Chapter V: MOREOVER it likewise sometimes happens, that the STRING comes along

with the _Shoulder_, _Elbow_, _Hand_, _Foot_, &c. without touching the _HEAD_: Upon this then as soon as the _Humours_ have flow’d, I would pass my _Hand_ quickly up, and bring the _CHILD_, _Head_ or _Feet foremost_ into the _Passage_, according to its _Situation_, always detaining or stopping the _STRING_ from coming out before the _BIRTH_: Whereas if the _STRING_ be already excluded along with the _Foot_ or the _Arm_, it is to be _repelled_ with all necessary Speed, Conduct, and Caution, and then the _INFANT_ ought to be dextrously drawn out by the _Feet_.

VI. I have also seen the _CHILD_ brought forth by the _HEAD_, with the _Umbilical_ circumvolv’d, or turn’d twice or thrice round the _NECK_; by which means of the _STRING_’s being so much shortned, the _BIRTH_ was stopped or retained in the _Passage_: Upon this Occasion, I endeavour’d to slacken the _STRING_, and so bring it over the _HEAD_, but finding it too _strait_ and _short_ to be so ordered, I _tied_ it in two places (at about two or three _Inches_ distance) and then _cut it in two_ betwixt the _Ligatures_: That being done, it was my Business to lose no Time in attracting the _INFANT_ and delivering the _WOMAN_; otherways in this _Condition_, it would have soon expired.

CHAP. XXV.
_Of Preternatural BIRTHS, from the AFTER-BIRTH’s coming first into the
PASSAGE._

ANOTHER _Preternatural Accident_ to which the _BIRTH_ is also sometimes liable, is the _Falling down of the_ PLACENTA into the _Orifice_ of the WOMB; which of course must needs obstruct the _Passage_, and prevent the timely _Egress_ of the _INFANT_.

NOW tho’ the ignorant MIDWIFE often occasions this untoward _Accident_ by her own unskilful and imprudent _Treatment_, or rough and indecent _Usage_; yet the Ingenious _MIDWIFE_ discovers this _Case_ in time by _two_ certain different _Ways_: Namely, FIRST, by the TOUCH, when she can neither feel the _MEMBRANE_, nor the naked _HEAD_; but (on the contrary) perceives a thick, soft, fleshy, boneless _Substance_: SECONDLY, by a _Bloody Flooding_, which constantly attends this _Condition_; whereby both the _MOTHER_ and the _CHILD_ are imminently endangered, as is already more abundantly set forth[180]: Unless the skilful _MIDWIFE_ can prevent the fatal _Consequence_, by accelerating the _BIRTH_; which, however yet, is not to be rashly attempted without due Circumspection.

BUT notwithstanding the daring _Difficulties_, and time-serving _Precautions_, mentioned by most _Authors_ of my reading and revolving, in this _Case_; I can conceive no extraordinary _Perplexity_ which can attend it, if the _DELIVERY_ be but _timely_ or _seasonably_ undertaken, before the _Woman’s Strength_ and _Blood_ be too much exhausted. I know _Daventer_, _Peu_, and some _others_, make long _Ambages_ or Circumlocutions upon this _Head_; for _some_ are at great Pains to teach us how to perforate the _SECUNDINE_ with a _Hair-Needle_ instead of our _Fingers_, and _others_ how to keep it back, until the _INFANT_ be first born: But for my part, as I already foresee sundry _Difficulties_ that will arise in these Practices, so I shall be loth to come into them, and that because——

FIRST, in penetrating the PLACENTA with any _acute Instrument_, the _CHILD_ (if not the _MOTHER_ also) may be easily wounded: SECONDLY, supposing it to be done with the FINGERS, the _Hole_ must be dilated in proportion to the _Aperture_ of the Mouth of the WOMB, and then _this_ mangled MASS must be dispersed to _all Sides_ of the _Orifice_; by which Means, _Daventer_ himself acknowledges, that it often perfectly _congeals_ with BLOOD, and sticks so fast to the WOMB or VAGINA, that the _Ignorant_ would not only take them to be _grown together_, but also believe them rather to be _one and the same Body_: Which consequently must require both great _Pains_ and _Difficulty_ to be separated, and at last a very diligent _Scrutiny_ must be made, that no _Fragment_ be left any where _Behind_, since in this _Condition_ no just _Conjecture_ can be made by the Eye: THIRDLY, by retaining the _SECUNDINE_ in the WOMB, when its heaviest and most bulky _Part_ (the PLACENTA) is fallen down into the _Entrance_, let it be never so judiciously managed and moved, it possesses a considerable deal of _Room_, and consequently obstructs the _Operation_ of the _MIDWIFE_’s _Hand_, lying as a cross thwarting _Impediment_ in her way, which at the same Time _blockades_ or totally shuts up the _Passage_ of the _CHILD_.

WHEREFORE, and considering that this _Body_, when so loosened and separated from the WOMB, can never possibly be any more _serviceable_; but, on the contrary, highly _detrimental_ to both the _MOTHER_ and the _INFANT_, as aforesaid; I cannot but be of Opinion, that it is both the safest and shortest Way, to extract the _SECUNDINE first_; by which expeditious _Step_, the _MIDWIFE_ not only gains more _Room_ to turn the CHILD, but also (this being done) she can much more commodiously draw it out by the HEELS: Animadverting always by the way, that in this critical _Condition_, the _BIRTH_ must immediately follow the _SECUNDINE_, without the Loss of one Moment’s Time, and _that_ especially for stopping the _Floodings_, which would otherways not only soon suffocate the weak INFANT, but also in a short Space of Time effect the certain _Death_ of the tender MOTHER.

CHAP. XXVI.
_Of Preternatural BIRTHS, proceeding from the Death of the INFANT._

AMONG the many _Preternatural BIRTHS_ mentioned, I think _that_ of a _Dead CHILD_, may now at last justly take place.

BUT because this _Case_ is too commonly mistaken, and that the _Live INFANT_ is too often taken for _Dead_, and consequently the wretched innocent _Creature_ treated accordingly; I think it may not be amiss, before I enter upon this DELIVERY, that I make a few previous requisite _Remarks_; by which the extraordinary _MIDWIFE_, who is commonly sent for too late, may perfectly know whether the _BIRTH_ be _dead_ or _alive_; to the End that, so also in Case of _Necessity_, it may be accordingly managed: Since in this fatal _Condition_ I have known _several Persons_ to have been grossly deceiv’d, who have depended upon the _Relation_ of the sick WOMAN, or taken it upon the _Credit_ of the ignorant attending _MIDWIFE_.

FIRST then I know it to be ALIVE, if, by laying my _Hand_ on the MOTHER’s _Belly_, I find it _stir_ or _move_: Or, SECONDLY, If I have not full _Satisfaction_ this way, I would convey my _Hand_ into the WOMB, as soon as the _Waters_ break, to feel the _Pulsation_ of the NAVEL-STRING; which the nearer I feel to the _CHILD_’s _Belly_, the stronger I find it _beat_, if ALIVE: Or, THIRDLY, I would put my _Finger_ into the _INFANT_’s _Mouth_ to feel its _Tongue_, which (if ALIVE) I should perceive it to _stir_, as if it would _suck_.

WHEREAS, on the contrary, we may know it to be DEAD, when a certain nauseous and cadaverous _Humour_ flows from the WOMB: Or, when the _Woman_ feels a great ponderous _Weight_ in her _BELLY_, tumbling always towards that _Side_, which she inclines to, or lies upon: As also when we find the _CHILD cold_ in the WOMB; or the _Umbilical_ Vessel without PULSE; or the TONGUE _immoveable_: Or lastly, when I perceive the _Dissolution of the Cuticle_ on the Top of the HEAD, I am then positive that the FOETUS is DEAD; because, as _this_ is not easily _dissolved_, neither does it happen immediately, but some Space of time after DEATH.

IN this _Case_ then of a _dead CHILD_, the _Labour_ is commonly lingring and dangerous, because of the few, faint, and slow _PAINS_ which seize the _Woman_; so that _Nature_, being half overthrown by the _Death_ of the _INFANT_, which now can no ways help itself, absolutely requires to be assisted by the most expeditious ART: And _that_ best, in my humble Opinion, by the _Means_ and _Method_ following, _viz._——

FIRST I would endeavour to awaken and promote the _PAINS_, by one or more sharp and strong _Clysters_: But SECONDLY, if _these_ do not succeed so expeditiously as necessary, I would introduce my _Hand_ into the WOMB, sliding it all along under the BELLY towards the FEET; and so, with _Face_ and _Breast_ downwards, I would gently extract it by them; in the same manner, as if it was ALIVE. Only, in this _Case_, great _Care_ must be taken, that the HEAD may not unhappily _sever_ itself from the _Body_, and consequently _stay behind_ in the WOMB; which Accident may easily happen in the _Passage_, especially if the _BIRTH_ is any ways _putrefy’d_.

HOWEVER, after all, in _Case_ of such an untoward _Occurrence_, I would still excuse myself from the _Use_ of an EDUCTOR, and debar myself from the Practice of any _Instrument_ whatsoever, save only that of my own natural HAND; which, I think, in all _Conditions_ of _BIRTHS_, whether _Natural_ or _Preternatural_, _Dead_ or _Alive_, is solely _obliged_, and only best serves, according to the _Rules_ of my _Profession_, to discharge the _Duty_ of all the _INSTRUMENTS_ in the _Surgeon’s Shop_; excepting only in the _Case_ of a _MONSTER_ or a very _Hydropical CHILD_.

BUT in the present _Circumstance_ of the HEAD’s being separated from the _Body_, as soon as I have extracted the _CARCASE_, as above; I would instantly convey back my _Hand_ into the _WOMB_, and put one or two of its _Fingers_ into the _Mouth_ of the _HEAD_, placing my _Thumb_ under the _Chin_: For by _thus_ taking Hold of it by the _Jaw_, I would extract it gently, and _that_ with the greatest _Ease_ and _Safety_ to the _PATIENT Woman_.

NOW having thus, in fine, both particularly and at large, treated of the several _Sorts_ of _Natural_, _Difficult_, and _Preternatural BIRTHS_: And having also for the common _Good of Mankind_, without any Affectation, Hesitation, or Reservation, candidly laid down, and ingenuously set forth the most _certain_, _brief_, _plain_, _easy_, and _unprejudiced INSTRUCTIONS_, which perhaps have ever yet been committed to PRINT, upon the excellent _Subject_ of _MIDWIFERY_: And having likewise, in a Word _lastly_, for the true _Direction_ and good _Government_ of all _MIDWIVES_, fairly laid (as it were) and faithfully _delivered_ the _big-belly’d Woman_, in every relative _Case_ or _Condition_ of _BIRTH_, which may or can happen to her: It now only remains, I would modestly think, that I should (in the next place) come to take all the necessary _Care_, and make the most requisite _Provision_ possible for the perfect _Recovery_ of my CHILD-BED-WOMAN; and _that_ in the ensuing _Method_.

SECT. VI.

CHAP. I.
_Of the DIET and REGIMEN of the Puerperial or Child-Bed-Woman._

THE _Good Woman_ being now delivered, and laid in CHILD-BED, may rightly be compared to a SHIP, which, after a dangerous nine or ten Months _Voyage_, rides at _Anchor_ in her PORT; where, tho’ arriv’d with great Security, yet if not well _moor’d_ against sudden _Winds_ and _Storms_, she may perhaps at last drive from her _Anchors_ and suffer SHIPWRECK: So in like manner if both the MOTHER and the CHILD be not duly taken _Care_ of after the _BIRTH_, _Both_ may be still expos’d to the Danger of _DEATH_. Wherefore, to prevent all such melancholy _Accidents_, I shall first point out the proper _REGIMEN_ of the _One_, and then successively direct THAT of the _Other_, in the following Manner; _viz._——

I. THEN, immediately after the _BIRTH_, a soft gentle _Closure_ may be apply’d to the WOMB for repelling of the _cold Air_; of which we must be now very cautious, if we will _avert_ the fatal _Consequences_ that may thereby happen: As also a small _Plaister_ of GALBANUM with a little _Civet_ in its Center, may be applied to the _NAVEL_ for attracting, or rather retaining the WOMB in its proper Place, where the _MIDWIFE_’s careful _Hand_ has fixed it after the _DELIVERY_.

II. THE _Patient_ having her _Body_ wrap’d about with a _warm Cloth_, and her _Hips_ girt round with the same, is to be placed conveniently in a _warm_ BED; that is, directly upon her _Back-Bone_, with her _Head_ and _Body_ a little elevated, for her _breathing_ and _cleansing_ the Better; as her _Thighs_ and _Legs_ also are to be stretched down close together: Whereupon _now_, if not _before_, she ought to have a little good _Chicken_ or _Pullet-Broth_ for her Refreshment; which being done, all _Doors_ and _Windows_ are to be shut, and the _Bed-Curtains_ drawn close, that she may rest and sleep quietly.

III. IN the next place, the _Closures_ are to be remov’d, and the _clotted_ BLOOD taken away; which being diligently done, the _BELLY_, _LOINS_, and _PRIVITIES_ are to be anointed with the Oil of _sweet Almonds_, or _white Lillies_, mixed with a little warm _Wine_, which may be repeated at pleasure, for allaying the _PAINS_ of these _Parts_: And as the _Woman_ is to be carefully kept always very _warm_, as well as disposed to _Rest_ and _Sleep_; so every now and then, she is to be comforted with some small Matter of any convenient FOOD; abstaining however chiefly from _strong Meats_, as well as from all _hot_ or _strong Liquors_.

IV. A DECOCTION of _Barley_, _Linseed_, and _Chervil_, or _Marsh-Mallows_ and _Violet-Leaves_, with a little Honey of _Roses_, may be afterwards used _Milk-warm_ three or four times a Day, by way of _Fomentation_ for the first five or six Days of _CHILD-BED_: Or, instead of these Things, fresh _warm Milk_, or _Barley-Water_ only may be properly used; always remembring that the _Parts_ be duly cleansed from the _clotted_ BLOOD, _&c._

V. IN the mean time, the _Woman’s_ BREASTS are all along to be kept very close and warm-cover’d with soft _Cloaths_, that the _MILK_ may not _curdle_; which however is no ways yet in the beginning fit for the _CHILD’s Nourishment_, until the _Conflux_ of the _MILK_ and the _Humours_ is over; which, upon the first days after _DELIVERY_, run in abundance to the BREASTS.

VI. SPECIAL Care also must be taken, when the _Woman_ is resolv’d not to _Nurse_ the _CHILD_ herself, that the LOCHIA or _Child-Bed-Evacuations_ flow-off plentifully, in order that thereby the _Shock_ of the _BLOOD_ may be averted from the _BREASTS_; which if not sufficient to prevent that _Inconveniency_, they may be properly anointed with the Oil of _ROSES_ and a little _Vinegar_ beat-up together; or a _CATAPLASM_ of the Meal of _Beans_ and _Vetches_ mixed with _Oxymel_ may be applied to the _BREASTS_; or they may be fomented with a _Decoction_ of the Leaves of _Mint_, _Dill_, or _Parsley_.

VII. IN the time of _Cleansing_, all Noise and Clamour about the _Woman_ ought to be suppressed; and as she herself ought not to talk much, or _aloud_, neither ought any Person about her to be _obstreperous_: Because her _Repose_ is not only thereby disturb’d, but also her _Spirits_ exagitated; which violent Commotion of _Humours_ may readily stop the _natural Course_. And as for the same Reason, all _Passions_ of the Mind are to be suppressed; so the _Woman_ is to keep herself as much as she conveniently can upon her _Back_, carefully avoiding frequent _TURNINGS_ to either Side.

VIII. AFTER ten or twelve Days, proper Measures may be taken to fortify and strengthen the _Members_; and after she has fully done cleansing (which may be about the 20th _Day_, sooner or later after _DELIVERY_, according to the PATIENT’s _Constitution_, or her way of _Living_) some proper _Astringent Medicines_ may be discreetly made use of, for corroborating and reconsolidating the _Parts_.

IX. AS to her _DIET_, during this Time, she ought to be very regular, and live _abstemiously_ (especially the _first Days_) as if she had a FEVER, using only good _Broths_, _Jellies_, fresh-laid _Eggs_, _Ale-soup_ made with fresh _Butter_, or the like; after which, she may begin by degrees to eat a little _Chicken_, _Pullet_, _Capon_, _Veal_, _Mutton_, or any thing else of good _Nutrition_ and easy _Concoction_.

AS to her _DRINK_, if she has no _Fever_, she may use besides her _Cawdles_, small _White-Wine_ and _Water_ for Variety’s sake; but in case of a _Fever_, Water boil’d with a little _Cinnamon_, or _Coriander-Seed_; or a _Ptisan_ of _Liquorish_, _Figs_, and _Aniseeds_ boil’d in Water; or _small Ale_ a little butter’d, as the _Woman_ pleases, are far more convenient; observing always carefully that her _DRINK_, of whatsoever sort, be at all times a little _warmed_.