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-The Project Gutenberg EBook of The Province of Midwives in the Practice of
-their Art, by William Clark
-
-This eBook is for the use of anyone anywhere in the United States and most
-other parts of the world at no cost and with almost no restrictions
-whatsoever.  You may copy it, give it away or re-use it under the terms of
-the Project Gutenberg License included with this eBook or online at
-www.gutenberg.org.  If you are not located in the United States, you'll have
-to check the laws of the country where you are located before using this ebook.
-
-
-
-Title: The Province of Midwives in the Practice of their Art
-       Instructing them in the timely knowledge of such
-       difficulties as require the assistance of Men, for the
-       preservation of Mother and Child; very necessary for the
-       perusal of all the sex interested in the subject, and
-       interspersed with some New and Useful Observations.
-
-Author: William Clark
-
-Release Date: May 16, 2016 [EBook #52086]
-
-Language: English
-
-Character set encoding: UTF-8
-
-*** START OF THIS PROJECT GUTENBERG EBOOK MIDWIVES ***
-
-
-
-
-Produced by RichardW and the Online Distributed Proofreading
-Team at http://www.pgdp.net (This file was produced from
-images generously made available by The Internet Archive)
-
-
-
-
-
-
-
-
- The Province of Midwives in the Practice of their Art,
- by William Clark, M. D. 1698–ca. 1780.
-
-
-
-
- THE PROVINCE OF MIDWIVES
-
- IN THE
-
- Practice of their ART:
-
- Instructing them in the timely Knowledge of such
- _Difficulties_ as require the Assistance of MEN,
-
- For the Preservation of
-
- MOTHER and CHILD.
-
- Very necessary for the Perusal of ALL the SEX
- interested in the Subject,
-
- And interspersed with some
-
- _New_ and _Useful_ OBSERVATIONS.
-
- _By_ WILLIAM CLARK, _M. D._
-
- _And of the_ College _of_ PHYSICIANS.
-
- _Molliter Aufer Onus._      OVID. FASTI.
-
- Printed for _William Frederick_, in BATH; and sold by
- _M. Cooper_, in _Pater-Noster-Row_, LONDON.
-
- MDCCLI.
-
-
-
-
-ADVERTISEMENT TO THE READER.
-
-
-_The following small Tract will appear contemptible to those who
-judge of the Worth of Books by their Bulk; but the Author believes
-such as are practis’d in Midwifry will acknowledge both the Want
-and Usefulness of an Essay of this Kind._
-
-_The Division of the Chapters, naturally arising from the various
-Circumstances which are treated of, will rather assist than
-burden the Memory, and admit of a ready Recourse to the short
-Instructions, in the Knowledge and Practice_ absolutely necessary,
-_given under each Head._
-
-_The Reader will the more readily excuse any Defect in the Stile,
-when he considers_ _the Necessity of a strict Expression on the
-Subject and the Difficulty a Man lies under, who writes not to
-the learned and experienced, but chiefly for the Sake of Persons
-ignorant in Anatomy and Philosophy, on a Subject which for the most
-Part excludes Information by Sight._
-
-_On such a Subject it will not be imagined Vanity or Applause can
-incline a Man to write a Pamphlet, rather than a Volume; when the
-Author is not conscious of having omitted the Instruction to be
-found in any Book extant, within the Limits of his Design; and
-hopes Experience will teach its Value both to Midwives and Matrons;
-and that the Perusal will not at all injure, if it does not
-improve, the most knowing and experienced._
-
-       *       *       *       *       *
-
-The READER is desir’d to correct the following ERRORS with the Pen.
-
- Page 9, Line 16, _read_ Pains about the Back, Navel, _&c._—P. 33,
- l. 12. omit the Period after the Word Pain; and make a Semicolon,
- instead of the Comma, after touch’d it.
-
-
-
-
-CHAPTER I.
-
-_The_ DESIGN.
-
-
-The Case of _Child-bearing_ Women is very lamentable, in the
-Country especially, by Reason of the Ignorance and Unskilfulness
-of _Midwives_; for by their Negligence and perverse Management,
-many Mothers and Children are destroyed, to the great Misfortune of
-particular Families, as well as of the _Publick_, at a Time when it
-suffers by the Loss of useful Hands, from too many other Causes. It
-were therefore to be wished, that all Midwives were so far appris’d
-of their Duty, as to be able to distinguish between Cases within
-their Abilities, and such Difficulties as may occasion the Loss of
-the Mother, or Child, or both, for Want of necessary Assistance.
-
-They who intend to practice Midwifry in PARIS, are oblig’d to
-attend _anatomical_ Lectures and _Dissections_, that their
-Judgments may be inform’d, by the Knowledge of the Structure of the
-Body, for an Undertaking so hazardous in ignorant Hands.
-
-London, at present, affords equal Advantages of Information; for
-the _anatomical_ Wax-work, with suitable Lectures, might furnish as
-good a Qualification, with less Offence than real Dissections; and
-there are not wanting those who professedly instruct both Sexes by
-_mechanical Demonstrations_.
-
-And for the future, it is to be hoped, there will be no Necessity
-for Men to have Recourse to PARIS for _Observation_, since we have
-_Infirmaries_ at Home for the Accommodation of Women in Child-bed;
-and tho’ they are expos’d naked to the Eye in the _Hotel de Dieu_,
-it must be confess’d, that the fundamental Rules of the _Art_ are
-not built on what the Eye of the Observer can possibly discover in
-the most expert _Operators_; but depend on Circumstances conceal’d
-from Sight, within the Body of the Patient.
-
-But whatever Advantages LONDON and WESTMINSTER afford for the
-Instruction of Midwives, the Country is entirely destitute of them;
-and the best Books on the Subject, adorn’d with elegant Figures,
-can give but a very imperfect Notion of the Parts they represent,
-to any who have not attended _Dissections_, or seen more natural
-_Resemblances_ than Cuts.
-
-The Figures in Books, exhibit the _Bones_ of the _Pelvis_, a
-Variety of _Situations_ of the Infant, and _Uterus_, the Placenta
-and umbilical Vessels and Membranes, _&c._ whereas it would be
-no less serviceable to those, who assist Women in Travel, to be
-acquainted with the Viscera, liable to suffer by a difficult
-Labour; for the _Liver_, _Spleen_, _Sweetbread_ and _Kidneys_,
-if not the principal Contents of the Chest, may be so injured by
-the ill _Position_ of the Child, Compression of the Parts, and
-rash Assistance, as to prove fatal, more or lets immediately;
-occasioning _Inflammations_, _Suppurations_, _Mortifications_,
-_Schirrhu’s_, _Cancers_, or _Consumptions_.
-
-The best Writers of Midwifry, such as _Mauriceau_, _Deventer_, _De
-la Motte_, _Heister_ and others, explain the Causes of difficult
-Births, and the proper Methods of Assistance; but instead of
-improving most _Country_ Midwives, fill them with Conceits of what,
-it is impossible, they should understand, and thereby occasion the
-Loss of great Numbers of Women and Children.
-
-In order therefore that Midwives may acquit themselves with
-Reputation, and that _Child-bearing_ Women may be the better
-Judges for themselves, or the charitable Part of the Sex, who are
-past these Dangers, the better able to assist their Friends and
-Neighbours, I shall endeavour to shew how far they may act with
-Safety under the Disadvantage of Country Practice, and describe
-those Symptoms, which for the most Part accompany hard Labours,
-very probably beyond their Abilities; when they will justly incur
-the Censure of Inhumanity and Rashness to depend upon their own
-Skill.
-
-
-
-
-CHAPTER II.
-
-
-In this Chapter I have avoided the Use of Terms of Art, or
-explain’d them, in Regard to those for whom I chiefly write, as
-far as my Regard to Decency admits; but if any Word should occur
-not easily understood by any of my Readers, almost any _English_
-Dictionary will explain its Meaning; and it cannot be expected that
-any Book can instruct those who cannot read, tho’ I am sorry to say
-too many such assume the Office of _Midwives_.
-
-As Curiosity may reasonably induce many of the Sex concern’d in
-the Subject of these Sheets, to be inform’d of somewhat of the
-Provision supreme Wisdom has made for the Existence of Children in
-the Womb, I shall briefly mention the most obvious _Instruments_
-relating to their Breeding and Birth, without puzzling my Readers
-with minute _anatomical_ Descriptions.
-
-The Vagina, or Passage, lies between the Neck of the _Bladder_ and
-the large or strait Gut; it is connected at the inward extreme to
-the _Womb_, and called the _outward Orifice_ at its beginning.
-
-The _Womb_ lies between the _Bladder_ and _Strait Gut_, and is
-connected to both; during the Time of _Breeding_ it increases in
-its _Dimensions_, and rising higher in the Body, by Reason of
-the Weight and Substance of it, with its Contents, at the Fund,
-or remote End of it, may be liable to swag too much _forward_ or
-_backward_, or incline more or less to either Side, especially in
-such, as by their Occasions of Industry in Life are obliged to
-a Variety of _indirect_ Situations; by which Means the _inward_
-Orifice is perverted from a _direct Site_ with Respect to the
-Passage, and obstructs an easy Exclusion of the Infant in Travel.
-
-The _Placenta_ or _After-birth_, adhering to the _Fund_ of the
-_Womb_, receives the _Mother_’s Blood, by the _Umbilical-Vessels_,
-or _Navel-String_, conveys it to the Child for its Nourishment, and
-retransmits what is superfluous; maintaining by the Intercourse of
-_Arteries_ and _Veins_, the Circulation of the Blood between Mother
-and Child.
-
-The _Membranes_ closely connected to the _Placenta_, and the _Fund_
-of the _Womb_, between both which they seem to take their Rise,
-contain the _Humours_ in which the Infant swims, the better to
-preserve it from Injuries, by its Pressure against _unyielding_
-Parts, and the _Humours_ before, and after the _Breaking_ of the
-_Membranes_, commonly call’d the _Breaking of the Waters_, in the
-Birth, very much facilitate it, by opening the _inward Orifice_
-of the _Womb_, and lubricating the _Passage_ for the Child: These
-_Membranes_ come away with the _Placenta_, under the Name of the
-_After-birth_, or _Secundines_, indifferently.
-
-The _Pelvis_ or _Bason_, wherein the _Uterus_ or _Womb_ is seated,
-is form’d by the _forward_ Bones, commonly call’d the _Share-Bone_,
-the _Hip-Bones_ and their Continuation on each Side, and the lower
-Part of the _Back-Bone_, all which are so contiguous to each other,
-as to form this Cavity, generally much larger in Women than Men,
-cloathed with Muscles, between which the _Vagina_ is inserted.
-
-The right Formation of the _Pelvis_, is of the greatest Consequence
-in Favour of an _easy_ Birth; when the _Bones_ forming it,
-_forward_ and _backward_, and on _each_ Side, both above and below,
-don’t too much approach each other, and prevent the Exclusion of
-the Child between, by a free Admission.
-
-
-
-
-CHAPTER III.
-
-_The Symptoms preceeding_ Natural Labours.
-
-
-I shall pass over the Symptoms of Pregnancy, and the Distinctions
-of true and false Conceptions, as Things of which Midwives can
-seldom be expected to be _proper_ Judges, and proceed to their
-Business, _Natural Labours_; comprehending, under this Name, all
-such Cases, which require no further Assistance than _Midwives_, in
-a general Way, may easily give; or in their Absence a Nurse, or any
-sensible Woman, who has attended Deliveries.
-
-After the Woman has gone her due Time of Nine Months, the most
-usual Term; the Signs preceeding Labour are Pains about the Back,
-Navel and Loins; a considerable Falling of the Tumour of the Belly,
-by the Burden’s sinking lower; and incommoding the Woman in
-walking; a more frequent Inclination to make Water: These Symptoms
-increase in Proportion as the Birth approaches; but as the most
-certain Knowledge of _natural_ Births, can only be obtained by
-_Touching_ the Woman in Labour, after having premised some Things
-concerning her _proper_ Situation; I shall direct how it ought to
-be done.
-
-
-
-
-CHAPTER IV.
-
-_Of_ SITUATION.
-
-
-Many in the Country choose to be on their _Legs_ or _Knees_,
-supported by a Woman on each Side, or _lean_ on a Chair or Bed, and
-pass well enough through the present Scene of their Miseries: But
-I would preferably advise a Posture between _lying_ and _sitting_,
-on a _Pallet_ or _common_ Bed, the _Head_ and _Shoulders_ being
-_rais’d_ by Bolsters or Pillows, the Feathers _beat back_ from the
-Bed’s Feet, to support the hollow of the Loins, and prevent the
-Pressure of any Thing against the _Bottom_ of the Back Bone, to
-obstruct the Passage of the Child.
-
-This _Situation_ is most commodious, during Labour, for a Woman to
-_assist_ her Pains with the greater Freedom of Respiration, and the
-least Fatigue and Expence of Spirits; especially if the _labouring_
-Woman lay hold of a _folded_ Napkin, held stiffly for that Purpose,
-drawing her Feet _upwards_ towards her Seat, _separating_ her
-Knees, and _fixing_ her Feet against something that will not easily
-give Way.
-
-If the Person in Labour will not be in Bed, the End may be
-answered by her _sitting_ in _another_’s Lap, with the _Bottom_ of
-her Back-Bone situate between the other’s Knees, with her _own_
-separated and supported, and Feet fixed as aforesaid, to favour
-her bearing down.
-
-’Tis inconsistent with the Design of my Writing to describe all
-the _convenient_ Situations, necessary in Cases of Difficulty, yet
-when the Operator has rectified all Obstructions to the Birth, the
-same Situation of the Body upon a _Slope_, from the Head downwards
-is most suitable, even altho’, for Conveniency, she should be
-deliver’d lying on one Side.
-
-I shall, on this Occasion, observe, what I have found Advantageous
-in my own Experience, as well as consonant to the Advice of the
-best Writers on the Subject: That the Delivery on the _Back_, by
-the Assistance of one placed on _each Side_, supporting her by
-the _Hams_, with her Knees _separated_, and raising her _Back
-Bone_ a little from the Bed during the _Activity_ of Pains, and
-the _Midwife_’s _Assistance_ of either Sex, is vastly preferable
-to the Delivery on _one Side_, to which I impute the Loss of many
-Children brought by _Turning_, as well as a more _tedious_ Labour
-in other Cases; because this Posture, in some Degree, _contracts_
-the _Passage_, and only admits the proper Separation of _one_ Knee.
-
-
-
-
-CHAPTER V.
-
-_Concerning_ TOUCHING.
-
-
-This ought to be put in Practice, as soon as, from the Symptoms
-given in the Third Chapter, it is reasonable to expect the Birth
-approaching; and a _Child-bearing_ Person would be very much her
-own Enemy to refuse the only Means of giving a _true_ Information
-of her Case, and the Knowledge how to do her the most effectual
-Service.
-
-The Midwife, having her Nails well pared, and very smooth, and her
-Fingers anointed with Oil or Lard, must introduce the two _fore
-Fingers_ of either Hand into the _Passage_ or _Neck_ of the _Womb_,
-as far as its _inward_ Orifice, directing them with a _gentle_
-and _easy_ Motion, somewhat upwards, as it were with a Tendency
-through the _Passage_ towards the _Navel_; in this Search she will
-find the _internal_ Orifice, joining the _Passage_ or _Neck_ of
-the _Womb_ more or less open, relaxed, and thinner than usual;
-and cautiously protruding her Fingers farther, she may possibly
-touch the _Crown_ of the Child’s Head; she will easily, by the
-_Sutures_, or _Opening_ between the Bones of the Skull, distinguish
-the _Crown_: Keeping her Fingers in this Situation, _during_ the
-Beginning, and Continuance of _strong_ Pains, she will observe the
-_Waters_ contain’d in the _Membranes_ including the Child, and
-After-birth _forming_ within the _inward_ Orifice, as if something
-like a Bladder _blown_, or _distended_ with Water, presented to
-the _Touch_, dilating the _Orifice_ with each _Throw_; these
-Appearances presage a _speedy_ and _easy_ Birth.
-
-
-
-
-CHAPTER VI.
-
-_Of a natural_ Birth, _and the_ Office _of the Midwife._
-
-
-As the _Birth_ approaches, the Woman grows _hotter_ and _red_ in
-the Face; the Pains bear more _strongly_ down; the _internal_
-Orifice _opens_; the _Vagina_ or _Passage_, at its _Entrance_,
-becomes more swell’d, as the Child’s Head advances; and the
-_Membranes_ are more and more _tensely_ stretched; before the
-_Birth_, the Person is often seized with a _Vomiting_, and
-_universal_ Tremor, without the Coldness of an _Ague_; and very
-often a _Humour_, _discolour’d_ with _Blood_, immediately preceeds
-the _Breach_ of the _Membranes_; when these Symptoms, or several
-of them, become urgent, ’tis Time to put the Woman in a proper
-Situation, as describ’d in the preceeding Chapter: The Midwife
-ought by no Means to break the _Membranes_, but _encourage_ the
-Woman now to make the best of her Pains, by _strongly bearing
-down_, as if going to Stool; the Midwife with her Fingers well
-anointed, putting them gently within the _internal_ Orifice, may
-cautiously, by separating them, assist its _opening_, and Removing
-it more behind the Child’s Head, thereby gradually promote its more
-easy Transmission, and at the same Time prevent, if necessary, the
-Womb from being too far protruded: After the _Waters_ are _broke_,
-as it is called, and the _Head_ of the Child comes into the
-_Passage_, the Midwife may lay hold on each Side of it, taking Care
-not to bruise it by rough Handling, and drawing it, by _Waving_ her
-Hands, if necessary, to loosen it, when fixed, rather than in a
-strait Line, assist the Birth; and if obstructed by the Shoulders
-in the Passage, inserting a Finger under each Arm-Pit, extricate
-them by the like Action.
-
-’Tis true, it happens, tho’ unobserv’d by Writers, as far as
-I remember, that _many_ Women have no _Waters breaking away_,
-either before or after the Birth; whether absorbed or not, in
-Time of Labour, I shall not at present determine; this is called,
-by the Country People, a _dry_ Labour, and often attended with
-Difficulty; however, if the _Crown_ appear _forward_, the Issue may
-nevertheless be favourable.
-
-The Child being born, the next Business is to tie the
-_Navel-string_ with a _waxed_ Thread, so _doubled_, as not to
-endanger _cutting_, about _two_ Inches from the Child’s Body,
-making another Ligature near the Body of the Mother, so far distant
-from the former, as may be convenient for _Cutting_ between _both_
-Ligatures, and separating the Infant from its _After-birth_.
-Midwives are too apt to leave a greater Length, which can be of no
-Service, but has been thought, on the contrary, by our Countryman
-CHAPMAN, to occasion _Navel_ Ruptures.
-
-After the _Separation_ of the _Navel-string_, the Care to get the
-_After-birth_ succeeds; this will often come by the Assistance of
-Nature, with a gentle Motion of the Hand gradually drawing and
-loosening it, by the Navel-string: But if it adheres to the _Fund_
-of the _Womb_, which is frequently the Case, whether from the
-_Waters_ being come away before the Birth or otherwise; it must
-cautiously be separated, and extracted by the Hand, to prevent the
-most mischievous and fatal Consequences.
-
-The Assistant holding the _Navel-string_ with _one_ Hand, must
-with great Caution introduce the _other_ into the _Womb_, avoiding
-_all Violence_ to any Part in the Way, ’till she reaches the
-_After-birth_, some Part of which probably, being loosened, will
-be found more _forward_ than the rest; which _taking_ between her
-_Thumb_ and _Fore-Fingers_, she must, by an easy Motion of her
-other Fingers, between the _Womb_ and _After-birth_, gradually
-_separate_ the Parts adhering all _round_, ’till finding the
-whole free, before the Palm of the Hand and Fingers, she brings it
-intirely away; for should any Part remain, the poor Woman’s Labour
-would still continue, and occasion _dangerous_ Floodings, requiring
-the immediate Assistance of an able Hand, to rescue the Patient
-from the immediate Hazard of Death.
-
-Sometimes when the _Womb_ has discharged its _Waters_, and the
-_Child_, by Reason of a Defect of Pains, or otherwise, remains
-_long_ very _forward_ near the _Birth_, the _Womb_ so _contracts_
-about the _After-birth_, as to make the _Separation_ of it very
-difficult; in which case Assistance is requisite, from one well
-acquainted with the Structure of the Body; and the longer this is
-delay’d, the more Danger there will be of all the bad Consequences
-of the Retention, and Corruption of the _After-birth_ in the Body.
-
-It requires great Care to prevent the _Protrusion_ of the _Womb_ in
-some Women of a _large Pelvis_, or _Opening_ between the _Bones_;
-or if the _After-birth_ remains closely fixed, the _Womb_, in a
-very _open Pelvis_, may be _thrust_ by the Violence of the Pains;
-or _drawn_ out of the Body by an _unskilful_ Hand, which is
-commonly very soon fatal to the poor Woman; and I believe happens
-much oftner than is apprehended, tho’ industriously conceal’d,
-by _guilty_ Midwives, under the Colour of the poor Woman’s dying
-in Child-bed, from some other Cause. DEVENTER says, he saw a sad
-Spectacle at the HAGUE, the _Head_ of the Child excluded to the
-_Shoulders_ quite without the _Passage_, when Three-fourth Parts of
-the _Head_ were conceal’d within the _Womb_, the _Crown_ appearing
-within its _inward Orifice_†.
-
- † See Chir. Op. Part ii. Page 32.
-
-A much worse Case happen’d in my Neighbourhood, _Sept._ 23, 1749. I
-was call’d to a Woman, whose Child, on the 21st came unexpectedly,
-without the least Assistance, in the Presence of an _old_ Midwife
-of _large_ Practice; she puzzled an Hour, as I was inform’d, to
-bring away the _After-birth_, which closely adhered to the _Fund_
-of the _Womb_; while the _unfortunate_ Woman lay senseless, saving
-the Memory of being long expos’d to the Cold, when she came to
-herself; after which she continued in violent _Labour-like_ Pains;
-upon Scrutiny, I found a large _Substance_ in the _Pelvis_, of the
-Size of a Child’s Head, considerably resisting my Touch; I observ’d
-on Trial, a Part of the Woman’s Body every Way _interposed_
-between my Fingers and this _Substance_, by her Sensibility of
-my _Touch_; therefore contenting myself with giving her some
-palliative Medicines, and telling the Persons present, a Mole, as
-I thought, or Child still remain’d to come away, I for that Time,
-took my Leave: On the 24th, she was said to be much better; on the
-29th, I was again call’d to this poor Woman, and inform’d, that
-upon her first going to Stool, since I had before seen her, which
-happen’d the same Day, the large _Substance_ before-mention’d,
-came intirely out of her Body; to which it join’d by a thinner
-Substance, of some length: I now perceived it was no less than
-the _Womb_ turned _inside out_, suspended by its _Ligaments_, and
-joining to the _Vagina_, but very much swell’d by the Obstruction
-of the circulating Humours; And an old Gentlewoman, who was present
-when the Child was born, inform’d me, she saw the Midwife draw
-this _Body_ from the Woman, by the _Navel-string_, and indeed,
-the Impression of her _Nails_, in separating the _After-birth_,
-remain’d still visible at the _Bottom_ of the _Womb_, and the
-Midwife having long expos’d the Patient, put this _inverted Womb_
-again into her Body.
-
-The Condition of the Part, after so long Delay, did not admit the
-Possibility of rightly reinstating it; I therefore return’d it,
-as well as I could, into the Pelvis, and introduc’d a Pessary to
-retain it; and as this Person had already contracted a Hectick, I
-charg’d her, as she valu’d her Life, to confine herself strictly
-to a _cooling Milk_, or _vegetable Diet_; she has since had
-large Discharges of a _bloody_ Corruption, with Portions of a
-fleshy Confidence from the Parts affected. In _April_, 1751, she
-told me the Discharge coming from her had long been much abated
-in Quantity, and what remain’d was the Whites; that she had an
-inward Fever, and the Piles, for which I gave her my Advice; her
-Complexion was chang’d from the most florid to a languishing
-Paleness.
-
-My Brother, much better known in this Country, and longer practis’d
-in Midwifry, has been concern’d in furnishing Medicines for the
-Person, whose History I have given, altho’ by Means of his Absence,
-he did not attend her on the most emergent Occasions.
-
-I have since been call’d to the Assistance of the _old_ Midwife,
-who attended, and she frankly told me, she had another Woman under
-the like Circumstance, who died the same Day.
-
-Having related such Things as occur in the most favourable
-Circumstances of Travil, about which all Midwives ought to be well
-inform’d, and those Injuries to which Women are sometimes liable,
-notwithstanding the most _promising_ Appearances: In the next Place
-I proceed to shew, what are the Symptoms preceeding _difficult_
-Labours, which by timely Assistance, may be secured from the most
-dangerous, if not fatal Consequences, and are of great Moment to be
-known by Midwives, as well as Matrons and Child-bearing Women, to
-enable them to judge when it is absolutely necessary to recommend
-calling that Aid, which is beyond their Capacity to give.
-
-
-
-
-CHAPTER VII.
-
-_The Difficulty from the_ Membranes.
-
-
-An _unforeseen_ Difficulty may occur, when Appearances are
-otherwise favourable, from the Strength of the _Membranes_,
-obstructing the _Birth_, and requiring great Caution to prevent;
-for in this Case, the Operator must break the _Membranes_, in order
-to promote the _Birth_; and as the _Waters_, they contain, are a
-Means to open the _internal Orifice_, lubricate the _Passage_, and
-facilitate the _Birth_; the _breaking_ the _Membranes_ too soon,
-will render the Labour more _tedious_; and should it be too long
-delay’d, the Patient’s Misery would be _prolonged_; wherefore
-the Midwife must not break _them_, before the _Orifice_ is
-sufficiently _open_ to admit the Head, when she may tear them with
-her _Nails_, but by no Means pull them, for as they adhere to the
-_After-birth_, she might by that Means separate it, and bring on a
-Flooding.
-
-
-
-
-CHAPTER VIII.
-
-_Difficulties occasion’d by the_ Navel-String.
-
-
-The _Navel-string_, by a Variety of Convolutions, sometimes
-obstructs the Birth, for being shortned, by its Contortions
-about the Neck, or any Part of the Body, the _Labour_ will
-become _unnatural_, by Reason tho’ the Pains are _strong_, the
-_Navel-string_, by its _shortness_, will pull the Child back with
-each Pain; and here an unskilful Management may break the String,
-and occasion a dangerous Flooding; but as the Woman’s Pains will
-prove _ineffectual_, notwithstanding their Strength and Force, the
-Midwife will, by this Means, find the Case out of her Province; I
-mean, where the _Navel-string_ is very much _abbreviated_.
-
-If the _Navel-string_ comes forward before the Child’s Head, it
-will seldom remain, when put backward by the Hand; therefore, if
-the Midwife has any Regard for the Life of the Child, she ought to
-call for Assistance, before the Birth is further advanc’d, or it
-will be extremely difficult, if not impossible, to save the Infant;
-and she would probably be foil’d for want of sufficient Strength,
-had she Skill to save it.
-
-
-
-
-CHAPTER IX.
-
-_Difficulties from the_ Placenta _or_ Secundines.
-
-
-The _Placenta_ or _After-birth_, being from any violent Shock
-or Accident, more or less, _separated_ from its Seat, during
-any Time of Breeding, will produce a Flooding, in Proportion to
-its Quantity, _dangerous_, which is sometimes so violent, as
-to occasion Death in an Hour’s Time; and nothing but _instant_
-Delivery can prevent it. When the Case is not so desparate, as all
-the _Blood_ in the Mother’s Body, necessary to support her own and
-Infant’s Life, may be drain’d away, the Consequence may be equally
-fatal in a more lingering Way.
-
-The 26th _Feb._ 1748, I was sent for to a Woman at
-MOUNTAIN-DEVEREL, within about Five Weeks of her Time, in a violent
-Flooding; her Midwife gave her an Opiate, which she thought check’d
-her Flooding, excepting that once a Week, it became very violent,
-for about three Weeks past; when I came, the Neighbours told me she
-had lost a Pail full of Blood; the poor Woman was so weak, that
-her Pulse were scarcely perceptible, and her Voice but a Whisper;
-I was unwilling to meddle, for fear she should die under my Hands,
-but yielded to the Importunity of her Friends: It was with great
-Difficulty I introduced the _Tops_ of my two Fore-fingers and
-Thumbs into the _internal Orifice_, which I gradually dilated,
-’till I could pass my Hand, when by _turning_, I brought away a
-_dead_ Child, depriv’d of its Nutriment by the great Loss of its
-_maternal_ Blood; but had considerable Trouble in getting the
-_After-birth_, by Reason of its _Adhesion_: After Delivery, the
-Flooding immediately very much abated, the poor Woman reviv’d
-to Admiration, and I left her the next Day, as well as could be
-expected in so low a Circumstance, tho’ dubious of her Recovery: I
-heard she died five or six Weeks after; but I am well satisfied,
-had she had an earlier Recourse for Assistance, she might have
-recover’d.
-
-In these Cases, Midwives are too apt to trust to their own
-Judgments, instead of calling for better Assistance; and tho’
-they have Recourse to external _Applications_, _Ligatures_, and
-_Opiates_, these Things, injudiciously practis’d, are frequently
-more detrimental than beneficial: For Instance, should the
-_Arteries_ be compress’d by too tight a Ligature of the _Arms_ and
-_Legs_, the _Flooding_ would become more violent.
-
-When ignorant Midwives, by rashly pulling the _Navel-string_, break
-it, or by the Adhesion of the _After-birth_, find it out of their
-Power to bring it away, they are apt to persuade People, it will
-come without further Help, which seldom happens; on the Contrary
-it most frequently occasions Death, more or less suddenly, or
-Hecticks and Consumptions, when left to corrupt in the Body: The
-_Uterus_ sometimes so strongly contracts about, and embraces it,
-that it may be impossible, after a few Hours Delay, to procure
-it, as I found in a Case that occur’d to me at COLEHORN, the 30th
-_Sept._ 1748, tho’ little more than four Hours passed, from the
-Time the Midwife broke the _String_ close to the _Placenta_, for
-the Part of the _Uterus_ next the _Placenta_ was so contracted, as
-barely to admit the _Tops_ of my two Fore-fingers; I endeavour’d,
-with all possible Caution, to make a larger Aperture, but in the
-ill _Situation_ of the _Uterus_, at the Extent of my Reach, all
-my Attempts were in Vain; this Woman rested well the succeeding
-Night, and had no extraordinary Complaints when I left her in the
-Morning, first prescribing what I thought most suitable to her
-Condition: I afterwards heard she died with a Frenzy, succeeding a
-_Suppression_ of the _usual_ Purgations; where the Corruption of
-the _Placenta_ takes Place, the Case is, at least, more Chronical,
-and the _Secundines_, gradually wasting, come away Piece-meal, the
-Patient labouring under a Hectick from the Contagion of putrid
-Humours, mixing with the circulating Fluids.
-
-I have at other Times, after a longer Delay, been more successful;
-the 28th _December_, the same Year, I was call’d, by Order of
-the late Lord WEYMOUTH, to the Assistance of a poor Woman at
-HORNISHAM, whose _After-birth_ had been retain’d three Days; she
-had contracted a Fever from its Putrefaction, which was so great,
-that scarcely any Body could bear the Room, and had lost a great
-deal of Blood by Flooding; the poor Woman soon recover’d after her
-Delivery, in the Use of a little Medicine, from his Lordship’s
-House: I have seldom found the Business difficult, when speedily
-call’d in the like Cases.
-
-
-
-
-CHAPTER X.
-
-_Difficulties attending the Contraction, or Ill-site of the_ Inward
-Orifice.
-
-
-In the Fifth Chapter I have told, how the Midwife may judge,
-by touching, of an easy Birth; carefully introducing her two
-Fore-fingers into the Passage, to find the internal Orifice of
-the Womb in the Beginning of Labour; now, in doing this, if the
-Orifice, she is in Search for, does not readily occur, she has
-great Reason to apprehend Difficulty; and if not well acquainted
-with the Parts she handles, by rude Usage, piercing through any
-Part of the _Vagina_, which presents to the _Touch_, may do
-Mischief. Such an Injury was done to one of Box, where I was
-called _Sept._ 21, 1748. This Woman had been in Labour several
-Days; the Midwife having, the last Time, been with her eighteen
-Hours, the Pole of the Child’s Head lay upon the Share-bone, which
-was rectifyed by one Limb of the Extractor and brought into the
-Passage; the other Limb being joined, the Infant was soon born; but
-what before surprized me, was to find a _Passage_, for my Fingers,
-considerably remote from the _internal Orifice_, with great
-Complaints of a smarting Pain when I touch’d it; a Suppuration
-follow’d, but the Woman soon recover’d, after the frequent Use of
-an emollient and discutient Fomentation.
-
-When the _Orifice_ presents rightly, and is easily found, it
-is next of Consequence to observe, whether the Pains _relax_,
-_open_ and _enlarge_ it; for should it remain _thick_ and
-_contracted_, instead of relaxing and growing thinner, if the
-Infant comes rightly directed, the Woman’s Pains are not _genuine_
-but _spurious_; it will then be proper to give an emollient
-and carminative Glyster, and probably the false Pains will be
-reliev’d, and the true succeed; or some Time may intervene, before
-her true Labour, especially if the full Time of Breeding should not
-be expired.
-
-If the Midwife cannot reach the _internal Orifice_, and the Child’s
-Head lays _high_, the Orifice may possibly lay _high_, _backwards_
-or _forwards_, or more or less so, inclining _Sideways_; the Reason
-of which may be apprehended, from the brief Account of the _Womb_,
-and the _Pelvis_, in the Second Chapter. In this Case it may be
-with great Difficulty, the Assistant can reach the nearest Margin
-of the _internal Orifice_, tho’ well instructed and experienced,
-and it will often require the Hand of an expert Artist, early in
-Labour to rectify it, or turn the Child, when Travil is advanced;
-or if too long neglected may occasion the Death of one, or both
-Mother and Child.
-
-
-
-
-CHAPTER XI.
-
-_Difficulties attending a wrong Position of the_ Child_’s_ Head.
-
-
-If in the Progress of Travil, the Midwife perceives any Part of
-the Head, besides the _Crown_, discoverable by its _Sutures_,
-presenting, and it appear _broad_, and very _hard_ to the _Touch_:
-If the _Waters_ may be _felt_ descending in a _long_ Form through
-the _internal Orifice_, somewhat like a Piece of a Gut distended
-with Water: These Appearances presage the utmost Difficulty and
-Danger, commonly owing to the small Distance between the _forward_
-and _back_ Bones; an ill Situation of the _internal Orifice_; the
-_comparative Largeness_ of the Child’s Head; or the _ill_ Site
-of the _Womb_; whereby the Head may be pressed against the Bones
-_forward_ or _backward_, or somewhat inclined to _either_ Side,
-in a wrong Direction for the _Passage_. These Causes, singly or
-concurring, render the Case much beyond the Skill, and very often
-the Strength, of a Midwife to redress.
-
-When unqualified Midwives observe the Head present to the inward
-Orifice, they are too apt to promise good Success, and behave with
-the utmost Confidence, wherein they are often egregiously mistaken;
-for there cannot be a more difficult Birth, than frequently
-happens, when any other Part, instead of the Crown, offers; and
-the Misfortune is, the longer Recourse to proper Assistance is
-delay’d, the greater the Difficulty becomes every Moment; and the
-poor Woman may think herself happy, if she escapes with her Life,
-the Danger of a most _fatiguing_ and _tedious_ Labour, succeeded,
-perhaps, by such a Relaxation of the _Vagina_ or _Passage_, as
-will occasion great Uneasiness in going, or being in an _upright_
-Posture, without the immediate Help of Medicines, both externally
-and internally; or wearing a _Pessary_ for its Support, during
-Life.
-
-Whereas ’tis certain, that if the Mother’s Pains, _strongly bearing
-down_, the Muscles of the Belly contracting and becoming sensibly
-_hard_ to the _Touch_, don’t manifestly promote the Birth, it must
-needs be owing to some Obstruction beyond the Midwife’s Skill;
-who in this Circumstance is apt to complain, the Pains are not
-sufficiently _strong_, ’till the poor Woman is ready to expire,
-from the Loss of her Strength, by her long Suffering under them;
-and told she must patiently wait God’s Time, who in Case he
-miraculously interpos’d, wants not the Midwife’s Assistance: And
-what still adds to this deplorable Calamity, ’tis likely she is
-put upon exerting her utmost Strength, assisted by Cordials; when
-_encouraging_ her _Labour_ and _provoking_ her _Pains_, ’till the
-Obstructions in the Way of the _Birth_ are remov’d, contribute
-still further to the Danger attending.
-
-I don’t deny but that in some Cases, a _tedious_ Labour may be
-owing to a Defect of _sufficiently_ strong Pains; but as this
-often proceeds from _Circumstances_ obstructing the _Birth_,
-true Labour naturally takes Place, when they are remov’d; and, by
-a right Management of the Hand, is more _effectually_ promoted,
-without Cordials or _forcing_ Medicines, where the Pains are
-deficient.
-
-Under this Sort of unnatural Birth, may very well be enumerated,
-the _Face_ presenting _towards_ the Mother’s Belly, or the _Side_
-of the Head coming _Foremost_, for its Passage must be extreamly
-difficult in these Postures; as well as when the _Face_ comes
-_forward_; for then by Reason of the great Tumour, about the
-_Head_, _Face_, _Eyes_, and _Mouth_, from Lodging between the
-Bones, the Infant expiring in the Birth, has been often taken for
-a Monster. I have often been so happy, when the Head has long
-remain’d, wedg’d between the Bones, as to bring the Child alive,
-by the _Forceps_, in a few Minutes, if seasonably call’d, when the
-Woman in Travil has been in the utmost Danger of Death.
-
-The 5th of _May_, 1751, I met with as bad a Case, as most of this
-Kind at WIGGLETON: This Woman, by the Midwife’s Account, seem’d to
-be in _Labour_ at Times near a Month, and for a Week last, almost
-in continual Pain, with her first Child: as I was call’d late to
-her Assistance, I could not judge, by early Appearances, of the
-Situation of the _Uterus_, or _Infant_; this is most commonly only
-in the Power of the Midwife to observe; her _Waters_ had gradually
-drain’d away above a Week, and there still remain’d some Part of
-the _Membranes_ depending like a _Gut_ in the _Vagina_, the _Head_
-offer’d, firmly wedg’d in the _Pelvis_; the Part most obvious
-to the _Touch_, by its Softness and fleshy Consistence, seem’d
-to be the _Cheek_: The poor Woman’s Pains, for some Hours, were
-_ineffectual_ for want of Strength, her Spirits being exhausted, by
-a Labour so fatiguing; there was no Possibility of _turning_ the
-Child; I endeavour’d, with some Success, to promote the _Birth_, by
-bearing _strongly_ against the inferior Part of the _Os-sacrum_,
-but her Weakness, depriving me of the small Benefit of her Pains,
-I had for a Time; there was an absolute Necessity for a speedy
-Delivery, for the Mother’s Sake: ’Twas with some Difficulty I
-overcame her Prejudice, and those Present against the Use of any
-Instrument, tho’ at length they yielded; when introducing a _Limb_
-of the Extractor on each Side of the Head, and Co-operating with a
-small Pain, encouraging the Woman to bear down as strongly as she
-could, I immediately brought a Daughter, with a monstrous long Head
-alive.
-
-I HAVE, however, met with some Cases, which I could relieve by
-no better Method, than lessening the Head; but considering for
-whose Benefit I am chiefly Writing, and how dangerous the Use of
-Instruments may be in injudicious Hands, I rather choose to advise
-Women not to meddle with them, than pretend to relate the Method of
-using them.
-
-
-
-
-CHAPTER XII.
-
-_Difficulties from other_ ill Positions _of the Infant._
-
-
-The _Arm_ or _Shoulder_ presenting, is so well known to be attended
-with Difficulty, that few Women will attempt such Deliveries,
-unless they are so very ignorant, as to imagine they can bring the
-Child by _pulling_ at an _Arm_.
-
-As our Miscarriages, or rather Misfortunes, in Practice, may no
-less contribute to the Information of others, by Caution, than our
-Success, by Example; I shall not scruple to give a candid Relation
-of the most fatal Occurrence, which ever fell to my Lot.
-
-The 12th _September_, 1748, I was called to a Woman at TROUBRIDGE,
-her _Matrix_ lay _forward_ in a _prominent Abdomen_ hanging very
-low, the _Os-uteri Internum_ lay very much _backward_, _both_ Hands
-_presented_ to it, this Woman had been very ill the preceeding
-Week, and in extreme Misery the last Twenty-four Hours; with a
-great deal of Trouble, I got and drew towards me one _Foot_,
-with the _Heel turn’d towards the Mother’s Belly_; in drawing
-the _Infant_ so far as the _Arm-pits_, I found the _Face_ of the
-Child did not _turn_ so readily as I expected towards the Mother’s
-_Back_; as soon as I had brought the _Feet_ some Distance without
-the _Vagina_, while I endeavour’d to extract the Child by hold of
-its _Thighs_, the Midwife, unknown to me, officiously laying hold
-of the Infant’s _Feet_, exerted her Strength at the same Time with
-mine; I intended to leave the _Arms_ according to DEVENTER, as a
-Security to the more safe Transmission of the _Head_; and while
-our united Strength was exerted, I found the _Neck_ gave way, with
-something of an _audible_ Crack; and with some Surprize, looking
-about me, saw the Midwife _labouring_ at the Child’s _Feet_, and
-check’d her, as acting very rashly, without my Direction; thus
-we had really separated the _Spine_ of the _Neck_, and the _Head_
-only adhering to the _Body_ by the _Skin_, was with little or no
-Force separated from it: In passing my Hand, after a tye on the
-_Navel-string_, I found the _Head_ fell _back_ into the prominent
-Part of the _Abdomen_, insomuch that I could only reach the
-separated Part of the _Neck_, and I endeavour’d, in vain, to get
-hold of the _Head_ by the _Crotchet_: While I was thus employ’d,
-a _Flooding_ came on, by the Separation of the _Placenta_, which
-quick’ned my Endeavours, from the Apprehensions of her sudden
-Death, if she was not immediately deliver’d; but the poor Woman,
-much spent with Fatigue and Loss of Blood, begg’d I would desist,
-preferring Death to Life; in which being join’d by the People
-present, and not a little exhausted of Spirit and Strength myself,
-I was, much against my Will, obliged to leave her to her Fate.
-
-Here I would observe, it appear’d the _Body_ was that of a large
-Boy, and tho’ I find GIFFARD and others made no Scruple of leaving
-the _Arms_ of a small Child, I must join with them in advising
-not to bring a _large one_, without first _procuring_ the _Arms_;
-tho’ I will not say, whether the Method of delivering on one Side
-instead of the _Back_, the lower Part somewhat _raised_ from the
-Bed, at the same Time _encouraging_ Labour with Hopes of immediate
-Delivery, recommended by DEVENTER, may not occasion the Danger of
-leaving the _Arms_.
-
-There are Variety of other wrong _Situations_, and _Cases_ of
-Difficulty, which I could illustrate by Examples in my own
-Practice, and may be found in the Observations of MAURICEAU
-DE-LA-MOTTE, GIFFARD and others, for the Information of such as
-practise Midwifry, that have no Relation to the Information of
-Midwives, either in their own Practice, or Occasions of Assistance.
-
-
-
-
-
-CHAPTER XIII.
-
-_Of_ TWINS.
-
-
-The Case of _Twins_ may, in many Country Places, be esteemed beyond
-the Skill of Women _practicing_ Midwifry; but as they are not alike
-ignorant, and this Delivery, with a right Management, is attended
-with no great Difficulty, I shall describe it as plainly as I can.
-
-If a Child comes naturally by the Force of the _Mother_’s Pains,
-and the _After-birth_ does not easily follow, the Midwife, by
-passing her Hand to separate its Adhesion as directed in the sixth
-Chapter, will readily find whether _another_ Child still remains
-to be born, by the Appearance of other _Membranes_, including
-_Waters_, &c. And as where more than one is to be born, they are
-generally proportionably smaller, and tho’ the first Child comes
-naturally, the second may not, she need not wait for the _Birth_
-of the other, by the meer Force of Nature, for this would greatly
-hazard the Life of the Child, and sometimes of the Mother, by
-a Flooding; but ought to break the _Membranes_, and search for
-the _Feet_, carefully preventing their being intangled with the
-_Navel-string_; and having got both in her Hand, draw them into
-the _Passage_; if the Child’s _Toes_ point to the _Mother’s Back_,
-there will be no Danger of the _Chin_ or _Nose_ being hung on the
-_Bones_ before, and she may draw the _Feet_ forth with the rest of
-the _Body_, without delaying to bring down the _Arms_, encouraging
-the Mother to assist in the mean Time, by _bearing down with or
-without Pains_.
-
-In Case the _Child’s Toes_ should point to the _Mother’s Belly_,
-the Midwife, in drawing the Child forth from the _Hips forward_,
-must gradually _turn_ the _Belly_ of the Child towards the
-_Mother’s Back_, by the Assistance of the other Hand in the
-proceeding.
-
-If the Woman be straiter, or the Child larger, than ordinary,
-when she has brought the Infant into the _Passage_ somewhat short
-of the _Arm-pits_, she must, by introducing her Fingers, first
-over one _Shoulder_, cautiously bring down one _Arm_, and then in
-like Manner the _other_, and drawing the Child forward, she must
-make Use of both Hands to extricate the _Head_; the _Fingers_ of
-one Hand between the _Mother’s Back_ and _Child’s Jaws_, bearing
-and drawing them from the _Back-bone_, and with the Fingers of
-the other Hand over the _Shoulders_, and the _flat_ against the
-_Child’s Back_, draw it forth, the Mother as aforesaid assisting
-all the while.
-
-Writers advise putting two Fingers into the _Child’s Mouth_; but
-as great Injury has often been done that Way, it is much safer to
-bring the Child by _bearing_ with the Fingers against its _Jaws_.
-If an _Arm_ should be broke in _bringing down_, let it be spliced
-with thin Paste-board, and bound at its full Extent to preserve its
-right Shape.
-
-In fetching an Infant by _turning_, ’tis necessary to draw its
-_Feet_ into the _Passage_, with the _Toes situate_ towards the
-_Infant’s Belly_, for it may be extreamly difficult, if not
-impossible, to draw it backwards, contrary to the natural _Bent_
-of its _Thighs_ and _Back_; and a _Limb_ may sometimes as easily
-be pull’d off, as the Child brought to the _Birth_ this Way; the
-Midwife must therefore make Use of the _right_, or _left_ Hand
-in doing it, which happens to be most convenient, to the natural
-_bending_ of the Infant’s Body.
-
-I THINK it cannot be safe for a Woman to _turn_ a Child upon ether
-Occasions requiring it; their Strength, as well as Skill being
-frequently inferior to the Task; besides, there may be great Danger
-of injuring the Vitals of the Mother in other Cases, especially
-after the Operation is unseasonably delay’d.
-
-As each Child has a Navel-string, as well as After-birth belonging
-to it (tho’ both _Placenta_’s are sometimes so joined as easily
-to be distinguished) the Care respecting the _Navel-string_,
-already related in the Sixth Chapter, must of Course be taken for
-the First-born, and its _Secundines_ left, ’till after the Birth
-of the Second, when both, if necessary, must be separated and
-brought away, as there advis’d, with Regard to one alone, and the
-_Navel-string_ of the last Infant tied after the same Manner as in
-the Birth of one Infant.
-
-
-
-
-CHAPTER XIV.
-
-_Of a_ Dead Child.
-
-
-A Dead Child is often born with abundantly more Difficulty than a
-_living_ one, for the last by its Struggles considerably promotes
-its own Birth; whereas, the first lies _immoveably_ in the _same_
-Posture, without changing Situation by its own Activity.
-
-When the Death of the Child proceeds from any _accidental_ Injury,
-the _breeding_ Woman commonly knows it, by the Perception of a
-_Weight_ within her, in the Part where it lies, instead of its
-_usual_ Motions, which from that Time cease, and occasion, not
-without Reason, a Solicitude for the best Assistance.
-
-One of my Neighbours, whom I lately deliver’d, had the Misfortune
-to fall flat on her Face, between the 7th and 8th Month of her
-Pregnancy; from which Time to that of her Labour, above three
-Weeks after, she had a continual Sensation of a Weight within her,
-without _any_ of the Child’s Motions, as before this Accident,
-although it was not succeeded by a _Flooding_, as is common upon
-a _partial_ or _total Separation_ of the _Placenta_: She had
-frequently been attacked with Pains resembling Travil, for above
-two Weeks before it came on effectually; in this Case after I had
-brought the Child by _turning_, I found the Secundines extremely
-offensive, by Reason of their Putrefaction.
-
-From Causes less manifest, ’tis a Thing more precarious to judge
-of the Infant’s Death; the Woman in Travil has not perceived the
-_Motion_ of the Child for some Days, while it was yet living;
-a _cadacerous_ Smell is not infallible; the coming away of the
-Child’s _Excrement_, may proceed from the _Compression_ of its
-Abdomen in the _Birth_, especially when the _Buttocks_ present;
-these Appearances therefore can only be a Foundation at best for
-_probable_ Conjecture; nothing short of the Peeling of the Cuticle
-or Scarf-Skin of the Child upon _Touching_ it, can be a _certain_
-Token of its Death.
-
-
-
-
-CHAPTER XV.
-
-_The necessary Care of a_ Mother _and_ Child.
-
-
-After Delivery, tis too universal a Practice to palliate the
-After-pains by _Opiates_, which if given beyond the Proportion,
-necessary to take off the Spasms attending, are mischievous,
-tending to obstruct the natural Cleansings, so absolutely
-necessary to succeed; and as these Pains cease of Course for
-the most Part in two or three Days, it were much better to have
-recourse to _Sperma Ceti_ dissolv’d with the Yolk of an Egg in a
-Draught of Caudle, or a Linctus of Sallad Oil and Sugar, if Oil
-of Sweet Almonds cannot be had fresh, as often as the Pains are
-violent.
-
-Particular Occasions may indeed require other Methods, but
-then ’tis best to be well advis’d, whether _Opiates_, or other
-_Medicines_ are necessary. During their Purgations, the Woman, in
-Child-bed, ought to be kept warm, from all Danger of taking cold,
-to a Degree of sensible Perspiration, and if she has no Stool by
-the third Day, which commonly brings, with the Milk, a feverish
-Heat, a Kitchen Glyster ought to be given and repeated in costive
-Habits, as there is Occasion.
-
-I SHALL conclude with some Things of the Care of Infants newly
-born; a Subject the more interesting, as our Natives are known
-greatly to decrease from the free Use of Spirituous Liquors; which
-Loss might in some Degree be repaired by a better Care of their
-Offspring, who are not only expos’d to suffer by the Ignorance of
-Midwives, but must undergo a second Martyrdom from swadling and
-cramming.
-
-Their fond Nurses greatly contribute to the general Cause of all
-their Distempers, _Indigestion_, frequently feeding them ’till they
-return it by the Mouth, which under these Circumstances, unless
-supply’d by a Looseness, is the only Means of their Preservation
-from more immediate Death.
-
-This Overcharge of their Stomachs, producing Crudities, gives them
-the most excruciating Pains in their Bowels; occasioning very
-often Fevers and Convulsions, and yet their Cries are customarily
-appeas’d by more Food, furnishing an Encrease of sharp Crudities
-in their Bowels; and ’tis well if Syrup of Poppies, _Godfrey_’s
-Cordial, or some other Opiate, be not given to stifle their
-Complaints, but in Effect to encrease the Mischief, by confining
-the Acrimony of an Overload within them.
-
-Infants are born with their Stomachs and Intestines charged with
-the Recrements of the Humours in which they swim, before Birth, and
-the glandular Secretions within them, which will naturally purge
-away with the first Milk they draw from the Mother’s Breast; and
-they would sleep, were they not too soon fed, ’till this Provision
-of Nature is ready for them, as Dr. CADOGAN found from Experience
-in his own Family; but as the Humour of Feeding them sooner
-generally obtains, and the Mother too often is not the Nurse; Half
-a Drachm of _Castile_ Soap diffolv’d in a Spoonful or two of thin
-Caudle, and sweetened with Honey, would cleanse the Child, and
-prevent many Distempers, owing to a Retention of Impurities within
-them before the Birth, if given soon after.
-
-’Tis well worth remarking, that the Food the Nurse takes
-communicates its Nature to the Milk, so that the Child may be
-intoxicated by her giving Suck too soon after strong Drink or
-Spirituous Liquors, by which Means many are destroy’d; it is
-likewise well known, if the Nurse takes a Purge, her Milk will
-purge the Child.
-
-This informs us, that when the Child is troubled with Gripes,
-attended with green, sour-smelling Stools, the Mother, or Nurse, by
-being confin’d to an Animal Diet, will, in a great Degree, prevent
-the Gripes, Looseness, or Convulsions, occasion’d by the Acidities
-of the Child’s Stomach and Bowels, from the contrary Qualities
-communicated to her Milk. On the Contrary, a vegetable Diet will
-greatly relieve the same Complaints, attended with strong smelling
-Stools, and a Tendency to the Putrefaction of the Humours, and the
-Child’s Spoon-meat, when any Thing is given besides the Mother’s
-Milk, may be regulated accordingly: In the mean Time, in both
-Cases, these Indigestions ought to be purged off with a few Grains
-of Rhubarb, or double the Quantity infus’d at Night in a Spoonful
-of common Drink, strain’d and sweetened with Honey.
-
-This, with a suitable and commodious Dress, leaving them Freedom
-for all their Motions, taking Care not to fill them with Crudities,
-by over-charging their Stomachs, would preserve the Health of young
-Children, they would then sleep away most of their Time, without
-those continual Cries of Misery, calling on the Compassion of all
-about them, whereby abundance of Trouble to their Nurses, and the
-continual Occasion of Medicines, to sweeten and purge away the
-Effects of Indigestion, would be prevented.
-
-
-_FINIS._
-
-
-
-
-TRANSCRIBER’S NOTE
-
-Original spelling and grammar were generally retained. The
-following two corrections were made in conformance with the spirit
-of the list of errata on page vi.
-
- Page 9, l. 16. “Pains about the Navel and Loins” was changed to
- “Pains about the Back, Navel and Loins”.
-
- Page 33, l. 12. Changed “great Complaints of a smarting Pain;
- when I touch’d it a Suppuration” to “great Complaints of a
- smarting Pain when I touch’d it; a Suppuration”. This correction
- is not quite what the erratum on page vi recommends—but the
- recommendation is not quite correct.
-
-Page 21. Changed “which happpen’d the same Day” to “which happen’d
-the same Day”.
-
-Page 49. Changed “and its _Secondines_ left” to “and its
-_Secundines_ left”.
-
-
-
-
-
-
-
-
-
-
-
-
-End of the Project Gutenberg EBook of The Province of Midwives in the
-Practice of their Art, by William Clark
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