ the _BIRTH_, than we may save _One_ or _Both Lives_: As in the _Case_ of a _smooth_ PELVIS, the OS PUBIS and the VERTEBRÆ of the SACRUM being but little distant, the CHILD’s _Head_ is stopped; when if the MOTHER should labour much, or endeavour to force an expeditious _BIRTH_, its tender _Head_ (of course) must suffer in proportion; Or perhaps the BRAIN may break, by so hard a _Pressure_ against the _Bones_; or, finally (which is worse) it may be so closely squeez’d between the _Bones_, that both the _MOTHER_ and the _INFANT_ may peradventure die, before any _BIRTH_ can possibly succeed or come happily into the World.

BUT in this critical _Condition_, the WOMAN is to _labour_ gently, and bear her _PAINS_ (how violent soever) patiently; the _MIDWIFE_ always directing the _Head_, at the same time by her safe _Hand_, into the _larger Space_; by which _Means_ at last, it passes gradually through that _narrow Passage_ without the least _Danger_.

THE same also is the _Condition_ when the _PELVIS_ is too _small_ or _narrow_; for by the _Woman_’s labouring gently and deliberately, the _Head_ is depressed softly into an _oblique Figure_, and passes easily by Degrees: Whereas, on the other hand, if it is forced by _Violence_, it becomes _flat_ and _broad_, and consequently incapable of _Passing_, if not also _dash’d to Pieces_, as aforesaid.

HENCE we clearly see, how easily _Ignorance_ in this Point, may lead common MIDWIVES into the grossest of _Mistakes_; For what is more ordinary with them, even in all _Cases_, than to advise the WOMAN to _strong Labour_, and to force her to _violent Depressions_: Insomuch that SOME have _Arrogance_ enough to carry their BOTTLES or POWDERS about them, of which they neither know the _Quality_ nor _Virtue_; taking them only as they are told (by the confident QUACKS or _Mercenary Hands_ which vend them) that they may encrease and promote the PAINS of Labour, and _This_ without having any regard to the _Form_ of the PELVIS, or the _Position_ of either the _WOMB_, or the _INFANT_.

IN short, the mature _Consideration_ of this very CASE, was not the least _Motive_ which induced me to the WORK in Hand; since I cannot but heartily commiserate so many fine delicate WOMEN, as are _thus_ every day miserably handled, tormented, and exhausted, by the _preposterous Management_ of such indiscreet and imprudent _MIDWIVES_. I may well say _exhausted_, or _worn-out_; _This_ being too evident, from the vast Number of most beautiful _Women_, who, by this ill-manag’d _Condition_, (notwithstanding they have all along heretofore, enjoy’d a good State of _Health_, together with the _Affluence_ of other Worldly _Blessings_) have been more dejected and broken both in _Complexion_ and _Constitution_, after _one_ or _two BIRTHS_, than some _others_ (judiciously and expertly _delivered_) have been after _Twenty_: Such is the great _Difference_ betwixt the unskilful _Hands_ or _Conduct_ of common MIDWIVES, and those Dextrous TOUCHES or ingenious _Operations_ of the more judicious _Andro-Boethogynists_. Whence I come in Course to——

CHAP. IX.
_Of Difficult BIRTHS, proceeding from Causes of the Bones of the
PELVIS._

THE READER may easily conceive, by the way, that _these_ are neither to be made _bigger_ or _lesser_ by ART; notwithstanding which, by using them _Skilfully_, and treating them _Judiciously_, many a _Difficult BIRTH_ may not only be prevented, but also many a LIFE saved, as will manifestly appear from what follows.

NOW the _Bones_, upon which the Success of the _BIRTH_ chiefly depends, are the OS COCCYGIS, and the Point of the SACRUM; which sometimes bend too much _inwards_, and thereby obstruct and render the PASSAGE so _narrow_, that no _BIRTH_ can possibly succeed. And again, It sometimes happens, that the _INFANT_ falling down into the _PELVIS_, and presenting itself _Head foremost_, is oppos’d and stopped there by the OS COCCYGIS: As it also sometimes falls out, that the _Shoulders_ stick fast against the _Edge_ of these BONES; or the _Buttocks_ falling down and offering themselves _first_, may be so fastened or affixed to them, that they can never be _extracted_.

THESE Misfortunes may proceed from _Either_ of these two different _Causes_; viz. Either from the _Grossness_ or large _Size_ of these _Parts_ of the INFANT, or from the _Narrowness_ of the _PELVIS_, occasion’d by an ill _Position_ of its _Bones_, particularly of the OS COCCYGIS; which _Bone_ when the _Head_ cannot make it yield or move, neither can it then possibly reach the _Orifice_ of the WOMB, to dilate it sufficiently: And, in short, if the _Head_ cannot effect this _essential Point_, much less can the _Buttocks_, or any other _Part_ be supposed capable of doing it.

BUT in all the above-mentioned _Cases_, I am sensible, that most _MIDWIVES_ (not knowing better) ascribe the whole _Difficulty_ to the _Orifice_ of the WOMB and the VAGINA; upon which they ignorantly fall atearing and dilating both the _One_ and the _Other_, (never minding the _Point_ of the SACRUM); and finding _these Orifices_ but little _open’d_, notwithstanding the frequent _Repetition_ of very severe _PAINS_, they imagine that their substantial _Hardness_ or _Thickness_ is the only CAUSE: So that therefore (without regarding any _adjacent Part_) they go on violently dilacerating sometimes the _Mouth_ of the WOMB, and sometimes _That_ of the _PRIVITIES_, (as I have found it by Experience) quite to the RECTUM. For such is their _Stupidity_ in this Condition of LIFE (as _Daventer_ well observes) that whilst they _thus_ tear and rend the WOMAN to _Pieces_ in a manner, they allow her to sit over and above with the _Point_ of the OS SACRUM, upon her _Seat_ or _Bed_; or in some other wrong _Posture_, which so presses and confines the OS COCCYGIS at the same Time, that neither of _these_ can move: Not minding at all that the chief _Pressures_ and _Impulses_ of the HEAD, must first bear upon the OS COCCYGIS in order to remove it, before it can effect the _Dilatation_ of the _Orifice_ or _Mouth_ of the WOMB. Thus they spend the WOMAN’s _Strength_ in vain, break her _Spirits_, and ruin her _Constitution_ thro’ Ignorance; whilst a capable _Person_, administring seasonable and judicious _Help_, according to the Circumstances of the _Case_, refreshes _Nature_, renews _Strength_, gives _Courage_, and fills the (otherways languishing and despairing) _WOMAN_, with _Hopes_ and _Assurances_ of a happy _DELIVERY_.

IN short, the True _Method_ of _Delivering_ and helping the WOMAN conveniently, in the different _Conditions_ contain’d in this _Chapter_, depends entirely upon _repelling_ or thrusting back the _Point_ of the OS SACRUM, together with the OS COCCYGIS. I say (therefore) the whole _Point_ of the OS SACRUM, and that _Fleshy Part_ lying about it, is to be _thrust back_ and _dilated_, so that the _Passage_ may be sufficiently opened for the INFANT to pass through; which patent _Dilatation_ is to be promoted by _pressing_ also _back_ the OS COCCYGIS. Now these Things, in short, may be all done cautiously without creating any intense _Pain_, or the least Damage; and _thus_ the obstructed _Passage_ being clear’d and open’d, the BIRTH advances regularly of Course, and the _CHILD_ is born with the greatest _Ease_, in the Space of a few Minutes: Whereas otherways (without the Use of these _Means_) both its _Own_ and the MOTHER’s _Destiny_ may be precarious or uncertain after some _Days_ LABOUR.

THUS it is certain, that by assisting a _Woman_ in LABOUR seasonably and skilfully, her _PAINS_ are happily excited and encreased; whereas, on the contrary, by _imprudent Treatment_ they unhappily cease and vanish, to her great Prejudice. Moreover, daily _Experience_ teaches us, that the very _different_ TOUCHING of Things, occasions different _Sensations_; and from thence it is, that the _dextrous MIDWIFE_ knows by _one_ way of TOUCHING, how to promote the _PAINS_ of _Labour_; and by _another_, how to retard or put them off according as the Necessity of the _Case_ requires; which hereafter will appear more at large.

BUT that we may more particularly satisfy such _MIDWIVES_, of our _Method_ of repressing these BONES, and _Delivering_ the _WOMAN_ in the abovesaid _Cases_; I must add, that, after placing the _PATIENT_ in the most convenient _Posture_ for a _WOMAN_ in _Labour_, as before fully enjoin’d[168], I would direct _Her_ to be _supported_ by two Women, and mov’d so far off the BED or COUCH, that the _Point_ of the OS SACRUM may be free to yield or give way _backwards_, without any the least _Impediment_: Then I would pass my whole _Hand_ at once (being first well anointed or dipp’d in _Oil_) into the _VAGINA_, and from thence (if the _Head_ will admit it) into the _WOMB_, as occasion should require: where, upon opening my _Hand broad_, that it may press equally every where, I turn the _PALM upwards_, and the _BACK downwards_ against the _RECTUM_, and the _OS SACRUM_: Thus I extend my _Fingers_ as far as possible to the _Head_, thrusting it a little _backwards_, rather than hinder my _Hand_ from being firmly placed against the OS COCCYGIS: Upon my _Hand_ being thus properly placed, as soon as the _PAIN_ begins to threaten (which I commonly perceive before the _WOMAN_) I advise her, to make good Use of the approaching _Pains_, in order to _Labour_ mutually, and depress with all her Power, promising her my most faithful _Assistance_: By which Time, as soon as the PAINS have seiz’d her, and she doing her _Part_, I press my HAND _backwards_, first _softly_, and by degrees more _strongly_, against the _Point_ of the SACRUM, bringing it at the same time gradually _downwards_, that I may thereby make Room for the _Head_ sliding the same way; so that the more _severe_ the _PAINS_ are, the more I depress still, and the _harder_ I press down with _Effectual PAIN_, the more vigorously and successfully the _WOMAN_ is able to _Labour_.

THUS I enlarge the _Passage_ with great Moderation, so that the INFANT’s _Head_ succeeds or follows my _Hand_, as I bring it by little and little _back_ again; and this adviseable _Method_ I would reiterate as often as the _Case_ should require, always encouraging my _WOMAN_, by the most obliging Words: Upon which _She_ suffering no _PAIN_ in vain, finds immediate _Relief_, recovers her _Strength_, recollects her _Spirits_, and by jointly _labouring_ her _Best_ with all her Force and Might, at last produces her CHILD with Comfort and Satisfaction, whilst I congratulate her upon the Success of being a _joyful MOTHER_.

BUT supposing by the way, that the _INFANT_ offers its _Buttocks_ first, they being neither so _round_ nor _hard_ as the _HEAD_, I would then intrude all my _Fingers_ into the WOMB more easily; some of which (or sometimes _All_) I would pass into the _Orifice_ of the WOMB under the _Buttocks_ as before into the _VAGINA_. Now my _HAND_ being placed there, I intently observe the _PAINS_ as they come on; then inviting the _Woman_ to _Labour_, I gradually press _backwards_ as hard as I can conveniently, drawing my _HAND downwards_ as before: But if in attracting it so, the _HAND_ should slide too much out of the WOMB, (which however I endeavour to prevent) while the _PAINS_ are yet upon her; then as soon as they are over, I pass it up again, that I may be ready against their _Return_. And _this_ I would reiterate upon every _PAIN_, so that the CHILD (guided by my _HAND_) may slide down at every Turn, until at last the _Passage_ is so dilated, that it may advance gradually with _ease_ into the World.

BY these judicious _Means_; forcing back the _OS COCCYGIS_ by the _Pressure_ of the _HAND_, as the _PAINS_ come on, I may not only dilate the _Passage_, and enlarge the _Orifice_ of the WOMB; but also upon retracting the _HAND_ by degrees, I can gradually attract the _CHILD_ out of the WOMB, through the _Narrowness_ of the _PELVIS_: And thus, by this curious ART, (which I take to be one of the chief _Points_ belonging to MIDWIFERY) I do fairly _deliver_ the WOMAN, who by no other _Means_ whatsoever, could be preserved, together with her _INFANT_, in all Probability.

HOWEVER, tho’ I have candidly laid down this _Method_, (conformable to the Doctrine of the most excellent and ingenious _Instructers_) yet I would not advise every coarse _Clumsy HAND_ to undertake it, nor _such_ as are not thoroughly acquainted with the _Parts_ of Generation: For this _Performance_ requires _Judgment_ and _Prudence_, as well as ART and _Experience_. But however yet in _Case_ of _Necessity_, where no _Extraordinary Person’s Assistance_ can be had, as it often happens in the _Country_, the _Ordinary MIDWIFE_ ought not to neglect her _Duty_: nevertheless, before she offers to attempt this piece of extraordinary _Skill_, she ought to be very certain that these _BONES_ are the great _Impediment_ and _Difficulty_ of the Delivery.

CHAP. X.
_Of Difficult BIRTHS, proceeding from Causes of the BLADDER and RECTUM_.

DIFFICULTY in _BIRTH_ may also proceed from the _BLADDER_, as (in like manner) it may from the _RECTUM_ or _Strait Gut_.

I. FROM the _BLADDER_, when affected with _Tumours_, _Ulcers_, or _Glands_, obstructing the _Passages_; which however is more frequently occasioned by _Stones_ lodged in the _BLADDER_, or in its _Neck_: In either of which _Conditions_, the MIDWIFE, by dilating the _Passage_ with a subtile _HAND_, must repel the _OS COCCYGIS_ according to ART (as taught in the preceeding _Chapter_) that the _HEAD_ in falling down, may the less offend the _BLADDER_.