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diff --git a/old/52086-0.txt b/old/52086-0.txt deleted file mode 100644 index eda15aa..0000000 --- a/old/52086-0.txt +++ /dev/null @@ -1,1525 +0,0 @@ -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 - -*** END OF THIS PROJECT GUTENBERG EBOOK MIDWIVES *** - -***** This file should be named 52086-0.txt or 52086-0.zip ***** -This and all associated files of various formats will be found in: - http://www.gutenberg.org/5/2/0/8/52086/ - -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) - - -Updated editions will replace the previous one--the old editions will -be renamed. - -Creating the works from print editions not protected by U.S. copyright -law means that no one owns a United States copyright in these works, -so the Foundation (and you!) can copy and distribute it in the United -States without permission and without paying copyright -royalties. 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