Chapter X: FINALLY, as the Child-Bed-Woman’s Body is always to be kept open,

if not otherways naturally so, by a proper gentle _CLYSTER_, repeated as often as Necessity requires, until the _Course_ of the LOCHIA is quite over; so afterwards she ought to take one or more proper gentle PURGES, for cleansing the _Stomach_ and the _Bowels_ of such vitious _Humours_, as _Nature_ could not otherways evacuate: Upon which, a repeated Strengthening _BATH_ may be most pertinently used, as also, in order that she may again the more successfully _begin upon a new Score_, other proper Measures may be prudently taken.

THUS we suppose that all things have succeeded well with our _Puerperial Woman_; in which Condition the above-mention’d is her only requisite _REGIMEN_: But in Case of any _Preternatural Accident_, we must come to her _Assistance_, according as the Nature of _Circumstances_ does require: Of all which in their Order, as they most commonly happen to the _Woman_ in her present _Condition_; and FIRST——

CHAP. II.
_Of the AFTER-PAINS._

THESE PAINS, which usually accompany or follow after the _BIRTH_, are common to all _Child-Bed-Women_; and in that _Natural Sense_, as they proceed only from the quantity of _BLOOD_ abounding in the relaxed Womb, distending its _MEMBRANES_, or arise from its _Acrimony_; so they gradually cease, and in two or three days quite vanish: Wherefore I am not to insist upon _Those_, which only affect the debilitated WOMB.

BUT it often and too commonly also happens, that another Sort, justly call’d _Preternatural AFTER-PAINS_, afflict the _Woman_; which she sometimes feels about her _Loins_ and her _Groins_, sometimes about the _Navel_, sometimes all over the _Belly_, and sometimes in the WOMB only, and that sometimes with a little, and sometimes without any _Intermission_.

THE most common _Cause_ of which _PAINS_ is generally one of the _Five_ following; _Viz._ 1. The _External AIR_, especially the more _frigid_, which easily penetrates into the WOMB, if not carefully prevented: 2. _Clotted BLOOD_, or some other _foreign Body_ left behind in the WOMB: 3. Some _Acrid_, and _Mordacious_ BLOOD adhering to the WOMB, which excites and stimulates _Excretion_: 4. The _SERUM_ vellicating or twitching the _excoriated_ part of the WOMB: Or, 5. _WINDS_ elevated from the _Humours_ fermenting in its _Substance_; which, together with those turgent _Humours_, tear its tender _TUNICKS_.

NOW because these PAINS often excruciate the _Woman_ as much as the _real_ LABOUR-PAINS do, and since they are not always without _Danger_, Necessity demands that they should be either _cured_, or at least _mitigated_: Which may be most properly done, by convenient relaxing and attenuating _Medicines_ outwardly applied, as well as inwardly taken, when the _Case_ does not require the _Hand-Cure_, or manual Operation.

HOWEVER, yet more particularly, in respect of the PAINS, from what _Cause_ soever they may proceed, _CLYSTERS_ of _Milk_ with the _Yolks of Eggs_ are proper; as are also emollient _Fomentations_ mix’d with attenuating and _Uterine Medicines_; a _Fumigation_ of _BRANDY_; a _Decoction_ of the _Recrements_ of the _Regulus_ of _Antimony_; such things being of a _sulphurous Nature_: And moreover, in fine, all _AFTER-PAINS_ are eased by _Aromatick_ and _Carminative Remedies_; such as Seeds of _Anise_, _Carway_, _Cummin_, _Fennel_, _Penny-Royal_, _Roman-Camomil_, &c. infus’d or boil’d in _Wine_ or _Water_, adding thereto a very little _Mace_ and _Saffron_.

CHAP. III.
_Of the Suppression of the LOCHIA, or Child-Bed-Purgations._

THE _LOCHIA_ are nothing else, but the ignobler part of the _Blood_ and congested _Humours_, which after the _BIRTH Nature_ evacuates and discharges out of the _Uterine Vessels_, in consequence of the _Divulsion_ and _Separation_ of the PLACENTA from the WOMB. Which _LOCHIA_ however differ always according to the Constitution and Disposition of the _Woman_, and that not only in _Quantity_, but also in _Quality_: For if the _PATIENT_ be otherways Healthy, and Well-disposed, _these_ are at first of a _florid rosy Colour_, degenerating day by day into a _Pale-dye_; Whereas if otherways, they are sometimes _Aqueous_, and sometimes _Bilous_, _Melancholick_, &c. And, according also to the usual _Habit_ of Body, and _Way of Living_, _some_ Women _flood_ more plentifully, _others_ more sparingly; _some_ a longer, and _others_ a shorter Time: as for Instance——

A _Woman_ given to _Ease_, and _high Living_, being delivered of a MALE, may _cleanse_ from twenty to thirty Days; and if of a FEMALE, from thirty to forty-two Days at most, however still declining in _Quantity_ from Day to Day: Whereas _another_ given to _Exercise_, may _flood_ only from eight to fifteen Days; and _that_ also perhaps more _sparingly_, or by _Intervals_ of one or two Days. But it oftentimes happens, that this _Evacuation_ is either suppressed in Whole, or in Part; of which _Suppression_ or _Preternatural Retention_, I am now about to speak.——

FIRST then, the _Cause_ of this EVIL, proceeds either from an _Obstruction_ of the _Uterine Vessels_, occasion’d by _thick BLOOD_ stopping the _Passages_: Or, SECONDLY, from a _Constriction_ or _Compression_ of the same _Vessels_, occasioned by an _oblique Situation_ of the WOMB, or by cold _Air_, cold _Drink_, or the like, which readily constrict their _Orifices_, as well as contract the WOMB itself: Or, THIRDLY and lastly, the _Cause_ may proceed from the _BLOOD_’s being retracted and converted to some _other Part_ of the Body; which is most commonly occasion’d by some _Passion_ or _Perturbation_ of Mind, that may not only turn the _Shock_ of the _BLOOD_ to the BREASTS, but also retard the _Motion_, and thicken the MASS of the same _BLOOD_.

THE _DIAGNOSTICKS_ however of this _Distemper_ are manifest; for either no _BLOOD_ is voided at all, or too small a _Quantity_, in respect to the _Size_, _Temperament_, and _Constitution_ of the _PATIENT_: But besides, it may be also known by the following _Symptoms_; viz. a _SWELLING_ of the _BELLY_, upon the Retention of the _Humours_ that ought to be evacuated; a _Difficulty of Breathing_ arises; PAINS seize the _Abdomen_, as also the _Loins_ and the _Groins_; a _Fever_ and _Tremblings_ follow; as _Faintings_ do upon a weak, quick and unequal _Pulse_; something _fuliginous_ appears in the _Urine_; and a livid, black, grumous, or nauseous _Matter_ is excreted.

HENCE proceed various _PROGNOSTICKS_; viz. _Fevers_, _Spitting_ or _Vomiting_ of BLOOD, _Melancholy_, _Inflammations_ of the _Liver_, _Quincy_, _Pleurisy_, _Frenzy_, _Dropsy_, _Apoplexy_, and _Madness_ itself: The _least_ of which may prove of fatal _Consequence_, wherefore Delays in this _Condition_ are most dangerous; because when any of _these_ heavy SYMPTOMS has befallen the _Woman_, there is scarce any Hope left for her _Recovery_; whereas _before_, they may be artfully prevented, and the _Cure_ duly perfected by convenient _DIET_, _Venæsections_, _Revulsive Medicines_, &c.

BUT more particularly the _Cure_ ought to vary, according to the _difference_ of the co-incident SYMPTOMS: For since continual _Fevers_ and _Inflammatory Diseases_ most commonly follow upon this _Suppression_ or _Diminution_ of the LOCHIA, we must take great Care that, endeavouring to promote the _FLUX_, and to open the _Uterine Vessels_, we do not augment the _FEVER_ and _Inflammation_; which will certainly happen, (if without distinction) we use the _hot Medicines_ prescribed by many AUTHORS.

WHEREFORE in this _Case_ repeated _Venæsections_ sometimes in the _Ancle_, and sometimes in the _Arm_; and _cupping Glasses_ applied to the _Thighs_ and _Shins_; as also _Rubbing_ of the _Legs_ and _Thighs_ well, are generally sufficient _Remedies_; especially if followed with one or more Cleansing, or partly opening, partly cooling, and Emollient _CLYSTERS_, of a _Decoction_ of _Mallows_, _Pellitory_, or the like; in which strain’d _Liquor_, the _Pulp_ of _CASSIA_ with a Dram of _Nitre_, and _Sugar_, and _Honey_ may be dissolved: As also _Fomentations_ and _Fumigations_ of Emollient and Aperient _Medicines_ that are not sharp, may be very pertinently used. Finally, the _Infusion_ of JESUITS-BARK in Water, may be properly given three or four Times a day; and purging _PTISANS_, after the _first days_, are of good _Service_ in the present _Case_.

CHAP. IV.
_Of the immoderate Flux of the LOCHIA._

THE too copious and long lasting, or immoderate FLUX of the _Child-Bed Purgations_, is no less _Preternatural_, than the former _Case_ of their being altogether _suppressed_, or in part _diminished_. Tho’ it is however to be observ’d, that there can be no certain _Quantity_ of flowing BLOOD, nor any certain _Time of Duration_ of this FLUX prefix’d or determined to the _Puerperial Woman_, as aforesaid: Wherefore the _Excess_ of this _Evacuation_ is best known by the _Loss of Strength_, _sinking of the_ SPIRITS, and the great _Uneasiness_ of the PATIENT.

THE _Cause_ of this _Distemper_ is, either _1st_, a too great _Plenty_ of the abounding BLOOD; or _2dly_, its _Tenuity_ and _Acrimony_ stimulating Nature to _Excretion_; or _3dly_, too great an _Apertion_ of the _Uterine Vessels_; or _4thly_ and lastly, a violent _Extraction_ of the _AFTER-BIRTH_: For the _Flux of the LOCHIA_ proceeding meerly from the _Separation_ of the PLACENTA from the WOMB, the more strong and violent this _Separation_ or _Divulsion_ is, the more the _Vessels_ in the _Concave Part_ of the WOMB are torn or dilacerated; and so being either too much _opened_, or too difficult to _reconsolidate_, they discharge BLOOD immoderately.

HENCE, I say, this immoderate _FLOODING_, is not only known by the great _Quantities_ of _BLOOD_ voided, by its _Continuance_, or by coming away in _Clods_, and much at a time; but also by the _Loss of Strength_, and a _Defect_ of _SPIRITS_; upon which follows a low, debilitated and frequent _PULSE_; Loathing of _VICTUALS_; _PAINS_ in the _Hypochondriacks_, with a _Twisting_ of the _GUTS_, and _Griping_ of the _BELLY_; a _Dimness_ of _SIGHT_; a _Hissing_ of the _EARS_; and at last _Swoonings_ or _Convulsions_, proceeding from the _Depauperation_ of the _BLOOD_: Which after an immoderate _FLUX_ always disorders the _SPIRITS_, because when the MASS of it is much lessened, it cannot keep its due _Mixture_ and _Disposition_.

IN this _Case_ the true PROGNOSTICK is, that, if all immoderate _Hæmorrhagies_ are dangerous; because by them, the _Treasure_ of _LIFE_ (the _natural Heat_) is exhausted: _Then_, without Controversy, the immoderate _Flux_ of the LOCHIA, whether after LABOUR, or after a _MISCARRIAGE_, is full of _Danger_; as coming upon the _PATIENT_ at a most unseasonable time, when her _Strength_ is already spent.

THE _Cure_ of this _Distemper_ ought to be well-weigh’d, and very cautiously perform’d, because the definite _Quantity_ of _BLOOD_ to be evacuated cannot be well or certainly known: And because if any Part of _That_ be stopped, which ought to be ejected, it of course flows to some _other Part_, and excites _Inflammations_ or other heavy _SYMPTOMS_. Wherefore this is only, in the Beginning, to be corrected by proper _DIET_, and some other convenient light Means: But afterwards by repeated _Venæ-Sections_ in the ARMS, if _Strength_ will permit; and proper _Astringents_ inwardly taken, as well as outwardly applied; continuing always a _Thickening_, _Cooling_, and _Astringent DIET_: But farther yet, as the Patient grows _weaker_, she ought also to have some _corroborative Remedies_, to enable her to stand out the _Cure_. _Fomentations_ for the _lower Belly_ of OXYCRAT, or an astringent _Decoction_; _Fumigations_ of the same _Decoction_, or of hot OXYCRAT, are very convenient and helpful on this Occasion, as are also _astringent Injections_.

BUT however sometimes, and not seldom, it happens, that this _Case_ proceeds from the negligent or ignorant _MIDWIFE_, by her not duly _cleansing_ the WOMB; by which Means, some part (how small soever) of the _SECUNDINE_ or _Membrane_, or some _clotted BLOOD_, or perhaps a _MOLE_, miscall’d a _false Conception_, may be left behind in the WOMB; which distending that _Body_, occasions not only an immoderate FLUX, but also stirs up violent PAINS, not unlike to _those_ of LABOUR: In this pitiful _Condition_, all possible Diligence must be prudently used to fetch away and remove this _Cause_, which is only most effectually to be done by the _Hand-Cure_, in the manner already abundantly set forth.

AFTER which, the _PATIENT_ is to be treated as _before_, laying her _equally flat upon her Back_, and keeping her very _still_ and _quiet_ in BED; which BED may however in this _Case_ be kept a little _Cool_, as well as her _Chamber_, lest HEAT should provoke and continue the _Course_ of the FLUX.

MOREOVER, in fine, it also sometimes happens, that immoderate _Purgations_ proceed from some gross _Excrements_ contain’d in the RECTUM antecedent to the Time of LABOUR; which, as they puff up the _Belly_, so they also commonly occasion severe CHOLICKS; but these being discreetly evacuated by a pretty strong emollient CLYSTER, the FLOODING immediately ceases.

CHAP. V.
_Of the Acute Distempers incident to CHILD-BED-WOMEN._

WE are in this place only to consider the _Acute Distempers_ of the _Puerperial Woman_, because the Time of _lying-in_ is not of such a long _Continuance_ as to admit of _Chronick Diseases_: And these _Acute Ones_, in short, which they are most commonly subject to, are continual FEVERS, (Either, 1. _Essential_, that is, FEVERS proceeding first from the BLOOD; or, 2. _Symptomatick_ FEVERS, that is, such as follow upon the internal _Inflammations_, which often attend the _Child-Bed-Woman_;) as also _Frenzies_, _Watchings_, _Lethargies_, _Convulsions_, _Epilepsies_, &c.—

BUT more especially there is _one_ particular kind of FEVER, which invades almost all labouring _Women_ the third or fourth Day after the _BIRTH_, and is commonly call’d the _MILK-FEVER_; because about that time, the _MILK_ begins to generate more plentifully in the BREASTS, taking its _Rise_ from the Motion and Agitation of the BLOOD, which converts it from the WOMB to the BREASTS. This _Distemper_, resolving itself about the ninth Day by SWEAT, is of no dangerous _Consequence_; provided the _PATIENT_ observes a good and proper DIET, and duly prevents all _Cold_, that might readily stop the SWEAT, and carefully preserves the MILK from _coagulating_ or _putrefying_ in her BREASTS, whence the _Symptomatick FEVERS_ commonly arise: Wherefore, I say, this _MILK-FEVER_, being of the extended _Ephemerick_ Sort, and ceasing of itself, requires no great _Cure_.

ONLY in this _Case_, it is a vulgar _Error_ among the _good Women_, that because this _FEVER_ lasts only four or five Days at most, coming on about the fourth, and ending about the ninth Day after the _BIRTH_, they take all _Fevers_ in this time, for the _MILK-FEVER_; and consequently thro’ this _Mistake_, neglecting, or not regarding duly the true _Condition_, the PATIENT is very often endanger’d: Which _Mistake_, that they may for the future diligently avoid, I shall subjoin here some certain SIGNS of _Distinction_ in due Course. But previously——

THE _Causes_ of all _FEVERS_ incident to the _Child-Bed-Woman_, are either the _Suppression_ of the LOCHIA in whole or in part; or the vitious _Quality_ of the _Humours_ accumulated in _Gestation_, and exasperated in the BIRTH; or a vitious irregular _DIET_ in the time of _lying-in_; or the cold AIR, or any such _Accident_ by bad Management, may readily convert the _MILK-FEVER_ into a putrid and dangerous _one_; as a latent _CACOCHYMY_ may also easily dispose it to _Corruption_.

THE true _DIAGNOSTICKS_, in my Opinion, are as follow, _viz._ FIRST, the _MILK-FEVER_ is known from hence, that it always begins about the _Fourth Day_, when the _BREASTS_ begin to fill with _MILK_; and then the _LOCHIA_ flowing regularly, the _Woman_ finds a certain _Gravity_ or Weight in her _Back_ and _Shoulders_.

BUT, SECONDLY, when the _LOCHIA_ are _suppressed_, whether in whole, or in part, ’tis then certain that the present _FEVER_ proceeds from thence; the _BELLY_ thereby swells and is puffed up, as also it is _pained_ when _touched_; and the _Humours_, at last, putrefying in the _WOMB_, it ejects a certain _fœtid or corrupt Matter_.

WHEREAS, THIRDLY, if the _FEVER_ neither proceeds from the _MILK_, nor from any Irregularity of the _LOCHIA_, why then it must necessarily either proceed from the _vitious Quality_ and Preparation of the _Humours_; or from a _Cacochymical Habit_ of Body; or from an _irregular Way of Living_ in time of _GESTATION_.

THE most certain _PROGNOSTICKS_ are as follow, _viz._ FIRST, All _Acute Diseases_ in _Child-bed Women_, whose _Strength_ is impaired by their _LABOUR_, are much more dangerous than in any _Others_. SECONDLY, These which proceed from the _Suppression_ of the _LOCHIA_ are most dangerous; because the _Humours_ putrefying in the _WOMB_, occasion most severe _SYMPTOMS_, yea and too commonly _DEATH_ itself, unless a lucky _Diarrhæa_, or a timely _Ejection_ of the corrupted Matter, prevents the _Misfortune_. THIRDLY, The self-same is the unfortunate _Consequence_, when the _Distemper_ proceeds from the vitious _HUMOURS_; for _Nature_ then not being able to expurgate their abounding Superfluity by the _LOCHIA_, the _PATIENT_ must needs be greatly endanger’d, if not overwhelm’d.

THE most adviseable _Cure_, FIRST, as to the _MILK-FEVER_, is only to be committed to _Nature_, the _Woman_ using always a proper _DIET_, and carefully animadverting, that the _SWEAT_, in which it commonly terminates, be no ways checked, impeded, or obstructed.

SECONDLY, As to the _Watchings_, _Deliria’s_, _Epilepsies_, &c. which the _PATIENT_ is subject to in this Condition; as they proceed only from _Vapours_ of the _BLOOD_ and _Humours_, ascending to the _Head_, when the _LOCHIA_ do not flow regularly, or when the _Woman_ is _Feverish_: So the _Cure_ of these distemper’d _Cases_ depends (at first) chiefly upon retracting the _HUMOURS_ from the _Head_ to the inferiour Parts, and correcting the _Course_ of the _LOCHIA_: Because, if these flow orderly, and the vitious _Humours_, from which such depraved _Vapours_ as affect the _Head_, be removed and evacuated, all such _SYMPTOMS_ quickly cease and vanish of their own Accord.

THIRDLY, in the other above-mentioned _Cases_, the _PATIENT_ ought always to be treated according to the various Circumstances of her _Condition_; I mean, according to the attending _SYMPTOMS_, conformable also to which the ingenious _Physician_ will always judiciously take his prudent Measures: Since the _Cure_ does not always depend upon the _same Method_; especially when a _symptomatick_, or concomitant _FEVER_, joins the _first_, as it very often happens, by an _Inflammation_ of some _particular Part_, proceeding from something of the vitious _HUMOURS_ enforcing itself upon the same very _Part_.

NOW, in short, tho’ such _Inflammations_ may affect any _Part_ of the Body, yet (I think) the most common _Case_ is, that which affects the _PLEURA_; and from hence (the _Pleurisy_ joining the _FEVER_) the _Woman_ labours under both these complicated _Acute Diseases_ at once. The _Cure_ of which difficult and dangerous _Condition_ belongs only to the ablest _Physician_, to whom I should be justly censured, in impertinently offering any _Instruction_ upon this Subject. Finally, in a word, from what has been said in the _Chapter_ of the _Acute Diseases_ of Women with _CHILD_[181], we may more fully gather what is to be prudently done to Women in _CHILD-BED_, afflicted with the like _Distempers_.

CHAP. VI.
_Of the various other Accidents incident to the CHILD-BED-WOMAN._

FIRST then, Because these _accidental_ Distempers are very many and numerous, as well as various and different in _Kind_: SECONDLY, Because _some_ of them have been already treated, or occasionally discoursed upon at large: And, THIRDLY, because _others_ are only to be named in this Place; I shall take leave to include and comprehend them all, for _Brevity’s_ sake, in this present _Chapter_.

IN order to which, I may first observe, that most (if not All) of these unfortunate _Accidents_, depend entirely upon the indiscreet _Conduct_ of the _MIDWIFE_ in time of _LABOUR_, or the _ill Management_ of the _Woman_ after the _BIRTH_: Since by the prudent and judicious _Means_ of the expert _MIDWIFE_, many _Accidents_ may be prevented, which otherways must necessarily happen, especially in difficult or _preternatural BIRTHS_; as also, on the other hand, by treating the _Woman_ orderly, and guiding her carefully, many _Distempers_ may be totally averted, which otherways will inevitably seize the _PATIENT_. As for Instance——

IT sometimes happens, that she is troubled with a _Prolapse_, or bearing down of the _WOMB_, or _Vagina_, or _Both_; as also sometimes with a _Falling out of the FUNDAMENT_: In all which unhappy _Conditions_ the industrious _MIDWIFE_ will find her _Instructions_, not only with respect to the _Cure_, but also with respect to the _Prevention_ (which concerns her most) particularly set down and accounted for in _SECT._ V. _Chap._ 10, and 11. as she will also, upon _Perusal_, find the _Method_ of preventing that deplorable _Accident_, of making a _Rupture_ in, or renting the _Perinæum_, in _Chap._ 9.

BUT in _case_ of _Contusions_, or Smaller _Rents_ in the _VULVA_, or _Vagina_, which sometimes cannot be well prevented, especially in the _First BIRTHS_; _such_ are by no means to be neglected, lest they degenerate into malignant _ULCERS_: Wherefore they ought to be _cured_, as soon as possible, after the _Woman’s DELIVERY_; which _Cure_ is easily performed, when taken in hand _betimes_, by proper _Fomentations_, and convenient _CATAPLASMS_.

SOMETIMES again, the _WOMB_, the _Belly_, and the _Feet_ swell much after the _BIRTH_; which _SYMPTOMS_ commonly proceed from some _Cold_, or from _drinking too much_, or from either a _Suppression_ or _Diminution_ of the _LOCHIA_, or from any _irregular way of Living_ during the time of _GESTATION_: By which means the vitious _HUMOURS_, resolving themselves into _Flatulencies_, swell and puff up both the _WOMB_ and the _ABDOMEN_; and these _Winds_ descending, have the same Effect upon the _Legs_. But the _Cure_, however, of all such _SYMPTOMS_, is readily accomplished by convenient _DIET_, proper _Fomentations_, and discutient _Medicines_.

HENCE I might orderly descend to an _Indefinity_ of Particulars, deriving from the following general _Heads_, which I Shall only name at this time; _viz._ the various _Diseases_ of the _PUDENDUM_ and _Vagina_, as well as of the _MATRIX_ itself, together with their _co-incident SYMPTOMS_; as also the divers _Distempers_, and different _SYMPTOMS_ of the _Woman’s BREASTS_. But _These Subjects_ being as different as numerous (which I have already hinted) I must refer them to another Opportunity; being resolved to keep the present Work, for the common Good, within the _Purchase_ of all sorts of People as far as possible; and until such time as something on _these Heads_ appears more judicious or elaborate, either from _my own_, or some more _capable Hand_, I hope _English Women_ can be at no great Loss for good _Instruction_, or ready _Assistance_; especially not in this famous _City_ of LONDON, which is, by the Divine Mercy, abundantly well-stock’d, and singularly well provided, with some of the most excellent _Physicians_ of the Age, as well as with some very ingenious _Practisers_ in the Art of _MIDWIFERY_.

AND, thus, in fine, having _piloted_ the good _Woman_ (as it were) thro’ the _three Gulphs_ of _GESTATION_; _BIRTH_, and _CHILD-BED_, and at last brought her into safe _Harbour_; we may now (I hope) securely leave her there, to _refit_ for the same prosperous _Voyage_ again; whilst we, in the next Place, undertake to provide for the _Safety_ of her _CARGO_, or direct the _Regimen_ and _Nursing_ of the _CHILD_. And FIRST—

CHAP. VII.
_Of the Constriction of the NAVEL-STRING, and the Swaddling of the
Infant_.

IF after the _Torrents_ of Difficulties and _Oceans_ of Danger that the MOTHER has painfully gone through, and narrowly evaded, the CHILD should at last be lost; the _Comfort_ of her _Burden_ would be but small, and the _Reward_ of her _Sufferings_ but very little: Wherefore special _Care_ ought to be taken to prevent such melancholy _Events_; in order to which, we are not only to remedy such _Indispositions_ as it (too often) brings with it into the World, but also to defend it from the many periculous _Contingencies_, to which the _Tenderness_ of its Body, and the _Debility_ of its Age expose it.

THE first _Duty_ then, that the _INFANT_ requires of us after _BIRTH_, whether born by the _Head_, or extracted by the _Feet_, is the _tying_ and _cutting_ of the _Umbilical Vein_, or _NAVEL-STRING_; which being a thing generally well known, I shall have no Occasion to insist upon it, especially since tho’ the common GOSSIPS may differ in the _Performance_, yet they always agree in the _Fact_.

HOWEVER, that we may not pass this _essential Point_ by in Silence, in case a notable Word may drop by the By, I would,——

I. OBSERVE, that, until the _STRING_ be cut, the CHILD is to be carefully laid on _one Side_, not on its _Back_, for fear that the _HUMOURS_, running to its _Mouth_ or _Nose_, may choke it, for want of free Evacuation.

II. I would take notice, that, if need require, while the _MIDWIFE_ is busy about the _Mother_, in extracting the _AFTER-BIRTH_, cleansing the _WOMB_, &c. the most capable of the GOSSIPS should _tie_ and _cut_ the _STRING_, especially if the _INFANT_ is weak or ill; otherways it may be deferred until the _Woman_ be entirely _delivered_, and fairly _laid_. Then,——

III. AS to the _Performance_ of this Matter, it may be _tied_ with a good strong _Thread_, laid four or five-fold, according to its Strength; and the KNOT tied close within _two Inches_ of the _CHILD’s_ Body: Tho’, I say, that the KNOT is to be _tied_ close, yet it must not be so strictly _tied_ as to cut asunder the _STRING_; which might easily happen, especially to the _INFANTS_ of a tenderer Constitution. And the Reason that I would have the _Constriction_ made _two Inches_ from the Body, is this, That in case any _Blood_ should happen to drop out afterwards (as it often happens) there may be _room_ enough to _tie_ it again nearer the _NAVEL_.

IV. THE _STRING_ is not to be _cut off_ close to the KNOT, but also _two or three Inches_ from it; so that, if it happens to swell with Wind (as is very common) after being _tied_, it may be _loosed_ again, the _Wind_ discharged, and itself conveniently _retied_. But the far better and preferable way is, to tie this VEIN in _two Places_, and cut it asunder betwixt the _Ligatures_; being thereby secure from losing BLOOD. Some (I know) will not have the VEIN to be _tied_ before the _CHILD_ cries or makes _Water_; but, however, long _Delays_ in this _Case_ are no ways convenient, nor without Danger.

V. THIS VEIN or STRING being _cut_, must be wrapped up in a _three_ or _fourfold Rag_, to defend the _BABE_ from Cold or Pains of the _Belly_; which otherways might ensue from the _naked_ VEIN’s lying upon its Body: Which being done, this Part of the STRING is to be laid on the _upper Part of the Belly_, with a small _Boulster_ on the Top of it; and then swathed with a _Linnen Swath_ of about _four Inches broad_, to keep it firm and steady.

VI. THE first time that the _CHILD_ is _unswathed_, a new KNOT ought to be made or _tied_, and that to prevent all _Danger_ by Loss of _BLOOD_, which may readily happen by the first KNOT’s relaxing, as the _STRING_ begins to wither away or contract.

THIS being so duly taken care of, it remains only in general, that the Infant be presently _washed_, cleansed, and examined all over, and at last orderly _swaddled_. All which if the _MIDWIFE_ does not perform with her own Hands, she ought at least to see it carefully accomplished: Upon which she may then say, she has faithfully discharged her _Duty_ to both the _MOTHER_ and the _CHILD_.

VII. BUT more particularly, in the _seventh Place_, I must take notice, that as soon as the _NAVEL-STRING_ is thus duly handled and provided for, the _INFANT_ is to be tenderly cleansed of the adhering _Excrements_, and washed all over in a little warm _Wine_, _Milk_, or _Ale_; especially its _Head_, _Arm-Pits_, _Groins_, _Cods_, or _Privities_, &c. are to be softly cleansed and gently bathed with a soft _Spunge_ or _Rag_, dipt in the same _Liquors_: But if the _viscous Matter_ sticks too fast or close to the tender Body, a little _Oil of sweet Almonds_, or fresh _Butter_, may be added to either of the foresaid _Liquors_. As also the _Ears_ and _Nostrils_ ought to be well cleansed and unstopped with small Tents of _fine Rags_ wet therein; and the _Eyes_ wiped with a soft dry _Cloth_; as the _Mouth_, _Tongue_, and _Jaws_ may be cleans’d by the _Finger_.

VIII. THESE things being all very carefully and tenderly performed, every Part of the Body ought to be diligently searched, in case of a _Dislocation_, or any other _Accident_, happened by _Violence_ in the _BIRTH_, or otherways; that present _Remedies_ may be used, according to the Nature of the _Circumstances_: And especially the two _Conduits_ of the _URINE_ and _ORDURE_ are to be examined; since it sometimes falls out that _these_ are not perforated, and consequently that the _Meconium_ cannot be voided, which inevitably proves fatal, unless timely _Care_ be taken.

IX. AS to the _URINE_, all _Children_ discharge it as soon as born, at least as soon as they feel the _Heat_ of the Fire; when if the _Excrements_, properly called _MECONIUM_, tho’ improperly _COLLOSTRO_ by the _Italians_, do not follow a little after; I mean within an _Hour or two_; then a small _Suppository_ may be used, such as a _sugar’d Almond_ anointed with a little boiled _Honey_; or a Piece of _Venice-Soap_ anointed with fresh _Butter_; as also a little _Syrup_ of _Roses_ or _Violets_, mixed with the Oil of _sweet Almonds_ by Expression, that is, drawn without Fire, may be given in the _Mouth_, anointing the _Belly_ with the same _Oil_, or with fresh _Butter_; in like manner as a small _Clyster_ (upon occasion) may be discreetly used and managed to purpose.