The signes to know whether a woman be with childe, or no. CHAP. I.

A Chirurgion must bee very cir­cumspect, in determining whe­ther a woman be conceiued, or no; because many haue preiu­diced their knowledge, and dis­cretion, by iudging rashly here­of. For there is nothing more ridiculous, then to assure a woman that shee is with childe; and afterward, that her naturall sick­nesse, The Chirur­gions must beware of iudging rash­lie. or store of water should come from her: and in stead of a childe, some windie matter should breake from her, and so her belly fall, and grow flat againe: which hath hapned vnto many men, that haue beene well esteemed, both for their learning, and experience. And wee haue seene the experience hereof in some women, which were (without all question) thought to be so great, that the Midwife was euen ready to receiue the child: A story. who notwithstanding haue beene freed and ac­quitted heereof either by their naturall purgings and euacuations, or by voiding of water, or else ex­pelling of winde. The which hapned vnto Mad. P. to her great griefe, who was deliuered of certaine gallons of water, when she thought assuredly that she had beene with childe. I saw the contrary hap­pen to the daughter of M. Marcel: who was iudged [Page 3] by foure of the chiefe Physitians, and as many Chi­rurgions, and two Midwiues, not to haue beene with childe; and yet being dead, there was found in her body, a child betweene six and seuen months old. And of late memorie, some of the most ex­pert Physitians, and Chirurgions of our time, Another. vn­dertooke the cure of an honest woman; and from the third vntill the eighth moneth of her time, ad­ministred vnto her infinite many Clisters, Apo­zemes, Potions, Fomentations, and Iniections, and yet could not they prouoke her naturall sick­nesse, much lesse cause her to be deliuered. At length in the ninth moneth, she thinking that she had had the Chollicke, was brought a bed of a faire daughter, being verily perswaded euen then when she was in trauaile that she was not with child, as she had assured vs, all the time that she went. Directions for the Chi­rurgion.So that a Chirurgion being called to giue his opinion of the conception of a woman, whether it be in a iudiciall, or priuate case, must be very warie and circumspect what iudgement he giues herein.

The ancient and moderne writers haue left some signes whereby we may foretell it, which are col­lected from the Husband, from the Wife, from the Child, and from the Midwife.

As for those signes which are taken from the Man, they are these: Signes of cō ­ception taken from the man If he finde an extraordinarie contentment in the companie of his Wife; and if he feele at the same time a kind of sucking or draw­ing at the end of his yard; if he returne from the field of nature, not ouer-moyst, these are signes that [Page 4] a woman may haue conceiued. Experiment. And by these ob­seruations I haue knowne men which haue assured their Wiues that they haue got them with child, as soone as they haue had their company.

Signes taken from the wo­man.The signes which are taken from the Woman are more manifest and certaine: and although the greatest part of them bee found in Women and Maids, which cannot haue their naturall courses: yet neuerthelesse all these signes ioyned together, a man may presume as farre of them as arte wil per­mit, and they be these: If she receiued an extraor­dinarie delight in the companie of her Husband: if from her naturall parts (whether they continue dry or moist) there issue or flow nothing forth, be­cause it is no necessarie consequence, that those parts should alwaies remaine dry, since the Matrice retaineth onely that, which is fit for the conforma­tion of the child. Likewise, if at the same time she hath a kind of yawning, and stretching, and feeles within her a shaking or quiuering (such as we com­monly find presently vpon making of water) which runneth through the whole body, with a kind of chilnesse, and is felt chiefely betweene the shoul­ders and the backe, with some paine about the Na­uell, and a rumbling or disquietnesse in the neather belly, which hapneth, because the Matrice shrinks it selfe together, The wombe shuts it selfe to entertaine and embrace the matter of generation which it hath drawne and suckt in, feeling thereby a kind of tickling. Againe, if within few dayes she falles a vomiting, and spit­ting, distasts her meate, groweth dull, carelesse, and [Page 5] qualmish, longeth after strange things, finding her belly fallen, and growne flat, according to the French prouerbe.

Which makes them oftentimes to complaine and say they be quite fallen away. Then not long after her belly swells and growes bigger; her hips and raines are inlarged; her courses appeare not, which should flow at certain times, Some women when they be with child haue their courses. (although some haue them whē they be with child.) Likewise if towards the second month her eyes grow hollow & wan, her eye-balls shew lesse: the lids be loose, limber, and soft: the veines in the corners of her eyes more swollen, and bigger then ordinarie. Hippocrates. For as H [...]ppocra­tes saith, if thou canst not finde by any meanes whe­ther a woman be with child, or no, her very eyes wil tell thee: for their eyes be more hollow, and sunke inward; and the white is turned bluish: the veines and arteryes of their neck are pust vp, and more ap­parent then vsually: their brests grow big, and hard, with some paine and pricking, hauing also milke within them: the nipple waxeth firme, and hard: red, if it be a boy; and sometime blackish, if it be a wench, which hapneth about the third or fourth moneth, when they begin to quicken.

Signes taken from vrines.Some iudge of their being with child by the vrine, as if it be white, and clearely mingled with little moates, and that at the top there is perceiued [Page 6] as it were a little cloud like to the Rainebow; or of an Opall colour, At the bottome there appeares a certaine thicke sediment, which beeing shaken, spreads it selfe into little flocks, like to carded wooll. Towards the end, their vrine is thicke and red­dish, by reason of the long retention of their na­turall courses.

Experiment of Fernelius. Fernelius makes this triall, which is, to take equall quantities of the womans vrine, and of white wine and to shake them well together, if this mixture looke like the broth of Beanes, it is a signe she is with child.

Hippocrates. Hydromell is made of hony and water boiled toge­ther. Hippocrates sets downe diuers experiments, as to giue the woman Hydromell to drinke made with raine water at night when she goes to bed, or else Hony and Annisseed beaten and dissolued in wa­ter. If she be with child, she will feele great paines and griping in her belly, (vnlesse she be vsed to such kind of drinke, Auicen. as Auicen saith.) Besides, if she receiue below any strong or stinking oder or smell, her clothes being well wrapped close about her, and the sent pierce not vp into her nose, she hath conceiued: As also, hauing ouer night put vp a cloue of Garlicke, if in the morning the sauour or taste come not into her mouth.

Truest signes gathered from the Child.But these signes are not so certaine, the truest and surest are those which are collected from the child, when he begins to stirre and mooue, which commonly happens in the third and fourth mo­neth. This motion is very gentle, not vnlike the stirring of a flie when he flieth.

[Page 7]Another certaine signe may be perceiued by the Midwife, Signes gathe­red by the Midwife. who putting vp her finger into the wombe to touch the inner orifice thereof, if the woman be with child she shall finde it so close shut, that the point of a needle will scarse enter therein, yet soft, and without any hardnesse, which also will bee drawn vpward being shrunke and as it were trussed vp, because the body of the Matrice doth gather it selfe together to embrace the seed, which is the reason that the Midwife can very hardly come to reach it with her finger.

Some women when they be with child hate the companie of their husbands: which quality is said also to be in brute beasts when they be great with yong, who commonly shun the company of the Male. And surely there be certaine times and sea­sons of the yeare proper for brute beasts to couple, but man (as Pliny saith) hath neither time nor sea­son limited him, neither day nor howre appointed him, that so he might haue his desire at all times: which hath been thus ordained by nature, as being more fit, and necessary for man to multiplie in his kind he being (the liuely image of God, and made to behold his glory) then for brute beasts, which were created onely for the vse of man.

I know well the answere that those two noble Ladies, Poppea the daughter of Agrippina, A pleasant answere. and Iulia the daughter of Augustus made concerning this matter. The one sayd, that brute beasts cannot taste the delight which women receiue that are with child, because they are without reason: and [Page 8] the other sayd, that when her ship was laden with wares, then she could take in passengers.

The signes whereby to know whether a woman be with child of a boy or a wench. CHAP. II.

HAuing shewne the meanes to know whether a woman be truely concei­ued, it will not be from the purpose to handle this question for the satis­faction of some curious minds, who as soone as the Chirurgion hath giuen his censure that a woman is with child, demaunds presently of him whether it will be a boy, The diffe­rence of sexe is hard to foretell. or a wench? But as it is very hard to know at the first whether the wo­man be with child or no, so by great reason must it needs be farre more difficult to discerne, and di­stinguish the difference of the sexe, and to deter­mine whether it will be a boy or a wench.

I know there are some that boast they can cer­tainely do it, but for the most part it hapneth rather by chance, then through either arte or skill. And for proofe thereof, I haue shewed them a child newly come from the mothers wombe, onely lay­ing my hand vpon the priuie parts, yet durst they not be so bold as giue their opinion thereof, saying, that it were more easie to iudge of it when it was in the wombe, seeing that from thence might be gathered many euident signes: but wee must ac­count the greatest part of them to be vncertaine, [Page 9] as we haue formerly said. Neuerthelesse, to distin­guish the Male from the Female, we will presently shew all the marks which we euer knew, or could obserue, either out of the ancient, or moderne writers.

And first of all, yong women commonly are with child rather of a boy then of a wench, because they be hoter then the elder women, which was obserued by Aristotle, who saith farther, Aristotle. that if an aged woman which neuer had children before, chance to conceiue, one may be sure it will be a wench. The like hapneth (as some write) to wo­men, which conceiue when the winde is in the South, who for the most part bring forth daugh­ters, and when the Northwind bloweth, sonnes. Obseruation.

Hippocrates saith, Hipp. Aph. that a woman which goeth with a boy hath a good colour, for a woman in her case, but if it be of a wench, she will haue a worse complexion. Likewise if the right breast be harder and firmer, the nipple hard, red, and more eminent, the milke white and thicke, which being milked or spirtled against a sleeke-stone, or some such smooth thing, continues in a round forme like a pearle, Signes of a boy. and being cast euen into water it dissolueth not, but sinks directly to the bottome: and if you make a cake with the said milke and flower, and in the baking it continues firme, and close, it is a signe the woman is with child of a boy. Againe, she that goeth with a boy, hath the right side of her belly bigger, and more copped, and there the child stirreth oftenest. This motion commonly at sixe [Page 10] weekes is scarse sensible, but at two months and a halfe more manifest. The Male child lyeth high a­boue the Nauell by reason of his heate, and the Fe­male at the bottome of the belly, because of her coldnes and weight. They which be with child of a boy are more quicke and nimble in all their acti­ons, and be in better health of body, without being subiect to many infirmities, which commonly hap­pen to women with child of a wench.

[...]gnes ga­ [...]hered out [...]f Auicen. Auicen obserueth these signes, That a woman with child of a boy hath the pulse of her right side stronger, higher, and thicker, then that of the left: she will reach out her right hand rather then her left, and in going she wil alwayes set forth the right foote formost: her right brest is bigger then the left, and the right eye greater, brighter, and more sparkling: and if a woman about her last months haue any great sicknesse, or any throwes, without being deliuerd, it is some likelyhod that she is with child of a boy, since the male child is faster tied and bound then the female, because the ligaments which hold and fasten him are stronger and dryer then they that bind and support a wench.

Signes of a wench.A woman which is with child of a daughter hath a pale, heauy, and swarth countenance, a melan­colique eye: she is wayward, fretfull, and sad: she beares in her face as Hippocrates saith, Hippocrates lib. de stipilitate. Maculam sola­rem, that is to say, her face is spotted with red, like those who haue been much in the sunne: her left brest is bigger then the right; and the top of the nipple blacke. The milke which comes forth of her [Page 11] brests is blewish, thin, and watrish: her belly is flat; and she feeles her burthen moue on the left side, and that, not before the fourth moneth: the veines of her thighes, and groine, are bigger, and more knottie on the left side then on the right. An honest Gentlewoman assured me that she had made triall of this receipt, which is, An experi­ment. to take an equall quantitie of Claret wine, and of vrine made in the morning, put them together into a glasse, and let them stand a whole day, if there appeare in the bottome a grosse cloud, thicke like to Beane-broth, it is a signe the woman is with child of a boy, if it appeare in the middest, it is signe of a wench, if there be no­thing found in the bottome but the ordinary resi­dence of vrine, it shewes she is not with child at all.

An experiment likewise may be made out of the practise of Liuia, Another experiment of Liuia. the Mother of the Emperour Ti­berius, who being with child, and desirous to know with what she went, tooke an egge from vnder a Henne that sate, and kept it warme so long in her hands, till at last a Cock-Chicken was hatched out of it, whereby she knew that she should haue a sonne, which proued to be Tyberius the Emperour, as Suetonius reporteth.

Heere will it not be beside our purpose to set downe what Hippocrates writes in his booke de su­perfaetatione, The meanes how to bege [...] a sonne, or a daughter. of the meanes how to get a man or woman-child. He that wil (saith he) beget a sonne, must know his wife as soone as her courses are stay­ed, and then try the vtmost of his strength; but if he desire to get a daughter, then must he compa­nie [Page 12] with his wife a good while after her courses, or at that time when she hath them: and beside, he must tye his right stone as hard as he can endure it; and when he would haue a sonne, he must tye the left. But Aristotle seemes wrongfully to blame his worthie man, when he sayth, that the genera­tion of Males or Females depends of the strength of the seed, and not of the stones, the vse whereof he saith, is not for generation. But experience tea­cheth vs the contrary, for the countreymen when they would haue a Bull beget a Cow-Calfe, or a Bull-Calfe, they tye the right stone for the one, and the left for the other.

The signes whereby to know that a woman goeth with two children. CHAP. III.

To know whether a woman will bring two children. THe signes that a woman hath conceiued two children, doe seldome appeare be­fore the third or fourth moneth, which then is knowne, both by the mouing of the children, and also by the greatnes and swelling of the womans belly. As for the motion, if it be felt strong and forceable both on the right and the left side, at the same instant, then it is apparent, that there be two children. Likewise for the greatnes of her belly, if it appeare more swollen and bigger then in her other child-bearing, if the sides be high­er then the middle of her belly, and from the nauell downeward there appeare as it were a line or sepa­ration [Page 13] betweene both sides creasted; if the woman beare her burthen with difficultie, and her belly fall vpon her thighes and hips, then may you safely say that she goeth with two children.

Of false Conception. CHAP. IIII.

WOmen are oftentimes deceiued in reckoning themselues with child, for they thinke themselues with child when it is nothing but the stopping of their naturall sicknesse, which kee­peth not due course. Some haue a false concep­tion, which is as it were the beginning of Mola. Others haue the Mola it selfe, which we common­ly call the Moone-calfe.

False conception is a lump of flesh gathered to­gether commonly like to the gizard of a fowle, What a false conception is. which is bigger or lesser according to the conti­nuance of it, which nature commonly expelleth in the second, third, or fourth month. But the Mola is farre bigger, and continues a yeare or two, yea ten or twelue, and sometime as long as the woman liues. Of this Mola there be two kinds, the one may be called a true, the other a false one. Mola is either true, or false. The true Mo­la is fleshy, being nothing else but an vnprofitable masse, without shape or forme, hard and firme, bred within the Matrice, and cleauing to the sides thereof. The false Mola is of three sorts, the one windy, being a collection of grosse winds: the se­cond watrish, or a heaping together of waters: the [Page 14] third humorall, or a meeting of many humors. All three contained within the capacitie of the womb, which doth make them differ from the swelling, hardnes, or Scyrehus of the said wombe, or from any flesh, water, or humor, which may chance to cleaue to, or touch the outward part thereof. These are often bred together with the child, Mola bred together with the child. but then they cause death, either for that the child is deceiued of his nourishment which is carried to the Mola; or because he wanting roome, cannot grow and come to perfection.

Hippocrates. Hippocrates saith, that there be some liuing and some dead Moles. The dead are like to the false burthens, so called, because women carry them not long, as being but lightly tyed and fastned to the sides of the Matrice. Sometime they are deui­ded into diuers seuerall pieces, so that Nicholas Ni­colus saith, he saw a woman which cast forth nine of them in one day, the least whereof waighed foure pound. The quicke and liuing Moles are they which wholy cleaue to the wombe, and continue with the woman euen to her death.

Cause of the flesh Mole.The cause of the fleshy Mole according to the ancient writers cannot wholly proceede from the woman, but the man must adde somewhat there­unto. Galen holdeth, that it is bred when the mans seed is weake, barren, imperfect, or in little quan­titie; and for the most part choked through the a­bundance of the menstruous bloud, which is grosse and thicke, vnfit for the framing of a child, so that in stead thereof is bread a lumpe of flesh that by [Page 15] little and little increaseth, being wrapped in his owne membrane, which nature effecteth, as desi­rous to bring forth any thing rather then to be idle.

The windie Mole is ingendred through want of heate in the Matrice, and other parts adioyning, Windie Mole. as the Liuer and Spleene, whereby much wind is bred and shut vp in the emptinesse of the wombe. It may also come from without, as in women new­ly deliuered, and in such which hauing had their naturall courses in great abundance, doe venture too soone into the cold aire.

The watry Mole proceeds from the abundance of watrie showres which is sent from the Liuer, Watry Mole. or the Spleene, or other parts thereabouts; or else through the weakenes of the Matrice, which can­not assimilate the bloud that is brought to nourish it, part whereof is turned into water, and being not voided, stayeth in the wombe.

The humorall Mole is bred by reason of too much moisture, as of serious, or whayish humors, Humorall of the whites, or watrish euacuations, which come downe through the vessels of the Matrice, and are stayed in the concauitie thereof.

False conception hath some common signes with the true, as suppression of the naturall courses, Common signes. depraued appetite, distastfulnesse, vomiting, swel­ling of the belly and breasts, so that it is very hard to distinguish the one from the other. But these that follow are more proper to the false, Signes of false concep­tion. then the true birth: for (as Hippocrates saith) In false concep­tion, or Mola, the face is commonly puft vp, their [Page 16] breasts which were swollen at the beginning, doe fall, and dayly wax soft, limber, and lanke, and with­out milke. In the end, the face, breasts, armes, thighes, and legs grow leane and thin: true it is, that they swell towards night, like those that haue the dropsie, the belly riseth and groweth quickly, and withall very hard, for the most part of an equall roundnesse, with diuers pricking paines in the bot­tome of the belly that neuer cease, which makes them that they can hardly walke, being hindred as it were with a heauie burthen, and hauing often­times a windinesse in the wombe, as Ahasis re­porteth.

Signes from the motion.The said Hippocrates obserueth, how that by the motion it may easily be knowne, for in true con­ception the male child beginneth to stirre at the end of the third moneth, or sooner; and the female at the third or fourth moneth: and where there is no such quickning, we must obserue whether there be any milke in the brests, if there be none found, it is a signe that it is a Mole. The child moueth of it selfe, and not the Mole. Beside, the mother fee­leth the child moue euery way, both on the right side, and on the left, as much aboue, as below, and in the middle, without any helpe. But in false con­ception, though there be some motion, it is not a­nimall, but proceedeth rather from the expulsiue facultie of the Mother then of the Mole, which ha­uing no liuing soule endeuoureth not of it selfe to come forth, neither prouoketh the wombe as the child doth, who hauing neede of aire to breath in, seekes after it. But this is a most euident signe when [Page 17] the woman lyes downe on either side, for then she feeles it fall like a boule, and is not able to vphold, or stay it; yea, and being laid on her backe, if her belly be pressed or crushed, it will remaine in the place whither it is thrust, without comming backe againe. Now that which most assureth vs, is, True signes. when the nine moneths are past, and the woman not deli­uered, but her belly growes bigger, and swelleth more and more, and all the other parts grow leane and lesse, this is a sure signe of a Mole, though there be some women that haue borne their children ten, yea, eleuen moneths.

The signes of the windy Mole are these, Signes of the windy. the belly is equally swollen and stretched like a bladder, sof­ter then in the fleshy Mole, and chiefely neere the groine and neather belly, which being struck vpon soundeth like a Tabour: sometime it decreaseth, and otherwhile it swelleth more: it is sooner bred and increased then the fleshy or watery, and stret­ches the belly as though it would teare it, which is not proper to the fleshy.

As for the watery and humorall, Signes of the watry and humorall. the signes are almost alike, the belly growes big, and riseth by little and little. If you touch it with your finger sometimes the print thereof will remaine behind: it is euen, without any hardnesse. It is true, that the woman lying on her backe, her flancks are fuller and bigger then the middle and bottome of the belly, which waxe flat, the water and humor running frō one side to the other; and in shaking the belly, they feele a swimming and floting of water.

[Page 18] Difference betweene the Watry and Humorall.This difference may be also added, that in the the watrish the flancks, groine, and sometime the thighes are more distended and swollen then in the humorall, because the waterish substance stealeth thither soonest: besides, that which passeth forth and bloweth below is cleare like water, without any ill smell; but that which floweth in the humo­rall is reddish, and like to the washing of flesh, and of a bad sent. This also is to be obserued, that in the false conception the naturall courses flow not, and that the Nauell doth shew it selfe but little, or not at all, as it commonly doth when the Mother is with child. Concerning the cure thereof, I meane (god-willing) to handle it hereafter.

What dyet and order a woman with child ought to keepe. CHAP. V.

THat a woman with child may enioy her perfect health, she must diligently ob­serue that which consisteth in the vse of the sixe things not naturall, which are the Aire, Meate and Drinke, Exercise and Rest, Sleeping and Waking, Fulnesse and Emptinesse, and the Passions of the Minde.

Good Aire fit for a wo­man with childFirst therefore she must dwell and liue in a good and well tempered Aire, which is neither too hote, nor too cold, or waterish: not subiect to any foggie mists, or winds, and especially the South-wind. For [Page 19] (as Hippocrates saith) when those winds doe blow vpon euery light occasion, women miscarrie. The Northwind also is hurtfull vnto them, for those winds breed thin rheumes, distillations, & trouble­some Coughs in great-bellyed women, The Cough naught for women with child. causing them oftentimes to abort, or be deliuered before their due time. Likewise such winds as bring with them ill smells and vapours, which being drawne in together with the Aire we breathe, into the Lungs, do many times breed very dangerous and trouble­some diseases. Aristotle saith, Bad smells to be auoided. that the smell of a Candle put forth, may cause a woman to abort, or loose her fruite: wherefore she must beware of all ill Aire, and make her abode in houses well and pleasantly seated, shunning as much as may be pos­sible all bad sauours.

Concerning her Dyet, Her Dyet. she must vse meates which be of good nourishment, and breede good iuice, moderately drying. The quantitie must be suffici­ent both for her selfe, and for her child, and there­fore they are to be dispenced withall from fasting at any time: for sometime too much abstinence makes the child weake and sickly, and causeth him often to be borne before his time, seeking after nourishment, which he cannot find within his Mo­thers body. As also the too great quantity of meate his Mother takes, may often stifle him, Too much meate stifleth. or else make him grow so big, that he cannot keepe himselfe in his place, which constraines him either to come forth, or else makes him sickly, seeing that those meates are corrupted wherewith he is nourished [Page 20] a fed. Hippocrates writeth in Epidem. that the Sister of Caius Duellius after she had eate her fill, aborted.

All meates which are either too hote, cold, or too moist, are to be auoided, and chiefely in the be­ginning of meales; Salt meates bad. as also those which are too salt, or ouer-much spiced; and likewise all baked meates are vtterly forbidden. Aristotle and Plinie write, that if a woman with child eate much salt meate, her childe will be borne without nayles; which shewes, that he will not be long liued. Her Bread must be of good Wheate, well kneaded, light, and also well baked. Fit meates. For her meate she may vse Henne, Chicken, Capon, yong Pigeons, Turtle, Pheasants, Larks, Partridge, Veale, & Mutton: and for Herbs, let her take Lettuse, Hearbs. Endiue, Borage, Buglosse, and Sorrell, abstaining from all raw Sallads. She may close her stomacke after meate with Peares, or Quinces bak't or preserued; as likewise with Che­ries, or Damsons. She must shun all diureticall things, Diureticall and windy meates are naught. which prouoketh either vrine, or the natu­rall courses, and such as are windie, as Pease and Beanes. Notwithstanding, women with child haue oftentimes such disordinate appetite, by reason of some salt or sharp humor which is contained with­in the membranes of the stomacke, that they desire to eate Coles, Chalke, Ashes, Waxe, Salt-fish raw, yea and vnwatred; and to drinke Veriuice, and Vi­neger, yea very dregs, so that it is impossible to hin­der them from eating and tasting them. But yet they must refraine and ouer-maister themselues [Page 21] therein as much as they can, since that such foode may much hurt and hinder both their owne and their childs health. Neuerthelesse if they cannot forbeare, suffer them a little, and let them haue their longings, for feare least it should proue worse with them. Accidents that may happen. For I haue seene many women which being hindered and forbidden frō vsing such trash, haue presently fallen into trauell: and in others, their children haue carried the marks of some of the things they so earnestly desired and longed af­ter. Beside, although that such meates for the most part are very bad and contrary, Lib. 2. Aph. 38. Cibus & potus deterior, suaui­or tamen: meli­oribus quidem sed insuauiori­bus est antepo­nendus. yet for the desire they haue to eate them they are digested com­monly without hurting the partie at all. Meate and drinke (saith Hippocrates) is better and fitter, though it be some-what worse, then that which is better, and not so agreeable and pleasing.

For her Drinke she may vse Claret wine, mature, Her Drinke. and not too strong, which she must allay very well. For this Wine hath power to comfort and streng­then the stomacke, and all the other parts seruing for nourishment and generation: and if she cannot away with Wine, let her drinke Hydromell, or Bar­ley-water well boyled.

Her sleepe must be in the night, Her Sleepe. the better to di­gest the meate she hath taken: for watchings doe ingender crudities and diseases, which cause vn­timely births in stead of faire and goodly children; and chiefely, she must auoid sleeping after dinner. But in the morning she may take her ease, as she shall thinke best, yet not turning (as some great La­dies [Page 22] do) the day into night, and the night into day.

Exercise.She may vse moderate exercise, but violent mo­tion loosneth the Cotiledons or vessels of the Ma­trice whereby the child receiues his nourishment. They must be forbid riding in Waggins or Coa­ches, especially in the three first months: for as vp­on a small occasion we see the fruits and flowers of trees do fall (as by some little wind that shakes the tree, or the like,) so many times through a light cause women great with child, Causes of Abortment. in stirring or moo­uing themselues, yea, or but setting their foot a­wry, may be deliuer'd before their time.

It was not without good cause that the Romanes forbad their Wiues to ride in Coaches, the which also ought to be obserued in these dayes, especially by those who are subiect to take hurt, and there­fore let them walke gently, taking an especiall heed and care to themselues the first three moneths.

Great noyses hurtfull.She must shun all great noyse and sounds, as of Thunder, Artillery, and great Bells. Galen in his booke de Theriaca, sayth, that many women with child haue died with the very fright they receiued by a clap of thunder: and when she is afraid of hur­ting her selfe or falling into trauaile, let her be car­ried in a Chaire or Litter between two strong men, and chiefely two howres before meales: for as a woman may easily loose her burthen the first mo­neth, because her child (though he be but little) is not yet firmely fastned and tyed to the wombe, so likewise being great or big through his weight, he may fall downe, and come forth; wherefore all vio­lent [Page 23] exercise, and too much labour, Violent ex­ercise hurt­full. is hurtfull and dangerous for her; as also to fret, chide, or laugh immoderately. The fourth, fifth, and sixth moneth she may vse more libertie, the seuenth and eight she must keepe herselfe still and quiet, but when she is in her ninth moneth, then may she vse more stirring, and exercise. And therefore is it that Ari­stotle in his Politicks appointeth, Sentence of Aristotle. that women with child should not be sedentary, nor liue too nicely, but that since God hath blessed them to beare children, they should dayly visit the Temples of the Gods for their exercise.

The which Plato expressely commandeth in his Common-wealth, and by a kind of deuotion, Opinion of Plato. and religious pietie. But Aristotle in that place speaketh like a Physition, as he sheweth in his booke de Gene­ratione. In the Countrey (saith he) where women accustome themselues to labour, they are brought abed more easily, and with lesse paine. In briefe, where women exercise themselues, Women that labour are easily deli­uered. they are sooner deliuered, for their exercise consumes the excre­ments, which idle and slothfull women gather and heape together.

In the first foure moneths she must likewise a­bandon Venus for feare of shaking the child, Venus for­bidden. and bringing downe her courses, which must also be obserued in the sixth and eight moneth, but in the seuenth and ninth she may boldly vse it, especially toward the end of the ninth moneth, which some are of opinion will help and hasten the deliuery.

Aristotle is of this opinion, (though herein he [Page 24] contradicts the authority of Hippocrates, Aristotles opinion.) The wo­man with child (saith he) ought not to haue the company of her husband. But Aristotle and Hippo­crates may easily be reconciled; the Philosopher meaneth, that they should not embrace their wiues all the time of their being with child, but onely toward the time of their lying in, thereby to shake the child, and make him come the more rea­dily forth; for comming into the world after this acte, he is commonly enwrapped and compassed with slime, which helpeth his comming forth.

Her belly must be so­luble.It is also requisite that her belly be loose, not re­taining her excrements, and that she haue (if it be possible) euery day the benefit of Nature, which if it be not done naturally, it must be helpt, taking euery morning some broth of Damaske-Prunes; Also Apples stued with Suger, and a little Butter, is very fit and good. She may vse Broth wherein Bo­rage, Buglosse, Purslane, Lettuse, Patience, and a little of the herbe Mercury hath beene boyled. She may likewise take Suppositaries so they be not too sharpe. Clisters. Clisters made of a Calues-head, or of a Sheepes-head, boyled with Annis-seed, and Fen­nil-seed, wherein some course Suger, and oyle of Violets is dissolued, are very conueniēt, vsing them neuerthelesse with discretion, leauing out all man­ner of ingredients which might cause a fluxe of the belly, Lib. 5. Aph. 34. Mulieri graui­dae si aluus pro­susior sit, aborti­onis periculum imminet. Lib.5. Aph. 21. for feare of Abortment, or being deliuered before their time, as Hippocrates saith.

Notwithstanding the same Hippocrates is of opi­nion, that women with child in cases of necessitie [Page 25] may be purged from the fourth to the seuenth moneth, A Woman with Child may be pur­ged. but before and after those times he ad­mits it not, nay, he forbids it directly; which for all that the Phisitions of our time obserue not in cases of danger, because the Medicines we vse in these dayes, as Rubarbe, Manna, Cassia, and Ta­marinds, are not so violent as those that were vsed by our Ancients, which were Hellebor, Scammo­ny, Turbith, Coloquintida, or the like: and wee must take especiall care of giuing them any ope­ning things which may either prouoke vrine, Opening me­dicines must be auoided. Lib. 5. Aph. 60. or their naturall courses; for as the same Author saith, It is impossible for the child to be healthfull if the mother haue her naturall sicknes.

Bloud-letting is forbid them, vnlesse it be very needefull, especially if the child be growne any thing big, because he hath more neede of foode and nourishment, then at the beginning when he was little: for take away his sustenance, and he will waxe leane and feeble, being oftentimes driuen for want thereof to seeke a passage forth. Notwith­standing there are some women so sanguine and full of bloud that we are forced to take some of it away, least the child be stifled with the ouer-great quantitie thereof, or when they fall into diseases where it is necessary to open a veine. Considerati­ons concer­ning Bloud-letting. The fittest time (if it be not in case of necessitie) is from the fourth, to the seuenth moneth. I haue seene a wo­man with child who for a Pleurisie was let bloud eleuen seuerall times, and yet stayed her full terme, and was well deliuered.

[Page 26] Passions of the mind.Now concerning the passions of the minde, a woman with child must be pleasant and merrie, shunning all melancholike and troublesome things that may vexe or molest her mind: for as Aristotle saith, A woman with child must haue a setled and quiet mind, which Auicen also counselleth, that those which haue conceiued, ought to be preser­ued from all feare, sadnesse, and disquietnes of mind, without speaking or doing any thing that may offend or vexe them; An obserua­tion. For great bel­lied women. so that discreet women, and such as desire to haue children, will not giue eare vnto lamentable and fearefull tales or storyes, nor cast their eyes vpon pictures or persons which are vglie or deformed, least the imagination im­print on the child the similitude of the said person or picture, which doing, women shall be sure to be well and happily deliuered, and that (With the help of God) they shall beare their burthen to the full terme, which shall be sent into the world without much paine, promising them a happie and speedie deliuerie. To conclude, they must leaue off their Busks as soone as they perceiue themselues with child, not lacing themselues too straight, or crush­ing themselues together, She must take need of la­cing her selfe too hard. for feare least the child be mishapen and crooked, or haue not his naturall growth: and their garments must be rather light and thin, then heauie and cumbersome.

How a woman must gouerne her selfe the nine moneths she goeth with child. CHAP. VI.

NOw I haue prescribed what manner of life a woman ought to leade, while she is with child: she may ob­serue (if it please her) this that follo­weth, though not so necessary, yet commodious and profitable both for the maintai­ning of her health, and preseruation of her beauty. To the end then that her breasts after her deliuery, be neither too big and pust vp, To preserue the breasts. nor yet hanging downe like bags, and to preuent the danger that might happen vnto her, by the too great quantity of bloud, that is turned into milke, (which may be curdled, and so suppurate, and putrifie.) As soone therefore as she knowes her selfe to be with child, (as in the second or third moneth) let her weare a chaine of gold about her necke. Some preferre a chaine of steele, or else a little gad of steele put be­tweene the two breasts, as likewise to put a piece of corke there, and to weare vnder her arme-pits two little pieces more of the same. This Fomenta­tion also is very good.

Take of Periwinckle, Sage, and ground-Iuy, A Fomenta­tion. of each a handfull, Hemlocke halfe a small handfull, boyle them in wine and water, and when you haue taken it from the fire put thereto a little rose-vine­ger. And with this decoction warme, bath your [Page 28] breasts in the morning with a cloth or spung dipt therein, a quarter of an houre, wiping and drying them afterwards with reasonable warme clothes. The like may be done with the waters of the same hearbs, What must be done, the 3. and 4. Mo­neth. and about the third or fourth moneth, when she feeles her selfe quicke, about which time her belly begins to swell and grow big, she must weare a Swathe (made fit for the purpose) to support her belly, being first annointed with this Liniment or Pomade, which she shall continue till the ninth moneth, to keepe her belly from being full of knot­tie and broken vaines, furrow'd and wrinckled, ma­king it grow deformed, vnseemely, and hanging downe lower then is fit, which hapneth by reason of the great burthen and weight of the child, that stretcheth and inlargeth the skinne thereof, and causeth them to indure great paine in their belly and groine.

The Pomade or Liniment approued. Take of Kids sewet, and the fat of a Sow, of each three ounces, of Capons and Goose-grease, of each an ounce and halfe, cut them small, and melt them in an earthen pot, putting thereto as much water as will suffise, then straine them through a cloth, and wash them in water till they waxe very white, and haue lost their sauour. Afterward melt them againe in a double vessell, adding thereto anounce of the marrow of a Hart, or Stag, then wash it a­gaine with Rose-water, or other sweet smelling wa­ter, mingling therewithall (if you thinke fit, or that it will not be hurtfull to the wombe) two or three graines of Muske or Ciuet.

[Page 29]Some vse this oyntment: Take dogs grease, Another Liniment- and the fat about a sheepes kidney, of each two oun­ces, Spermaceti one ounce, oyle of sweet Almonds an ounce and a halfe, the fats must be melted, pre­pared, and washed as before, then melted againe with the rest, and washed with rose or sweet water.

Some take good store of Sheepes-feet well bru­sed and broken in pieces, to the number of thirty or forty, and boyle them well in water, then taking off the fat, and marrow that swimmeth on the top, which they wash well in common water, and take therof two ounces, of Ducks-grease as much, Another. Sper­maceti one ounce, white Waxe sixe drams, melt them altogether in a double vessel, and wash them in the aboue named waters.

Some Ladyes and Gentlewomen which loue not to rub their bellies euery morning with any of these liniments, weare thereon a Dog-skin, or some other wel prepared and dressed, as followeth; and change it euery fifteene dayes, or according as it will last and continue, not taking it off, except it shriuell and grow wrinckled.

Take a Dog-skin, or some other skin ready dres­sed to make gloues of, wash it often in common water, afterward in Rose-water, and dry it in the shade, and being thus drest and dryed, lay it in soke in these oyles and fats following:

Take of Mesues oyntment of Roses an ounce and halfe, oyle of Saint Iohns wort, The maner to prepare it. and of sweet Al­amonds, of each an ounce, fresh Butter, and Sper­maceti, of each halfe an ounce, melt all these toge­ther [Page 30] in a double vessel, and let the skin lie and soke in it, three or foure daies, mouing & stirring them together daily: then take it foorth, and spred, it in the aire, and let it lie there two or three daies till it haue sok't in all the oile, & become drie: then cut it to the forme & bignesse of the belly, and so apply it.

The daintie and curious may vse the former liniments and skin: they that haue not the meanes to do either, Another easie to be proui­ded. let them; Take of fresh Butter well wash't in common water, and then in Rose-water, three ounces, oile of sweet Almonds, one ounce, Spermaceti, halfe an ounce: and with these melted together, rub their belly.

Obseruation.These Ointments must be kept in a gally pot, and couered with Rose water to keepe them from being mustie.

Gouernment of the ninth Moneth.When the Woman is come to the ninth Mo­neth, hauing been in good health all the time of her going with child: she must continue the vse of the aforesaid Ointments, and must begin to vse more exercise then she did before, walking gently before meales the first twelue or fifteene daies: and then afterward it will be good to vse stronger exer­cise.

It will be very profitable for her (especially after the ten or twelue first daies of the ninth moneth be past) to sit in the decoction following, after the maner of a halfe Bath, some quarter, or halfe an hower in the morning, and then being well dried, and laid to bed, let her be annointed behind, all along the lower part of her backe, and before, from [Page 31] the Nauill downward; and chiefly vpon Os Pubis, and the groine, with the ointment following.

Take of Mallowes Althaea, with their roots, The Bath. Mo­therwort, of each two handfull, white Lilly roots, three ounces, Chamomill, and Melilot flowers, of each a good handfull, Lin-seed, Quince-seed, and Foenigreeke, of each an ounce: Boyle them all in sufficient quantitie of running water, for the Bath.

Take of Hensfat, three ounces, Duckes fat, The Oint­ment. an ounce and a halfe, fresh Butter, two ounces, Lin­seed oile, an ounce and a halfe: Melt them all to­gether, then wash them verie well in Parietarie, and Mugwort water, adding thereto two ounces of the Muccilage of Althaea Roots. In which space, let her take this drinke euery morning fasting. A Drinke. Take of Oile of sweet Almonds newly drawen without fire, an ounce, white Wine, halfe an ounce, Parietarie water, one ounce, mingle them together. Some haue found good by taking the yelke of an Egge, and drinking a draught of Hypocras after it.

Others take a little Wine and water, wherein Lin-seed hath been stieped.

Let this or the like order and gouernment be ob­serued, for a Woman that is of a good habit of bo­dy, and who in her going with Child, hath not been subiect to any sicknesse, or accident of moment: bearing her Children well, & without much paine.

But because there be many, which are troubled with diuers accidents, which happen in their Child­bearing, I thought good heere, to treat thereof briefly, before I speake of their Deliuerie.

Of many infirmities, which trouble Women while they are great with Child. CHAP. VII.

A Woman must haue a care of her Beautie. IT becomes a Woman well at all times, and chiefly in her Child-bearing, and af­ter her Deliuerie, to haue a care, as much as she can possiblie, of the preser­uation of her Beautie: since there is nothing that sooner decaies and spoileth it, then the often bea­ring of Children. Health must be preferred. But as Health is more precious, and recommendable then Beautie: and seeing that a woman with Child may be troubled and oppres­sed with many accidents, and infirmities, during the nine Moneths she beares her child: it will be there­fore verie necessary and profitable to seeke out the meanes to free and deliuer them thereof: For in loosing the Mother, the life of the Child is also ha­zarded. Aristotle. Aristotle in his booke De generatione Ani­malium, is of opinion, That bruit beastes going with young, are not subiect to any diseases: and contrariwise, that Women are verie often sicke. Hippocrates saith, Hippocrates. That they be pale and wan, to shew that they are subiect to many infirmities. In times past when men and women were sold like slaues, if there were any found that were with child, she was not warranted for whole and sound by him that fold her, Vitruuius. as Vitruuius writes in his second book; because they were troubled and subiect to so many [Page 33] diseases. In the first three or foure Moneths such in­firmities chiefly happen for many causes. First, Why women with Child are sicke. be­cause they liue (as Aristotle saith) for the most part in idlenesse, and eate ill meates; which are turned into excrements, and breed many obstructions, the fountaine and beginning of all diseases: the second is, the great suppression and stopping of bloud, whereof they were wont to be purged euery Mo­neth, before their being with Child; which runs to the Matrice to be voided, & find that accustomed passage; which it had woont to haue: but being not able to get forth, and much lesse to be spent and di­gested, by the Child (which is as yet but little) it re­turnes backe into the vaines, & chiefly those which are neere the stomacke: and through the long con­tinuance, is there corrupted, and changed, to be of a bad qualitie, whereof proceeds this depraued and disordinate appetite, which the Latins call Pica, or Malacia: Loathing of meat, Hicket, Vomiting, Diuers disea­ses of wo­men. Paines of the stomacke, Flanckes, and Belly, Ache of the backe, Hips, and Groine, difficultie of ma­king water, Panting, and beating of the heart, with Sounning, the Cough, binding and Fluxe of the belly, swelling of the Thighs, and Feet, and some­times Abortment, not being able to beare their Children the full time: together with many other accidents; whereof we will speake hereafter, be­ginning with the Pica, which troubleth them oft­nest, and longest.

Of the disordinate longing called Pica. CHAP. VIII.

WEe commonly say the appetite is de­praued, when beyond measure we couet to eate and drinke too much (in respect of what hunger naturally requireth:) Or when we desire, or long after meats, which are vnusuall, and offend in qualitie, and are not drest and prepared as they ought.

Of this depraued Appetite there be diuers sorts. The first is called Boulimos of the Greeks, Boulimos. and of the Latins, Fames vaccina, & appetētia immodica. When they eate more then is requisite, not being able to satisfie themselues. And if hunger vrge them far­ther, and grow greater, then it is called of the La­tins Appetitus caninus, Canina appe­tentia. or Fames insatiabilis, and the partie eates, till he be full, euen to the throat, that he is constrained to vomit, his stomacke being so ouercharged. But then presently he is driuen to eat againe, and then to vomit: from whence the Pro­uerbe is taken; He is returned like a Dog, to his vo­mit. The like hapneth for drinking, as for eating, which the Latins call Sitis immodica, Sitis immo­dica. which is so great, that the tongue cleaues to the roofe of the mouth, not being able to eate or speake except the mouth be first moistned, and the tongue wetted. This accident is verie hard, yea, euen vnsupport­able [Page 35] to endure, the sicke party taking no other de­light but in drinking, and that often, and in great draughts. Men are more subiect to this drougth then women: Contrariwise, Women, and chiefly those with child, & such as haue not their Courses, or Wenches that are subiect to the Greene sick­nesse, are more troubled with this depraued or im­moderate appetite, called Malacia, or Pica; hauing this name giuen it, From whence it is called Pica. either because Pyes are trou­bled with this disease, or else for that their feathers be of diuers colours, blacke and white, according to the varietie of things, which Women long after. This sicknesse hapneth when they desire to eate or drinke things, that are wholie contrarie to Nature, as eating of raw or burnt flesh, yea, euen to long after Mans flesh, Ashes, Coles, old Shoes, Chalke, Waxe, Nutshels, Morter, and Lime: Storie of Fernelius. as Fernelius witnesseth of a man, who being a long time desi­rous to eat vnslak't lime, at last deuoured thereof the bignesse of ones fist; which helpt him, without doing him any harme, either in the stomacke, or guts. Notwithstanding, not long since, the daugh­ter of M. Forges died, with eating the plastering of wals.

Sometimes custome, which is a second Nature, makes vs couet to eat such contrarie things, as we desire, and the rather because we haue commonly eaten thereof in our youth: There is found the con­trarie hereof in some, who abhor and loath good meates, which is imputed to the Idiosyncrasie or particular constitution of the person. Others haue [Page 36] obserued, that there are such malignant humours sometimes bred in vs, that they are turned into poi­son, and make both these depraued appetites. As it is seen by poisons taken inwardly, and applied out­wardly, which make the like effect. The biting of the serpent Dipsas doth testifie the same, which breedeth an intollerable and vnquenchable thirst in him that hath been wounded by it.

Now therefore, leauing all these kinds of vitia­ted and depraued Appetites, we will onely speake of that wherewith great-bellied Women are trou­bled, which is called Pica.

Diuers causes of Pica.Some impute the cause of this sicknesse to cer­taine Crudities, and ill humours, which are contai­ned in the whole habite of the bodie, and imparted to the mouth, or orifice of the stomacke. But the soundest opinion is, that the sides and tunicles of the stomacke, and orifice thereof, are infected, and stuffed with diuers excrements, and ill humours; and according to the qualitie they haue, the Wo­man with child, Wherefore they desire diuers things. longeth after the like: As if Me­lancholie abound, not burn't or adust; she longeth after sharpe things, as Vineger, Citrons, and Oren­ges: if the Melancholie be adust, shee desireth Coles, Ashes, and Plastering: if the humour be salt, she coueteth salt meates, and so of the rest. And surely it often happens, that they long for the like things as are in their stomackes. This maligne and bad humour, is ingendred (as we haue said) through the retention of the naturall Courses in women with Child, which flow backe into the sto­macke. [Page 37] In some it beginneth the first weeks, yea, The begin­ning of the Pica. the verie first day; in others the thirtieth or fortieth day, and continues euen till the fourth moneth, and then ceaseth: which commeth so to passe, because the Child is growen bigger, and hauing need of more Nourishment, draw's to him a greater quan­titie of bloud; the which he consumes: and so by consequent, it returnes backe no more into the sto­macke. Besides also, this humour hath been much spent and voided, by the often vomitings which Women haue during the first moneths. And also because the Childs haire is bred, and grown great, The breeding of the haire causeth the Pica. which some hold to be partly a cause of this sick­nesse. Plinie writes, That women with Child, feel themselues worse, when their Childs haire begins to come, and chiefly about the new of the Moone.

Now that we may preserue them from this infir­mitie, or at least diminish it as much as may bee: she must chiefely vse meats that breed good iuice; Their diet in Pica. and that in little quantitie, increasing it neuerthe­lesse as her bignesse augmenteth, and the childe groweth: which at length waxing stronger and greater, will consume part of this great quanti­tie of bloud, and the rest may bee put into the membranes which wrap and infold the childe, and to the masse of bloud which is called the after-bur­then, which is as it were the liuer of the Matrice.

Now concerning their meat and drinke: Consi­dering that they that are sicke of this disease, and so infinitely distasted, that often times they doe euen loath and abhorre good meats: therefore wee must [Page 38] set an edge (as it were) on their appetite, Meats fit for those that haue the Pica. varying their meats in as many fashions as may be possible, thereby to make them the more pleasing and de­sireable.

Oliues and Capers, as likewise sallades a little parboiled, are very good for them.

All meats that are either too fat, or too sweet, bee naught, because they stirre vp a desire of vo­miting.

For their sauces: they may vse Veriuice, Orrin­ges, Citrons, Pomegranats, and good Rose viniger, all very moderately taken.

Auicen. Auicen commendeth tosted cheese, and Amy­lum dried: Aetius. which Aetius and Oribasius doe allow, and especially to those that desire to eat earth, Oribasius. and plastering of walles, Aegineta. or the like. Paulus Aegineta al­lowes them the vse of mustard, pepper, and cloues to make sauce thereof, for the stirring vp of their ap­petite, and to helpe to digest the crudities contai­ned within the stomacke: after meales she may eat bak't quinces, and rosted filberds. For her drinke, she must vse good clarret wine, well allaied: but if shee long for white, you may giue her leaue to drinke some, so that it haue a little astriction.

Much drink­ing is naught in the Pica.True it is, that the ouer great quantitie of drinke is hurtfull for her, by reason of the great washing which it might make in her stomacke: shee may take euery morning a draught of Wormewood­wine, or a little strong Hydromel, with a tost of bread. The vse of these Lozenges is much com­mended.

The Ancients, as Paulus and Oribasius, excee­dingly commend the decoction of Polypody, and Annis-seed, with suger of Roses. They may vse gentle fomentations to their stomackes, made of Wormewood, Balaustia, Cumin, Cytisus, and Fennill-seed wherewith likewise may be made Ca­taplasmes for the same vse. For these medicines will comfort and strengthen the concoctiue facul­tie of the stomacke, the better to digest the meat; the retentiue, to retaine and keepe that it hath re­ceiued; the expulsiue, to thrust that foorth which troubleth the stomacke; and the appetite, to couet and long for meat.

This ointment is also very fit and profitable.

As also this that followeth.

[Page 40]They may vse Galens Cerote for the stomacke, or that of Aecius, made with Quinces, Saffron, and a little oile of Spicknard.

Concerning generall purgations, which may e­uacuate downeward part of this superfluitie, they must not be administred when a woman is yoong with childe, Discretion in purging. but with very great care, and good ad­uice, not vsing any strong purgers. But if there bee need, and that the disease ceaseth not by light me­dicines, then may be giuen a little infusion of Ru­barbe, and a gentle decoction of Sene, taking the aduice of the learned Physitian. And therefore we must onely haue a regard to their vomiting, which at these times doth commonly molest and trouble them: taking heed of staying it, except it be immo­derate (as Auicen saith) or too violent. Auicens pre­cept. For other­waies it helpeth to cure this disease, euacuating part of those ill humours whereby it is nourished and increased. And if wee perceiue she hath a de­sire to vomit, and that the expulsiue facultie be not strong enough to helpe it, let her take a little Hy­dromell warme; and if the matter in the stomacke be tough and clammie, adde thereto a little vine­ger, the better to attenuate, and cut it. I haue beene the longer in this Chapter, because it is an accident that doth much annoy women with childe: thereby the better to instruct the yoong Chirurgion, when there is no Physitian neere at hand.

Of Distastfulnesse and Hicket. CHAP. IX.

MOst women, as soone as they are with childe, be so distasted, and doe so loath and abhorre meat, that they cannot endure either to eat, see, or smell it, yea, and some are sicke e­uen with the very hearing of it named: which makes them goe often times two or three daies without any desire to eat. This disease hapneth vpon the same reason we gaue before of the depra­ued appetite, The Cause. because the stomacke is filled and stuffed with diuers excrements (that oloy a great bellied woman) which by little and little are there gathered together, by the flowing backe of the courses that be stopped (which cannot bee put forth, much lesse consumed by the little one) and so come into the stomacke, and fill it.

But when these corrupted, The Hicket. and ill humours abide longer in the stomacke, there happens another ac­cident, commonly called the Hicket, or Yeaxing, which is a violent and conuulsiue motion of the stomacke, which seemeth to discharge it selfe of those bad humours, which are contained in the ca­pacity and membranes thereof: and offend either in quantitie, or qualitie, or both together. Discommo­ditie of the Hicket. From hence comes it that the stomacke willing to put them forth, casts vp with all the meat and food, the woman hath taken: to the preiudice of her selfe, [Page 42] which cannot keepe any thing for her owne suste­nance) and of the Child, who cannot find suffici­ent bloud to nourish him: which at length makes them both weake, and causeth the Mother either to be deliuered before her time; or else to breed a faint and feeble Child, and oftentimes one that will be sickly all his life time.

Cure.For the remedying of this queasinesse, we must haue recourse to those medicines, written in the Chapter of depraued Appetite; Both for the dyet and remedies. And touching the Hicket, when it comes through emptinesse, or want of eating; then the woman must nourish her selfe, taking often good meat, and in small quantitie, as yelkes of egs, cullis, veale, broth, hennes, and chicken: and let her belly be annointed with oyle of sweet Al­monds, and Violets. If the cause proceed of any sharp or biting humour, it must be drawen and pur­ged downward gently, as we haue said already: or else by vomit, Straining bad for women with child. without much straining Cow milke, and the milke of an Asse are verie much commen­ded; as also the vse of syrups of Violets, and Nenu­phar are verie profitable.

The Hicket may also come of some inflamation, that is in the Spleene, Liuer, or other bowels neere the stomacke, and so is impart to it: this hapning, it will be verie necessarie to let her bloud: and that she vse meats which moderately coole, as also me­dicines of the same nature both inwardly and out­wardly: consulting thereof with the Physitions.

Of the Vomiting which happens to Women with Child. CHAP. X.

THere be some women, who as soone as they be with child, yea, the verie first daies, are subiect to Vomit: Women with child Vomit often. casting vp store of water and slime by the mouth: and this vomiting continueth euen till they are quicke with child: and with some it remaineth all the time of their going: which I saw happen vnto a great Lady of this kingdome; who from the se­cond day after she had conceiued, vomited; and affirmed constantly that she was with child.

When this Vomiting hapneth, Vomiting must not be stopt on the suddaine. it must not be staied sodainly, if so be it continue gently, and without violence: for being stopped, there is such store of humors heaped and gathered together in their stomacks, that they are ready to be stifled, or stuft vp; which being by little and little cast vp without violence, they are much eased: for by this euacuation of noysome excrements, the first region of the belly feels it selfe free, discharged, and vn­burthen'd of many long and grieuous paines. Cause. The cause of this accident proceeds commonly of the abundance of humours gathered together in the stomacke: or else of some sharpe, and biting hu­mour, that doth stir and prouoke it, and chiefly the vpper orifice thereof: aswell, by reason of the ill meats they eate, and that in great quantitie, as also because they fill themselues too much with good meat, which doth putrifie and corrupt, (the natu­rall [Page 44] heat being weake) and requires rather to be cast forth, Accidents of Vomiting. then kept in the bodie. But it hapneth oftentimes, that this Vomiting is so violent, that euen the meat and sustenance which the Mother taketh, to nourish her selfe and the child is cast vp, and then it must be remedied.

Likewise, if this accident come from some weak­nesse of the stomack, or by the default of the reten­tiue facultie, which is not able to retaine and kepe the meat, although it were of good iuice, and in finall quantitie: or by some maligne vapour, which ariseth from the wombe, by reason of the feed and naturall courses retained; they maybe help'd by these meanes following.

First, if the great quantitie of meates whe­ther good or bad, which the woman hath taken, be the cause: then let her abstaine from eating them: obseruing the aboue mentioned Dyet, vsing good meats, and in little quantitie; there­by to roule it forth. If the ouermuch quantitie, or ill qualitie of sharpe and biting excrements, be the cause, then must they be gently taken away and purged: Notwithstanding, we must refraine from giuing them any purgations with Diagredi­um, or Coloquint: and also from such as do much soften and moisten, as Cassia, Electuar. Lenitiuum, and the like: because through their moisture, they relaxe the stomacke, and so consequently, all the meanes, which haue correspondence and traficke with the Matrice: for the similitude of their ner­uous substance.

[Page 45]Their purges therefore must be of Rubart infusi­on, and also in substance, of the compound syrup of Cichory with Rubarbe; which besides that they eua­cuate, doe likewise coroborate and strengthen: as also of the Syrup of Damaske Roses, Ma [...]na, and other which with drawing away the water, doe dry with­all. But aboue all pills are very fit for them, because they dry; both for their forme, and also for the dry­ing ingredients whereof they are compounded: as those of Rubarb and Sene, made with a little con­serue of roses, A good pre­cept. adding thereto (if there be any suspi­tion of some maligne or bad quality) a little of the confection of Hyacinthvs. This rule must be obser­ued in the purging of women with child, and here­of must be had the counsel of the learned Phisitian.

If some maligne vapour be the cause; they must vse cordials, as, a little confection of Hyacinthe, the electuary of Gemmis, these cordiall Lozenges, or the like.

While they shall vse the aforesaid remedies, it will be very necessarie to comfort the stomacke: as also if the vomiting proceed through some weake­nesse, the stomacke not being able to retaine, and hold the meate, the fore mentioned Lozenges are very good, as also Lozenges of Diarrhodon, if they [Page 46] should prooue distasteful, let them vse Codigniack, or some Citron pill condited. They may likewise take some digestiue powder after meales.

Let there be prouided some such fomentation for their stomacke, as this.

Then let them haue this ointment:

This Emplaster is very fit: which must be applied after the ointment, Emplaster. and remain there a good space.

If all these forenamed medicines helpe not the patient, Master Mercator doth set downe a remedy very easie to be practised, and of incredible vertue (as he saith,) which cannot bring (hauing often tri­ed it) any danger: An approued medicine. nor cause the woman to be deli­uered out of her time: which is to let her blood in the Saluatella of the right hand.

CHAP. X. Of the paine of the sto acke, stancks, and belly, which happens to a woman with child.

THere is great store of grosse winds bred, not onely in the stomacke, and guts, but also about the Liuer, Spleene, Mesente­rium, and Nauell, Causes of wind. by meanes of a weake and feeble heat, which is not able wholly to con­sume, and scatter them: from whence proceedeth a great distention of the belly, and other parts neere and chiefly about the Nauell: which in some often­times stands out, and is as big, as a goose egge. The which winds being thus inclosed, and not hauing free passage, cause such intollerable paine, that e­uen the breathing is thereby hindred, and the pulse almost lost, which at length might cause the wo­man to be deliuered.

Sometime also the wind is shut vp within the womb for I haue knowen some women, Wind inclo­sed in the wombe. that haue voided them with such a sound, & noise, as though it had bene, by the fondament, and this must be re­medied after this sort.

First shee must shunne all manner of moist, Dyet. and windy meats, & liue after the order before prescri­bed. If it bee needfull to purge her; let it be done, as is already set down. Then let there be applied some dry fomentations to the place affected, as this.

The same quilts may be boyled in wine, and fo­mitations made of the said wine with soft spunges. But you must obserue, that the too long vse of moist fomentations, oyles, and fats is forbidden women with child, for feare least by too much moisture, and oylinesse, the ligaments and vessels of the ma­trice bee made too loose and soft: which at length may cause the woman to abort. Apply vnto her belly and to me parts pained, in forme of a Pultesse this that followeth.

Let them chaw Fennil, or Anniseed, or a little Cinamon: and take a tost dipt in Hippocras, Some haue tolde mee, that the distilled water of Citron Pills, drunke, is very singular good. And it will not be amisse, sometimes to take a spoonfull, or two of this water.

If ye perceiue that shee is much troubled with paine you may giue her a Clister: as this.

Neuerthelesse, Admonish­ment I am of opinion (if it may be done possibly) that they should abstaine from Cly­sters: because I haue seene women sometimes, through as small a Clyster as this, fall into great tor­ments, yea, and euen into throwes; nature being thereto prepared and ready: which turned to the Chirurgions disgrace. Wherefore let her vse these Lozenges following:

She may vse Sugar of Roses, which to euery ounce hath two or three drops of the oile of Annis seed added to it.

Of the paines of the Backe, Hips, and Groine, with difficultie of making water, that happens vnto Women with child. CHAP. XII.

THere be some Women, which beare their children high, and (as they say) within their stomacke: so that they are nimbler, either in going, or stirring: with­out being let or hindred thereby at all. Others [Page 50] carrie them verie low, The diuers situation of the child. hauing their belly standing verie much out, which brings them much incon­uenience: as paine of the Hips, and Groine, and then they complaine, as if those parts, and their belly were rent and torne in pieces. Contrariwise, there be others, that hide their child, within their raines, and beare it verie backward; which causeth them to haue exceeding great paine in their backs. In the two latter cases, we had need to helpe them: for as Hippocrates saith; Hipp. When women with child are troubled with great paine in their backe, and legs; then are they in danger to be deliuered before their time. The like may be also said, of them that haue much paine in their belly and groine.

Cause of these paines.These paines commonly, do rather proceed from the heauinesse of the child, then of any quantitie of humors, which abound in the bodie. For at that time, the wombe being great, thicke, and full, by reason of the child which is big, and large, and of the bed, or after-burthen, and oftentimes filled with great store of water; on which side soeuer the wombe resteth, it drawes the ligaments and bonds with it, that hold and fasten it to the foresaid parts: and by the force of this dilation, and stretching, doth cause and prouoke paines in the backe, hips, and groine: aswell by reason they are tyed thereto; as likewise for the continuitie of those neighbou­ring parts, The Cure. which touch them. For the remedying whereof, the woman must keepe her selfe still, and quiet, without much stirring, or shaking: she must eat little, and often, and of meats that be light, and [Page 51] easie of digestion: for the stomake being full, doth presse the body of the Matrice, and thrusts it down­ward. Therefore she must were Swathes, which may helpe to support, and keep vp her belly: that by such a rest and swathing, the ligaments, which are lengthned, and stretched, may be somewhat brought backe to their proper places: which must be confirmed and strengthned by these meanes.

All the bottome of her backe, and raines must be annointed with Vnguentum Comitissae, or else this ointment.

If the woman with child feel any coldnesse (as it happens to some, by reason of their cold tempera­ture) which makes them shiuer, and quake: let there be added to the former ointment, Ol. Costin. & Aneth. an. ℥ ss.

But if she find any heat there, or burning, then applie some ointment, that hath vertue to comfort, and coole.

Likewise it may chance, A good ob­seruation. through the waighti­nesse of the wombe, which resteth in the bottome, that the woman with child cannot make water; which hapning, she herselfe, with both hands must [Page 52] lift vp the bottome of her belly: by meanes where­of, she shall hinder the bodie of the wombe, from pressing, and crushing the bladder, and especially the necke thereof, which is loaded and oppressed with the said wombe. You may applie below, some bathing or fomentation, made with the leaues of Mallowes, Althaea, Cresses, and Parietarie, with a little Lin-seed, to make the passage more loose, soft, and easie to be inlarged, or widened.

Of the panting, and beating of the Heart: As also of Swouning, which happen vnto women with child. CHAP. XIII.

AS there be diuers winds and vapours, that are shut vp, and inclosed in the neather belly of a woman with child, which procure great paines in her hips, backe, and groine: for the rea­sons before rehearsed. Cause of the trembling of the Heart. So likewise are there the like vapours, that arise from the wombe, and other parts neere, which are inclosed in the Arteries, and by them are carried, and imparted to the heart, which cause a panting, and beating: and the heart feeling it selfe offended, and oppressed by the said vapours, endeuoureth by his motion, to expell and driue them away, The wisedom of Nature in all her works. far from itselfe, (Nature ha­uing giuen to euery part, some particular meanes, whereby to repell, and thrust backe that, which [Page 53] doth annoy, or molest it. As the Braine by snee­sing; the Lungs by coughing; and the stomacke by vomiting. But because this accident is often­times the forerunner of a Syncope, or swouning, therefore will it be needfull to haue care thereof, it being easie to be knowne, both by the rela­tion of the party, who finds her heart beate, as also by feeling the breast vppon the region of the heart with ones hand, with which this motion lif­teth vp the ribs and the hand that is laide thereon, yea some women haue such a beating, that it makes euen the ribs stand out of their place. For re­medy whereof, such vapors must be kept from sea­sing vpon the hart, which may be done by well fen­sing of it, both within, and without.

If then you perceiue that the woman doe a­bound with any ill humors, from whence these vapours may partly arise: she must bee purged (as before,) and let bloud, according as the accidents doe require, and the ancients doe appoint, which must be done in small quantity, and that, not all at once: but rather at mâny times by little and little. For according to Galen. How a wo­man with child must be let bloud. There is no remedy that more hinders, and altars the course of blood and noysome vapors, from piercing and assailing the heart, then letting of bloud doth.

Let her take euery morning, one of these Lozen­ges, which are very proper

In steed thereof she may vse this opiate:

The Claret water before described is very ex­cellent good, some doe vse the water of Orringe flowers.

The hart must be garded.The heart must bee outwardly fortified with Quilts, Fomentations, Epithemes, & Cataplasmes, applied to the region thereof; made with the afore­named ingredient. Take for the Epitheme or fo­mentation, the waters of Borage, Buglosse, Balme, & of Oringe flowers, Cardus Benedictus, Roses and of Scordium, adding therto Saunders, Angelica seed: Cordiall flowers and the like.

The wombe desireth good smels.And because that the heart and matrice, are de­lighted with pleasant odors, let those that are trou­bled with this disease vse good smels; sweet, but nei­ther strong nor piercing.

CHAP. XIIII. Of the Cough.

ONe of the most grieuous, and almost in­supportable accidents, that can happen to a woman with childe, is the Cough: the which being violent, oftentimes cau­seth [Page 55] head-ach, pain of the sides, flanks and belly, Inconuenien­ces of the cough. vo­miting, & watching, the woman not being able to sleepe, or take any rest, for the great concussion and agitation which is made through the whole body, which oftentimes puts the woman in danger, to be deliuered before her ordinary time.

For the most part it proceedeth of some sharpe and biting vapours, Cause. which arise from the nether parts, or else by the distillation of some thinne hu­mor, that comes from the braine, and falleth trick­ling vpon the Trachea Arteria, or wind pipe, & the lungs, which prouokes them to cough, & yet brin­ging vp little or nothing: the distilation may also be of some thicker humor which falleth downe vp­on the said parts.

Therefore wee must haue respect to the antece­dent cause, Cure. by hindering such vapors and humors from breeding, then staying those, which may flow or fal downe: if there be any cause or matter ioined with it, already fallen and impacted in the lungs & brest, then must it be brought vp by spetting.

For the helping hereof, Dyet. they must auoide all salt and spiced meates, as also those that are sharp, and biting especially if it be caused by some vapours or destillation of a thinne or serous humour.

Concerning generall medicines: Generall me­dicines. if it bee accom­panied with a feuer, or some great heat, it will not be amisse to draw a little bloud. then (the better to turne the course of the distillation): which causeth the cough to apply cupping glasses vpon the shoul­ders, with some light scarification. And if the cough [Page 56] should bee of so long continuance, Cautery. I would coun­sell you to lay a cautery in the hollownesse of the nape of the neck: which I haue practised with good successe, but it must not be done before you haue tried the medicines following, and when the cough is great and violent.

Frictions.The rubbing of the armes, shoulders, and backe must not bee omitted, as also when the haire is shauen away to apply Emplasterum de Betonica, vpon the head, to stay the Rhume.

If the cough be dry, proceeding from some thin and sharpe humor or vapour, it must bee thickned, contrariwise if the humour be tough and thicke, it must be cut, and attenuated, by concocting both, and therefore in this case, the vse of Medicines, that do dull, the sence therof, are very profitable to mit­tigate violent Coughs: of which kind are these that follow. If the humor bee thin and sharpe this Iulep taken twice or thrice is very fitte.

If the humor be slimy, thicke, and tough she may vse this Iulep.

Let them often hold in their mouth suger candy, especially that which gathers about the pot side, wherein sirop of Violets or the like hath beene put. [Page 57] Let them vse Trochiscks, iuice of Licorise, and sometime chawe a peece of Lichorise in their mouth. The Lozenges of Diatragacanthum frigi­dum, Diairis simplex, and suger of Roses, are very good. The vse of Lohocs is very distastfull, but in steed thereof, let them vse Syrup of Iuiubes, of dry­ed Roses, and a little diacodium mingled together, I haue seene this medicine doe much good, especi­ally when the cough is great, and that they feele some excoriation, and roughnes in the throat. A medicine to take away the roughnes of the throat.

Let them take of this medicine in a spoone, swal­lowing it down verie gently, that so some of it may the better slide downe the sides of the windpipe.

It will be very fit to rub their breast all ouer with fresh butter, or oyle of sweet Almonds: and if they finde any heat, let them vse oyle of Violets washed with Barley water well boyled. Sleeping stop­peth fluxes.

And because there is nothing, that stayeth de­stillations, better then sleepe: and that those who haue the cough sleepe little, it will be very good to make the patient sleepe, without giuing any vio­lent sleeping medicine, this Iulep may bee giuen very safely.

[Page 58]This remedy procureth sleepe, and so by conse­quence stayeth the Rheume. If you haue any good Laudanum, you may giue safely three or four grains thereof; which I haue seene practised with prospe­rous successe.

CHAP. XV. of Costiuenes, wherwith women with child are troubled.

AMongst many other accidents wherewith women with child are troubled, there are two, the one contrary to the other where­unto they be much subiect: that is, either they are bound, and cannot go to the stoole but with much inconuenience, and very seldome: or else they are alwaies loose and subiect to the fluxe. Contrary ac­cidents in wo­men with child. Both may put the woman in danger of miscarrying. For when she is bound, with much strayning, and that vio­lently to vnburthen nature, the ligaments may bee loosened, or some veine opened: and cause fluxe of bloud: which may make her fall into trauaile, and therefore it is fit to prouide for it.

Cause of Co­stiuenesse.The retention of the excrements, and costiuenes of the belly, may happen, either because they haue vsed to be so naturally, or by alteration, and change of yeares, for as Hippocrates saith, they who haue their belly moist in their youth, in their age will haue it hard and drie, and so contrariwise. This ac­cident happens to others, because the guts are not prouoked & stirred vp by the clister of nature (which [Page 59] is the gall,) that they may expell, and thrust foorth their excrements. There might bee alledged many more reasons, which at this time I will leaue to speake of, and onely frame my selfe to that which most commonly is the cause of it in women with child, which is referred to two points, Other causes of Costiuenes either be­cause the guts are pressed by the vneuennes of the wombe, which is too full, and beeing placed vpon them (and chiefly vpon the great gut) crushes and thrusts them one against another, in such sort, that they haue no meanes to inlarge and dilate them­selues, thereby to uoid the excrements contained within them. The other is because the guts, and the excrements within them, are commonly very hard, and dried in women with child, through the great heate, that is in the intrailes, which makes them that they cannot easily flow. The sedentary life also, that women leade, is cause that their ex­crements are stayed, and gather themselues toge­ther, by little and little, and at the length stoppe vp the passage. This accident brings vnto them, flu­shing in the face, headach, beating of the Arteries; yea and oftentimes an Ague.

For the curing of this disease a good order in dy­et is verie needfull: Cure. vsing meates that doe moisten, and keepe the guts supple, and slipperie, and withall soften the excrements: which must bee done with very great discretion: for too much moysture may at length ouer much relaxe the ligaments of the the wombe, and of the child, and thereby hasten the deliuery.

[Page 60]Notwitstanding, a woman with child being too costiue, may vse tender meats, as Veale, where­with they may make Brothes, Brothes to loosen the belly. with Lettuce, Purce­lane, Sorrell, Spinach, Beets, Buglosse, Violet leaues, and sometime a little of the herbe called Mercurie. Let them vse Prunes, and bak't Apples. Some take two or three gulps of fresh water before their meales: but let them vse gentle exercise to make their excrement follow the more freely. It is also verie fit for a woman with child, in the mor­ning when she riseth, and at night when she goeth to bed, to make proffer to vnburthen nature, with­out straining her selfe, but verie gently. If for all this her belly will not be correspondent; it will not be amisse to giue her Clysters.

She may also take some broth wherein is put a spoonfull or two of the water, or wine of Seny, which is made after this maner.

Seny wine. Take halfe an ounce of Seny well cleansed, sixe cloues brused, put them into a dish, and poure vpon them halfe a pint of wine, or water redy to boyle, and so let them soke all night, and in the morning take two or three spoonfull, which must be put into [Page 61] your broth: keeping the rest, to serue you after­ward, at your need.

Of the Fluxe, or loosenesse of the Belly, which troubleth women with child. CHAP. XVI.

THe Laske, in what maner soeuer it be, doth put the woman in danger of com­ming before her time: and that for di­uers reasons. First, Fluxe of the belly dange­rous. because thereby the meat they take for their nourishment, is voided too soone, which should haue staied and been tur­ned into bloud, for the nourishing and sustaining both of the Mother, and the child. And therefore, they both remaine weake, and feeble, which com­pelleth the child to come foorth, and seeke for food else where. For as the Prouerbe saith; Prouerbe. Hunger makes the Wolfe come foorth of the wood. Beside, the Mo­ther is so troubled with rising out of her bedde, as also with much straining her selfe, (especi­ally if it bee the bloudie Flixe) that the wombe oftentimes is ouerturned, and relaxed: and cau­seth the childe to bee cast foorth of his place, by reason of the moistnesse which runneth continu­ally along the great gut, vpon which the wombe is placed.

Women with great bellies are commonly sub­iect thereto, because of the meats they eat, Women with child are sub­iect to loose­nesse of the belly. which are of ill iuice: whereby the stomacke being weak­ned, [Page 62] and not able to concoct them, the expulsiue faculty is compel'd to thrust them downward, halfe concocted, and indigested: otherwise they are cor­rupted, and turned into some maligne, sharpe, and biting humours: as into fretting, choller rotten flegme, or melancholie, which doe corrode and stir vp the bowels, and so cause the fluxe of the belly.

The Cure.Concerning the cure of it, many considerations must be had. And first, it will be verie fit to know of what kind, the fluxe is, and what may be cause thereof. Now, all Fluxes of the belly must needs be one of these three; either Diarrhaea, Lienteria, or Dysenteria, which soeuer it be of these, if it proceed of a maligne, and putride humour, it must not be suddainly stopped by astringent medicines, least it happen vnto the woman with child, as it did vnto Smyrnia, A wotrhy storie. (as Hippocrat. saith) who hauing a fluxe of the belly, suddainly stopt; was deliuered in the the fourth moneth.

How to pro­ceed therein.Now to know what kind of fluxe it may be, the stooles will shew and testifie. If it be not violent, it may be suffered to flow gently, and for a good while; not omitting in the meane time, the vse of some Clysters, that may asswage the paine, if there be any. But if it continue, & that it bee bred of some sharpe and biting humours which knaw the guts, and prouoke the expulsiue facultie; (of which kind are fretting and biting choller, or salt flegme) and that the Mother seeme to grow weake and faint: then must it be remedied with as much speed and care as may be: otherwise the woman hauing di­uers [Page 63] pangs, and prouocations, is in danger to be deliuered. Wherefore the humour offending must be purged with Rubarb, compound sirup of Cicho­rie, and the like, which haue been alreadie pre­scribed in the former Chapters: as also the like humours hindred from breeding. Her Diet. And there­fore she must abstaine from all vnholsome meats, especially if the cause thereof proceed from thence. Besides, the said humors must be allaied and made more gentle, that they may not any more prouoke or stir vp the expulssiue vertue: the which may be easily done by a good dyet, which shall breed as lit­tle choller, or other bad humours, as may be: vsing broths made with Purcelance, Sorrell, Bu­glosse, and the cold seeds, adding thereto a little Rise, or French Barley. The vse of new laid Egges is much commended, which must be poched in water: Her meat must be rather rost, then boiled: All spices are to be eschewed. Let her drinke be red Wine, or steeled water, wherein a piece of bread hath been soked.

This drinke is verie fit, and pleasant.

Take of French Barly, dried in a pan, a handfull, A Drinke. Fennill-seed, Coriander-seed, and Licorise of each, two drams, boile them in a quart of water, adding thereto an ounce of Berberis, or two ounces of the iuice of Pomgranats. A little before meales let her eat a slice of Marmilade.

And seeing there often happens paine and gri­pings together with pangs and throwes, because the guts are moued and prouoked: therefore they [Page 64] must be washed, and the paine mitigated with this Clyster.

But if the woman bee further molested with gri­pings and that she haue great, and often prouoca­tions: then this Clister will be very fit for her.

Clisters that are made onely with oyle of Violets and the broth of a sheepes, or calues head bee sin­gular good.

If the disease doe increase and the paines grow more violent, then we must proceed euen to stupi­fying or Narcoticke medicines, as Laudanum, or Pilulae de Cynoglossa, which may be giuen either by the mouth or in a Clister wherein the Physitians counsell must be asked.

I haue seene giuen with good successe one or two drams of new Triakle dissolued in a clister.

It will be very fit to annoint the bottome of her belly, and about the ossacrum with this ointment.

They may likewise vse Vnguentum Rosatum Me­sues.

The paine still continuing, with pangs & throws let there be made for her this Suffumigation.

Then (she beeing well dryed) annoint all the bottome of her belly, and about os sacrum, with this ointment.

Of the swelling of the legs and thighs which happe­neth vnto women with child. CHAP. XVII.

IN those women which were woont to haue great quantitie of naturall purga­tions, before they were with child; the bloud after they haue conceiued, which was vsed to flow, beeing stopt and suppressed, and not being conuerted into nourishment by [Page 66] the Mother, Cause of the swelling of the face. and much lesse by the child; most com­monly though it doth not breede the former acci­dents, yet is it altered, and conuerted into waterish humors: Moreouer the liuer through the aboun­dance of bloud, wherwith it doth ouerflow, breeds a serous or waterish bloud: and beeing not able to digest it, it is thrust downward by the expulsiue ver­tue of the vpper parts, and at length rests itselfe vpon the legges, feet, and thighs, the which makes them all swelled and oedematous. This swelling often­times doth continue both day and night, and som­times it is so resolued in the night that in the mor­ning it is scarce perceiued at all but presently al the day, the tumor is renewed, & at the euening doth much appeare: and then againe, in the night it is re­solued through rest, and the heat of the bed. Such as are much subiect to the whites, before their be­ing with child are commonly troubled with this in­firmity, which was obserued by Hippocrates in chol­lericke people, and those that abound with serous, sharpe, Who are not subiect to the swelling. and biting humors. Beside the said oede­matous swelling, there happens an inflammation, which doth cause the skinne to go off, and somtime breedeth filthy vlcers. But this must bee remedied before these vlcers happen.

These accidents continue commonly but the first foure moneths, yet with some they stay till their lying in, and so soon as they are deliuered, the swelling vanisheth of it selfe.

If this disease doe not much offend the woman with child, it shall not be needfull to vse many me­dicines, [Page 67] but it is sufficient that she keep a good dyet, and chiefly if it resolue of it selfe in the night. But if she be much troubled therewithall, Aduertise­ment con­cerning the cure. let her vse these remedies.

Let the swollen parts be rubbed with this medi­cine.

The swollen parts must be wrapped with clothes, Binding ne­cessarie. and swathed beginning at the bottome, and so go­ing vpward.

Some find good by laying thereon a Cabbage lease, and binding it as before.

Others vse the lye of Vine ashes, Lye of Vine ashes verie good. adding thereto a little Allom, & Fullers earth, then dipping therein a linnen cloth doubled, or else a spunge, and so ap­plie it. I haue made proofe of this fomentation and cataplasme, when there hath been no inflmma­tion.

I haue likewise vsed in steed of the foresaid fo­mentation, before the applying of the Pultesse, to take a quantitie of Danewort, A tried re­medie. a little Sage, with a few Chamomile and Melilot flowers, and heat them in a skillet, laying it round about the leg, and couering it quite with tyles which couer the tops of houses, being a little heated, to keepe the hearbs gently warme the space of an howre or two.

Some vse Snayles with their shels beaten toge­ther, and applie them like a pultesse.

Beside the former swelling of the legs, and feet, there hapneth to some a puffing vp, or windy swel­ling in the entrance of the wombe, so great, and swollen; that I haue seen it in some women, bigger then halfe a childs head: which doth so grieue, and trouble them, that they are scarse able to bring their legs together, but are faine to stand stradling: This swelling is verie cleare, and shining; and to say the truth, there is nothing but water contained within it, the which must be cured before her lying in. An obserua­tion. There are not any Cataplasmes, or the like, in this case that can do much good: (as I my selfe haue oft made triall) But onely the manuall pra­ctize, making many long and deep scarifications of all sides, which will cause great store of water to flow, and issue from the part: the which I haue practized vpon many. And it is to be noted, that oftentimes this tumor doth returne, and is fill'd [Page 69] againe, therefore it will be necessarie to make new scarifications. And to the end that it may not come so soone againe, applie thereto, A tried remedie. both within and without, fine lint moistned in the oyle of sweet Al­monds, and laying vpon it an emplaster made with a little Cerotum infrigidans Galeni, & Desiccatiuum rubrum, mingled together: this medicine will make the orifices vent and flow the longer. Not long since, there were two worthy Ladies (which for honor sake I will not name) that were troubled with this accident, about the time of their lying in; in whom I opened, and scarified those parts, to make the water flow and come foorth. And it is to be obserued, that we must awaite a fit opportuni­tie to do this; which will be when they are neare their lying downe.

The meanes to helpe women which cannot beare their Children the full time. CHAP. XVIII.

OFtentimes it happens to women, that they cannot beare their burthen to the time prefixed by nature, which is the ninth moneth. This accident is called either a shift, or slipping away, or else Abortment, or (as our women call it) a mischance: The shift is reckoned from the first day the seed is retained in the wombe, till such time as it receiueth forme and shape, in which time, if it chance to issue and flow [Page 70] foorth, it is a Shift. The Abortment hapneth af­ter the fortieth day, yea, euen to the end of the ninth moneth. For the Abortment is a violent ex­pulsion, or exclusion of the child already formed and endued with life, before the appointed time. But the sliding away, or shift, is a flowing or is­suing of the seed, out of the wombe, which is not yet, either form'd, or endued with life.

Those that haue been deliuered once before their time, for the most part they miscarie with the rest of their children, about the same time.

Causes of Abortment.This accident may happen vpon diuers occasi­ons, the which are either inward, or outward. The outward are, either an Ague, fluxe of bloud, or of the belly, vomiting, or any other sicknesse that may happen vnto a woman with child; as also leaping, daunsing, riding in a Coach, too much stretching of her selfe, and the lifting, or carrying of any heauie burthen: the immoderate vse of Ve­nus, Passions of the mind, as choller, sadnesse, longing after any thing; or the vse of violent and strong medicines.

The inward causes are gathered from one of these three: either from the Mother, or things be­longing to her, Causes from the child. or from the child. Those that are taken from the child, are, when he is either so weak and sickly, that he cannot be kept in the wombe, being not able to draw sufficient nourishment, and thereby doth decay and die: or else by being too big and large; so that the wombe is not capable to lodge and support him: which maketh the vessels [Page 71] of the wombe to bee relaxed and breake: then the entrance of the womb dilates it selfe, and the child commeth forth.

From the mother: when shee is eyther too small, Causes from the mother. or low of stature, which causeth that the child can­not grow in so little roome neither moue himselfe or breath (although he breath onely by the arteries of the mother) her breast beeing so straight that it cannot be stretched or inlarged: or else because she is too fat, which maketh the caule to presse downe, and crush the Matrice, and causeth the seed to flow and issue forth before it be formed. Leannes cau­seth Abort­ment. A woman also that is too leane, and doth eate but little, seldome or neuer beares her child the full time. For if the mother be not well nourished, much lesse can the child. Too much eating stifles the child: as likewise the vse of vnholesome meates doth engender ill bloud in the mother: wherewith the childe beeing nourisht, in the ende languisheth, whence follow­eth death. Another cause may bee the ouermuch fulnesse, and moistnes wherewith women abound, Fulnesse is cause of A­bortment. and chiefly in their womb, which oftentimes is ful, and ouerflowes with mosture, and filleth the vessels of the wombe full of slime, whereby the inner ori­fice is inlarged, and dilated, vnable to support, or keepe in the child. There may likewise bee ingen­dred some sharpe, and biting humors; wherwith the Matrice beeing stirred, or prouoked, while it en­deuours to expell them, may thrust out the child also.

This accident may also happen to those that in [Page 72] their child bearing are subiect to haue their natu­rall courses, They which haue their na­turall courses do often mis­carry. as if they were not with child: which commeth to passe, when nature striuing to put them forth, doth cause the child to be vntyed, and so he followeth the Purgings.

Things an­nexed to the mother which doe cause abort­ment.Concerning those things which are annexed or belonging to the mother, I vnderstand them to bee such as may bee growne or contained within the womb, as some impostume, Scyrrhus, or excrescēce of flesh, mole or false conception, therin contained, as also great store of water, the which I saw, not long since happen vnto an honest Gentlewoman, whose womb was so full of water in the eight mo­neth that the Orifice thereof was constrained to o­pen it selfe, and let them foorth, the which was in such quantity, that it is incredible to bee reported, and some sixe daies after, shee was deliuered, the wombe not being closed againe.

As this accident is very dangerous, both for the mother and the child; so will it bee needfull to pre­uent, and remedy it with all speed possible.

Signes of a­bortment.First we may know, that a woman is in danger to abort, or miscarry, when the milk in her brests doth flow and run forth in great quantity, her brests re­maining limber and soft: and if she be with child of two children, and one brest grow empty, it is signe she wil miscary with one of them. For this sheweth that the child doth loath & refuse his nourishment: chiefly if the nipple haue gotten any ill colour, it is a signe that the Matrice is distempered according to Hyppocrates. Hippoc. lib. 5. Aphoris. 37.38

[Page 73]They that are troubled with a great loosenesse of the belly, bee often deliuered before their time. Loosenes of the belly cau­seth abort­ment.

Likewise great paine of the backe, and thighs, which coms round to the groin, and bottome of the belly, doth oftentimes presage the like. As also when there floweth out of the conduit of nature, first certain waters, then bloudy and slimy matter, and last of all bloud.

To the end that it may be safely remedied, Cure of A­bortment. there must respect be had to the cause: Now concerning the outward causes, as if the mother bee troubled with any sicknes she must be handled as it is requi­site and fit: shee must shunne all violent exercises, passions of the mind, and the too often vse of Venus. If the abortment proceed, from the littlenesse or lownes of the mother, before her being with child, let her vse Bathes, fomentations, and oyntments that may loosen and inlarge her belly, and Matrice. And while she goeth with child let her feede mo­derately, to nourish her selfe, and her child, & when the ninth month is come let her vse supling and re­laxing oyntments like those formerly set downe.

If the cause be of too much fatnes, it wil be very fit and conuenient to purge her, and let her bloud, before shee bee with child; and to prescribe her a strict order of dyet thereby to make her leane, vsing meates that bee not too nourishing, or full of good iuice. Contrariwise she that is too leane, must vse good meates, and such as breed good iuice, and that in good quantity. If too much eating and drin­king, or the vse of bad meates, that breed ill iuice, [Page 74] be the cause: then must she absteine from them.

And when it doth proceed from the fulnesse and aboundance of humors, & water: as it happeneth in full bodied young women, or which before their being with child were subiect to some euacuations (as bleeding at the nose, Hemorrodes, or abun­dance of ordinary purgations, and whites) then will it also be very needful to purge, and let them bloud and before their beeing with child, to make them vse the dyet: When the di­et is necessary and especially those, that haue the li­gaments of the womb loose and soft, and the vessels full of thicke and slimy matter: to whome likewise may be administred cleansing, & strengthening in­iections, drying perfumes, Baths with sulphur, and emplasters for their backes, which shall heereafter be set downe.

Bloudletting fit for them that abort.And when they shall be gone about foure mo­neths and a halfe, it will be very fit to purge them gently, & let them bloud, the which may be done more plentifully and boldly (not all at once, but at sundry times) in those who before their being with child were vsed to more copious and frequent eua­cuations. For experience doth shew, that by this meanes, those which were wont to be deliuered be­fore their time, haue not onely born their children to the ordinary time, but thereby also haue beene brought a bed more easily, and with lesse pain and trouble. Store of nou­rishment cho­keth the child. So that the child shall neither be in daun­ger to bee stifled, by drawing more food then is needfull for his nourishment; nor of growing too big, by turning it into his owne sustenance, which [Page 75] might bee a meanes through his exceeding great­nesse to breake and teare the ligaments that sup­port him, or else, though he stay his ful time, (being thus big) that he should not be able to come easily into the world.

To helpe the abortment, Of the abor [...] ­ment that commeth frō the child. whereof the child is cause, being naturally either weake or sickly, it will be very necessary, that the mother put to her hel­ping hand, as much as she can possibly. Wherefore she must be merry; quiet, as well in body as in mind, not fretting or vexing her selfe: and especially a­bout the time she was wont to bee deliuered, shee must keepe her bed, vsing meates of easie digestion and distribution, and drinke good claret wine: let her take euery two houres, a good space from her meate, some of this opiate.

If shee like not this Opiate, let her vse these Lo­zenges.

Let her belly bee annointed with this ointment as well to comfort the Matrice, as also to giue strength vnto the child.

Let there bee laide vpon her backe, and os sa­crum, some such emplaster. Some women haue found good by applying vpon their Nauell a tost dipt in good red wine, strowing vpon it the powder of Roses; Grana tinctorum; Coral; and a little Cina­mon.

The emplaster must be often taken off, for feare of the itching, and put on againe; and if there hap­pen any heate to the part, annoint it with Mesues ointment of Roses.

Remedies if the child be to big.If you perceiue that the child be too great, and big; to the end that he receiue not so much nourish­ment, whereby he may grow bigger, and larger; the mother must absteine from all meates that are so iuicy and nourishing, and keepe herselfe quiet ha­uing her belly stayed vp with a fit roler, that it hang not downe, and least the ligaments which hold the child might stretch, and so by the waight be torne, and broken a sunder.

Causes of A­bortment an­nexed to the Mother.The like may bee obserued and practized in the causes annexed & ioined to the mother, as if there bee any Scyrrhus, Mole, Dropsie, Warts, Impo­stums, [Page 77] excrescence of flesh, or other indisposition of the wombe. The which must bee cured before the woman bee with childe, according as the disease doth require, it beeing very hard for a Woman to proue with child, when she is troubled with any of the aforesaid accidents.

And in regard of outward causes, Outward cause. wherin we did comprehend the Ague, Laske, Fluxe of bloud, vo­miting and the like. These accidents must bee pre­uented, according as the case doth require taking the aduice of the learned Phisitian, as we haue said before. But concerning medicines, which must bee more particularly applied to outward causes, as falls, blowes, and violent exercises, let them haue recourse to the medicines described, for the childe that is weake, and sickly, to which these following may be added as beeing profitable for both causes. As if there appeare any bloud, or red waters that begin to flow and come forth, by then naturall pas­sage, this medicine is excellent.

She may likewise take in the morning, a Lozenge of Diarhodon of the waight of a French Crowne. This powder also is very commendable.

Of this powder also may bee made Lozenges.

Let there bee applied to her backe the former Emplaster, or this that followeth.

If the emplaster breed any inconuenience, let them vse this ointment.

Hauing (with as much breuity, as possibly I could) treated of the Accidents which happen to women with child: and hauing likewise brought them euen to the time that nature hath appointed for their deliuery: it now remaineth, that wee handle the meanes, to helpe and ease them in this act and tra­uaile: the which shall be done, after wee haue spo­ken somwhat, concerning the beginning and office of Midwiues, as beeing the first that are called in this businesse.

Of Mid-Wiues. CHAP. I.

DAily experience doth shew vs, that many women are deliuered without the helpe of the Mid-wife, Notwith­standing Antiquity telleth vs, that there haue beene Mid-wiues euen from the beginning: yea, that diuers of that sexe haue practised Physicke.

Hippocrates sweareth by Apollo and Aesculapius and by Hygea, and Panacaea, as Gods, Hippocrat. Diuers wom Physitions. and Goddesses of Phisicke.

Ouid doth make mention of Ocyroe, Ouid. daughter to Chyron the great Physition, who out of her curiosity did practise Physicke.

[Page 80] Origen in his eleuenth Homely vpon Exodus speaketh of two Midwiues, verie skilfull in Phy­sicke, which were Aegyptians, and cals them Se­phora and Phua.

Beside this curiositie; necessitie, (the mistresse of Arts) hath constrained women, to learne and practise Physicke, one with another. For finding themselues afflicted, and troubled with diuers dis­eases in their naturall parts, and being destitute of all remedies, Why women did studie Physicke. (for want whereof many perished, and died miserably) they durst not discouer, and lay open their infirmities, to any but themselues, accounting it to be dishonest: Higinus. Women for­bid to studie Physicke. As Higinus testifies, who relateth, how the Athenians had forbidden women, by their Lawes, to studie in Physicke; and that at the same time there was a certaine maide named Agnodicea, verie desirous to studie therein, who the better to attaine vnto her purpose, did cut off her haire, and apparell her selfe like a man: and being so disguised, she became the scholler of He­rophylus the Physition: A notable Hystorie. And when she had learned Physicke, hauing notice of a certaine woman that was troubled in her naturall parts; she went vnto her, and made proffer of her seruice; which the sicke party refused, thinking she had been a man: But when Agnodicea had assured her (by discoue­ring of her selfe) that she was a maide, the woman committed her selfe, into her hands, who drest, and cured her perfectly: and with the like care and industrie she looked to many others, and cured them. Which being knowen by the Physitions, be­cause [Page 81] they were not called any more to the cure of women, they accused the said Agnodicea, that she had shaued off her beard, that thereby she might abuse women, faining themselues to be sicke. Then she putting aside her garments, made it euident that she was a maide: which caused the Physitions then to accuse her of a greater fault, for transgres­sing the Law, which forbad women either to studie or practize Physicke. This being come to the eares of the chiefest women, they presently went to the chiefe Magistrates, and Iudges of the Citie, called the Areopagites, and told them: that they did not account them, for their husbands, and friends, but for enemies; that they would condemne her, which restor'd them to their health: which made the Atheniaens to reuoke and disanull that Law, gi­uing Gentle-women leaue to studie and practize Physicke.

Now since the greatest disease that women can haue is that of the nine Moneths, the Crisis and cure whereof consists in their safe deliuerie: There haue been Mid­wiues from the begin­ning. Lib. de Carnibus. we must not doubt, but that there haue been some women addicted thereto, and practized therein, in all ages. Hippocrates speaking of the birth that hap­neth in the seuenth Moneth, doth refer the Reader vnto the Midwiues, who are present at such la­bours, and wisheth him to learne the truth thereof, of them.

Galen saith, Lib 3. de Fa­cul. natural that Midwiues do not bid the wo­men that are in trauaile, either to raise themselues, or to sit downe in the Chaire, Midwiues i [...] Galens time before that the en­trance [Page 82] of the wombe be open, for the comming foorth of the child; which they know by feeling with their hand. Lib. de Causis morborum. The same Authour likewise spea­keth of the errours committed by Midwiues, when they receiue the child; an euident testimonie that there were some such in the time of Hippocrat. and Galen.

Socrates mo­ther a Mid­wife. Lacrtius, and Valerius Maximus do testifie, that Phanerora the mother of Socrates was a Midwife: yea, and it is found, that the ancient Judges did ap­point a stipend for those women that practized Physicke well; and which were good Midwiues. Witnesse Vlpian: Lib. 1. §. 1. de Extraordinaria cognitione. as likewise, such were puni­shed, as had practized, or behau'd themselues amisse in their profession, as it appeareth by the Law. Item si Obstetrix.

But among those that haue practized Physicke, there were some that haue applied themselues most, to the deliuering of Women; and for a dif­ference from others, they were commonly called Cunning women: or else caused themselues to be so called: For women are of this disposition, that they desire to excell men, or at least to seeme to go be­yond them. Wherefore it may easily be percei­ued, Two sorts of cunning women. that there hath been, some women that haue practized Physicke: and others that were imployed in the deliuerie of women. And these last tooke vpon them three things, Gal. in 62. lib. 5. Aph. Hippocrat. as the Lawyers, Plato in his Thetetus, and Galen do witnesse.

First office.The first office was to make the match, and to ioine the husband with the wife, and likewise to [Page 83] iudge, whether they were sit, and capable, or else [...]ble, and vnsufficient to haue issue, and beget children: which is verie difficult to be knowen, and at this day there is no woman so cunning, who is able to tell it.

The second office was, The second office. to be present at the deli­uerie of women, and birth of children; whether it were in giuing of some medicines, Act. 3. Scen Andr. Quod iussi ei dare bibere, & quantum imperani, da [...] (as Terence doth witnesse) whose words are these; Let her drinke that, which I appointed, and the quantitie I comman­ded:) or else by vsing her handiworke: which worke was committed to none, but those that had had children; because (as Plato saith [...]) one cannot be so apt and skilfull in exercising a worke not knowen, as they which haue had the perfect knowledge and experience thereof. Beside, the said Midwife was not to begin to vse this art, before she was past child-bearing: The Midw [...] must be pa [...] child bea­ring. because Diana (the Patronesse of women in childbed) is barren and also for that a woman which beareth children, is much trou­bled, and more vnapt to labour and take paines.

The third office was to know, The third office. and tell whether a woman was with child, or no. And therefore the Law giuen à DD. fratribus did ordaine, that three honest Midwiues, skilfull in Midwifery, should view and make inspection, and then giue their iudgement, whether the Woman were with child.

But since that time beside the three former offi­ces, Another office of Midwiue [...] they haue taken vpon them authority▪ to iudge of the virginity of maids, Neuerthelesse all the fa­mous [Page 84] Vniuersities of Italy haue reiected, and con­demned the opinion of such Mid-wiues, who say they can iudge thereof. And Master Cuiacius hath done the like (for the French) saying, that it is very difficult, yea impossible, to know whether a maide, be a virgin or no; And that this power was neuer gi­uen vnto Midwiues by the Ciuill Law, to iudge thereof.

What manner of Woman, a Midwife ought to be.

MAny things are requisite, and needefull in a Midwife, but they are all referred to her per­son, The quality of a Midwife for her person to her Manners, and to her mind: First, concer­ning her person: she must bee of an indifferent age, neither too yong, nor too olde: well composed of body: not being subiect to any diseases, nor misha­pen, or deformed in any part therof, neat in her ap­parell, and person: especially hauing little hands & not thicke: cleane, and her nailes pared very neere, and euen; neither must shee weare rings vppon her fingers, nor bracelets vpon her armes, when shee is about her businesse. She must bee pleasant, merry, of good discourse, strong, painfull, and accustomed to labour, that shee may bee able (if neede bee) to watch two or three nights by the woman. Her manners. And. Act. [...]. Sc. [...]. Saue pol [...]lla tonul [...]n [...]aest mul [...]er, & teme­ [...]ria necsatis digna cu [...] c [...]m [...] p [...]mi sarin wherem

Concerning her behauiour, she must bee mild, gentle, courteous, patient, sober, chast, not quarrel­some; nor chollericke, neither proud or couetous, nor a blabber, or reporter of any thing she shall ei­ther heare or see in secret, in the house or person of [Page 85] her she hath deliuered. For as Terence saith, Drunkenness [...] reproued It is not fit to commit her into the hands of a drunken, or rash woman, that is in trauaile of her first child.

As for her mind, she must bee wise, discreet, Her mind and witty, able to make vse sometime of faire and flat­tering speeches: as Plato reporteth Midwiues were wont to doe in times past: which was done to no o­ther end but onely to busie and beguile the poore apprehensiue women. And it is a commendable deceipt, allowed also in a Chirurgion when it is done for the patients good. For as the same Terence saith. Deceipt doth serue oftentimes for a good medi­cine in extreame diseases.

Now aboue all things the said Midwife ought to know that nature, the handmaid of this great God, hath giuen to euery thing a beginning, increase, state, perfection, & declining, which he doth mani­festly, The chie [...] fice of a [...] wife. and chiefely shew (saith Galen) in the birth of a child, when the mother brings him into the world. For Nature surpasseth all▪ and in that she doth, is wiser then either Art, or the Midwife, whosoeuer shee bee, yea, then the best or most cunning workeman that may bee found, Lib. 7. de [...] partium. as Ga­len witnesseth. For it is she, that hath set downe the day of the childs conformation, and the houre of his birth. And certainly it is a thing worthy of con­sideration, to see how in a little space, Admira [...] thing. yea euen in the twinckling of an eye, the necke of the wombe, which all the time of the nine moneths was so per­fectly and exactly closed and shut, that the point of a needle could not enter therin: how (I say) in an in­stant [Page 86] it is dilated and inlarged, to giue passage, and way for the child; the which cannot bee compre­hended (as the same Galen saith) but only wondred at, and admired. The same Author in his fifteenth booke de vsu partium, desirous to shew the proui­dence of Nature saith, that the faults of Nature are very rare, and that she worketh alwaies, and in such order, and measure, that of a thousand births, there is scarce one found that is amisse.

Wherefore neither the Midwife nor any of the Womans kinsfolkes, or assistants, ought to doe any thing rashly, but suffer nature to worke; helping her notwithstanding in that which shall bee need­full, as heereafter shall be declared: deuiding the worke of their deliuery into three seueral times and seasons.

What must bee obserued, when the woman feeles her selfe, neare her time. CHAP. III.

THe time of deliuery being at hand, the woman is to prepare her selfe in this manner. She must presently send for the Midwife, and her keeper, it being better to haue them about her too soon, then too late; for there be some women that are deliuered sodainely without the helpe of any one, although they haue beene long in their first labour.

The beddeIn the meane time, she must haue a little bedde [Page 87] prouided her, like a pallet, which must bee of a rea­sonable bignes, strong and firme, and also of an in­different height (as well for her owne commodity, as the Midwiues, and others that shal be present a­bout her, to helpe her, in her labour) and it must be so set & placed, that they may conueniently come and go round about her, it must be placed far from any doore, and somwhat neere the fire. Let it also be conueniently furnished with beds & good store of linnen that they may be often changed, as neede shall require. And likewise there must bee laid crosse the beds feete, a peece of wood, for the wo­man to rest her feete vpon, that so she may haue the more strength when she bendeth her legs, as we will shew heereafter.

As soone as she feeles her selfe stirred and prouo­ked with throwes and paines, Women in trauaile mu [...] walke. which are vsuall in this case, it were good for her to walke vp and down the chamber, and then lay her selfe down warm in her bed: and then again afterwards to rise & walk, vp and downe the chamber, and then lay her down warme in her bed: and then againe afterwards to rise vp and walke, expecting till the water bee ga­thered, and the Matrice be opened: for to keep her selfe so long in her bed, would bee very tedious and painfull. Yet it may chance, Rest is oft profitable that being in bed shee may take some rest and haue a little slumber, and so by this meanes the mother may gather more strength, & the child be the better inabled to come at the time, which God hath appointed it, and also the waters will be the better prepared & gathered.

[Page 88]They may giue her, if the labour be long, a little broth, or the yelke of an egge with some butter, and bread, and also a little wine and water.

Diuers sorts of bringing womē to bed.It is very certaine, that all women are not deliue­red after one fashion: for some are deliuered in their bed; others sitting in a chaire, some standing being supported and held vp by the standers by: or else leaning vpon the side of a bed, table or chaire; others kneeling being held vp by the armes. But the best and safest way, The best way to be deliue­red. is; to be deliuered in their bed, (the which I aduise them to) the midwife, and assi­stants, as her kinsfolkes, friends, and keepers, obser­uing this that followes.

First the woman must be laid flat vpon her back, hauing her head raised somwhat high, The placing of a woman in trauaile. with a pil­low vnder her backe that it bow not: and vnder her buttocks and os sacrum, let her haue another pretty big pillow, that thereby those parts may bee some­what lifted vp: for a woman that sinketh down into the bed can neuer be well deliuered; and therefore the well placing of them is of great consequence. Let her thighs and knees be stretcht forth and laide abroad one from another: and her legs bowed and drawn vpward, hauing her heels & the soles of her feet, leaning hard against the peece of wood, which is laid crosse the bedde for this purpose.

About some they put a swath foure times doub­led vnder their backe, and hinder parts, which comes round about them: this swath must be a foot broad, & better, and so long, that it may be held by two women, standing on each side of the bed, there [Page 89] with to lift vp the woman in trauaile a litle, pulling it gently towards them, & chiefly when her throws come vpon her. For this raising or lifting vp doth much refresh her, and makes her endure her throws with more ease.

Beside the two women that hold the swath, there must be two more of her friends or kinsfolks, Another help for a woman in labour. to take her by the hands, thereby to clinsh or crush them when her throws come, and the other hand they must hold on the top of her shoulders, that she rise not vpward too much, and that she may the better straine her selfe, for oftentimes as shee thrusts her feete hard against the peece of wood, which is put crosse the bed, she raiseth her selfe vpward. Some­time I haue bid one of the women that stand by to presse gently with the palme of her hand the vpper parts of the belly, stroking the child downward by little and little, the which pressing did hasten the deliuery, and made them endure the throws bet­ter, and with more ease.

The woman in trauaile being thus placed, must take a good heart, and straine her selfe as much as she can, when her throws come vpon her, making them double and increase, by holding in her breath and stopping her mouth, and forming her selfe, as though she would go to the stoole, which is much fitter for her to doe then to lye crying and lamen­ting.

Aristotle hath well obserued, that those women, De generat [...] Animal. which draw their breath vpward, are deliuered with much paine, because they make the Midrife [Page 90] rise vp, which in this businesse, should rather be de­pressed, and kept downe. It is very fit indeede, that she take some ease and respite, not forcing her selfe much for euery little pang that happens, which she may gather all into one, thereby to make them a­uaileable; when time shall serue.

Actites.If she weare about her necke an Eagles stone, loadstone, the skinne of an Vrus or wild Oxe or the like, which might keepe backe the child, let them be taken away, and tied to her thighs.

But aboue all things she must be obedient to all that is commanded her, either by her kinsfolks, and friends, or by the Midwife. Likewise she must be pa­tient in her sicknesse, calling vppon God for helpe, since it concernes both her own life, and the childs, and shee must call to mind, that hee hath said with his owne mouth, Genes. That the woman should bring forth with labour and paine. For it would bee a rare thing to see a woman deliuered without any paine. Me­dea in Euripides saith, Euripides. That shee had rather dye twice in the warres, then to be once deliuered of a child.

Neuerthelesse we read in histories, of a certaine Country wherein women are deliuered without a­ny paine. And Aristotle in his wonderfull Narrati­ons reporteth, Women deli­uered with­out paine. that the women of Ligustria doe bring forth without paine, and that they returne to their businesse as soone as they are deliuered.

They that write the History of America doe tell the like, of the women in that country, which is; That as soone as they be deliuered, (they are so kind to their husbands, which tooke the paines to beget [Page 91] the child) that they presently rise vp and lay their husbands in their roome; Men that lye in. who are vsed and atten­ded, like women in childbed. And in this manner they be visited of all their friends, and kinsfolk, who bring them gifts and presents.

The office and duty of a Midwife, for the first time, she must obserue in the trauaile. Chap. IIII.

THe Woman that is ready to be deliuered being thus placed and laid in her bedde, must haue the Midwife neere vnto her: who ought first to aske of her woman, whether shee hath gone her full time, and bee ready to bee deliuered; and at what time shee conceiued; then must shee handle her belly, and marking it well, consider diligently whether the vpper parts seeme as if they were empty, and fallen, and the nether parts very bigge and full: which sheweth that the child is sunke downe. Be­side, shee must aske her, whether shee haue any paines, and in what manner they bee, Signes o [...] [...] ing in tr [...] where they begin, and where they end: and whether they bee little or great, and frequent: whether they begin at the backe, running downe all along the belly, with­out staying at the Nauell: and chiefly if they run a­long the groine, and end in the bottom of the bel­ly inwardly (that is in the inner necke of the womb) then it is a signe that she begins to fall in trauaile. [Page 92] And for the more assurance, let the Midwife thrust vp her hand, being first annointed, either with fresh butter, hogs grease, or some other ointment, which heere after shall be set downe. And if she perceiue that both the inner, and outward orifice of the wombe, be dilated and opened, it is a signe she be­gins to be in trauail, especially if there flow or come forth by the said passage, any slime, or water: the which doe foreshew, that the birth is at hand, as Hippocrat. saith, which if they be pale, it signifies for the most part, it will be a wench: and if it be reddish that it is a sonne. Now this slime commeth by the dilatation of the inner orifice, and from the mem­brane, that doth wrap and infold the child, which begins to breake. And also by reason of the vessels, and tyes which are loosened from the sides of the wombe the which may be perceiued by the waters which will swell, shewing like a bubble, or rather like a bladder full of water. And when the water begins to be thus gathered, there is no doubt to be made, but that the woman is in trauail: Hippocrates doth obserue three sorts of humors, that flow in the time of their trauaile: the first, is slimy: the second reddish: the third is the water wherein the child swimmeth, and heere endeth the first time, which the midwife must oberue.

Of the Second time that the Midwife must obserue. CHAP. V.

WHen the waters are in this sort ga­thered together, by meanes of the throwes, which come by little and little: The placing of the Mid­wife. then the Midwife must place her selfe conueniently neere vnto the woman, sitting in a chaire somewhat lower then the bed: and she must sit in such manner, that she may easily put vp her hand (being first annointed) into those parts, when need requires. And by this meanes, she may know, The mean [...] to know h [...] the child commeth. whether the child come naturally, or no, for in feeling gently crosse the membrane, that containes the waters, she shall find, either the roundnesse of the childs head, or else some vneuennesse. If in feeling, she perceiue that there is any hard and equall roundnesse; it is most likely to be the childs head▪ and that he comes naturally: but if she feele any vneuennesse, the contrarie may be imagined.

When she perceiueth, that all comes well, and according to nature, the throwes increasing vpon the woman, and that the child doth striue and en­deuour to come forth, and the wombe doth straine it selfe to be freed of this burthen; Then the Mid­wife must incourage the woman, entreating her to hold in her breath, by stopping her mouth, and to straine downward, as though she would go to the stoole: Assuring her, that she shall be quickly eased [Page 94] of her paine: and that her child is euen ready to come into the world, exhorting her to be patient, and promising, that she shall haue, either a goodly sonne, or a faire daughter, according as she know­eth her affection inclined.

And the Midwiues greatest charge must be, that she doe nothing hastily, or rashly, or by force, to inlarge the passage of the child: and much lesse, to let foorth the water, or to breake, and teare the membranes, that containe it: but she must expect till it breake of it selfe.

The water must not be let foorth.Some Midwiues either through ignorance, or impatience, or else by being hastned to go to some other womans labour, do teare the membranes with their nayles, and let foorth the water, to the great hurt and danger, both of the poore woman, and her child: who remaines drie, the water being issued, and voided before the appointed time; yea, oftentimes before the child be well turned, which hath been the death of many women, and children. But when the water, both by the inde­uour of the Mother, and likewise of the child, shall be newly broken; then aswell the Midwife, as the rest of the women present, must more and more incourage the woman, especially when her throwes increase; beseeching her in the name of God, that she would farther them, as much as she can possi­bly. In the meane time, the Midwife must conti­nually annoint the neather parts with butter, or some other fats. And when the head doth offer it selfe to come foorth, she must receiue it gently [Page 95] with both her hands: which being come soorth, and the womans throwes increasing, she must draw out the shoulders handsomely, sliding downe her finger vnder the childs arme-pits; taking the opor­tunitie and time when her throwes come fastest. And it is to be noted, that the throwes cease verie little, or not at all, after the head and shoulders be once come forth: Neuerthelesse, it will be very fit, to giue the poore woman a little breathing, intrea­ting her, that she would be of as good cheare as she can. After this, the Midwife hauing drawen out the shoulders, may easily draw forth the rest of the bo­dy: which must not be done either hastily or rashly.

But because the child naturally doth come into the world, with the face downward: therefore when he is quite taken foorth, he must be turned vpon his backe: for feare lest hee be stifled, or chok't. The Nauell string must be vndone. And if his nauell-string be woond about his necke, (as many times it happens) then must it be vnwoond. Oftentimes likewise, the child is so feeble, and faint, that there can scarsely be percei­ued any breath, or life in him: and therefore he must haue a little wine spirted into his mouth, nose, and eares, in that quantitie as shall be needfull. When he is come to himselfe, and begins to crie, then the Midwife must follow the string, wagging and shaking it, thereby to draw, and bring foorth gently the after-birth, to which it is tyed: Meanes to draw forth the after-burthen. bidding the woman to cough, and likewise to hold some salt in her hands, fast shut together, and then blow in them.

[Page 96]In the meane time the Midwife, or some other woman, must presse gently with her hand, the top of the womans belly, stroking it lightly downward: the after-burthen being come, it must be laid vpon the childs belly: What must be done to the child. and the child, together with the after-birth, must be wrapp'd vp handsomely in a bed, and a blanket, to be carried nearer the fire, couering the head with a linnen cloth fiue or sixe times double: and yet not exposing him sodainly either to the fire-light, day-light, or candle-light, lest by this sodaine change his sight might be hurt: but his eies must be couered, that by little and lit­tle he may open them, and acquaint them with the light.

But as I said before, the woman must be incou­raged when the water doth issue foorth, and cau­sed to straine her selfe to be deliuered, that the child may follow the foresaid water.

And they must likewise obserue diligently, whe­ther the paines, be the paines of trauaile, or no: and whether the water be that, wherein the child swimmeth. For there be some women that haue these waters issue out, and come away, long be­fore they are ready to lie downe. Which I haue seen happen vnto diuers women, and of late me­morie to Mad. Arnault, A notable storie. who hauing gone sixe or seuen moneths, and troubled with a great Co­lique, that had held her almost two moneths, and tooke her euery day at certaine howres: She being at her house in the Countrey, intreated me that I would come and see her, and to haue [Page 97] my aduise and counsell, whether it were fit for her to come into the Citie; which I adiused her to do: both because of the great paines she had, as also for her exceeding greatnesse: being of opinion, that she might haue two children, as she had had, not aboue a yeare before. Being come to Paris, her Colique was somewhat mitigated, and a little while after she voided two or three gallons of wa­ter, without any paine, thinking verily then, that she was not with child: yet fiue daies after she was deliuered very happily, and with little paine, of a faire daughter, there following very little water, or none at all.

I saw another Ladie in whom these waters came away, aboue ten daies before her deliuerie, yet she kept not her bed, but followed her ordinarie busi­nesse. And this is worth marking, that they may be carefull not to hasten the deliuerie; except the paines be proper for trauaile, and such as I haue already described.

The Third time that must be obserued by the Midwife. CHAP. VI.

AS soone as the child is borne, and that the Mother is deliuered of her after-birth, the Midwife shall cause her legs to be gently laid downe, taking away the peece of wood, that lay at her feet: and put a fine linnen cloth, or ra­ther [Page 98] a cleane spunge, washed in warme water, and wrung out, betweene her thigh's, neare vnto her naturall parts, that the cold ayre may not get there­in: and then must she take the child, together with the after-burthen, and carrie them to the fire, as hath been said already.

And if it happen, that the after-burthen be long ere it come, or be drawen foorth; and that the child may not stay so long there, for danger to be stifled, and die, it being oftentimes verie weake. The midwife shall first tye, and then cut the childs Nauel-string, to seperat him from the after-bur­then: Which must be done in this manner.

How the Nauell must be tyed.She must haue in readynesse, a good double thread, and a paire of sharpe Scissors: with the thread she must tye the Nauell a good inch from the childs belly with a double knot, or oftner: this knot must be neither too hard and straite, neither too loose: for too straite tying, beside the extreame paine it causeth, makes that which is tyed fall off too soone, and that, before the scar be growen be­tweene the liue and the dead part: And if it be tyed too loose, thereof proceeds a fluxe of bloud from the vmbilicall vessels, which are not exactly closed and stopp't by the said ligature: and there­fore, a meane must be obserued in doing it. Then being thus tyed, Where the Nauell must be cut. the Nauel-string must be cut off an inch beneath the knot; And that the knot may not slip, nor the thred slide away, she must take a little fine linnen rowler dip't in oile of Roses, where­with she must wrap the rest of the Nauell, and [Page 99] with a little fine bumbast moistned in the same oyle, she must lay it vpon the belly, that it be not crusht, when they dresse and swath the child. By this ligature, The Nauell must fall of it selfe. that which is tyed will come to wi­ther, and drie of it selfe, and some foure or fiue daies after, more, or lesse, the dead part will fall from the quicke, which must not be forc'd or pluckt off in any case.

Some do obserue, that the Nauell must be tyed longer, or shorter, according to the difference of the sexe, allowing more measure to the males: The measure in tying the Nauell. be­cause this length doth make their tongue, and pri­uie membres the longer: whereby they may both speake the plainer, and be more seruiceable to La­dies. And that by tying it short, and almost close to the belly in females, their tongue is lesse free, and their naturall part more straite: And to speake the truth, A common saying of Women. the Gossips commonly say merrily to the Midwife; if it be a boy, Make him good measure; but if it be a wench, Tye it short.

Hippocrates would haue them, in tying the Na­uell, obserue this that followeth. Precept of Hippocrates. If a woman (saith he) be deliuered with paine, and the child stay long in the wombe, and comes not foorth easily, but with trouble: and chiefly if it be by the Chi­rurgians help, and instruments: such children are not long liued, and therefore there Nauell-string must not be cut, before they haue either sneez'd, piss'd, or cried.

Anone after the Midwife hath cut the Nauell, she must wipe and make clean the child, not onely [Page 100] his face, but his whole bodie, and the wrinkles and folds of the arme-pits, buttocks, and ioints, either with fresh Butter, or oyle of sweet Almonds. Some do it with oyle of Roses, others with oyle of Nuts, thereby to make the skin more firme, and to stop the pores, that the outward ayre may not hurt him, and likewise to strengthen all his parts.

Auicens Method. Auicen boyleth Roses and Sage in wine, and wa­sheth the child with a fine soft Spung dipt therein: and so continues it three or foure mornings when he is shifted.

The child being thus shifted and annoynted, and then well dried, and wrap't vp by the Midwife, or others: What must be giuen the child after he is borne. they must presently giue him a little wine and Suger in a spoone, or else the bignesse of a pease, of Mithridate, or Triacle, dissolued in a lit­tle wine, if it be Winter, and in Summer (by rea­son of the heat) with a little Carduus Benedictus, or some other Cordiall water.

Auicen doth thinke it sufficient to giue them a little Hony: and to rub the top and bottome of the tongue with ones finger dip't in hony. And by this meanes, to see whether they be tongue tyed, and so to cut the string, if it be needfull.

of the Care that must be had of a Woman in Child bed. CHAP. VII.

WHile the Midwife doth cut the childs Nauell, and make him cleane, the Nurse, or some other that is present, must haue an especiall Care of two things: The first is, To giue the wo­man in child-bed this drinke.

Mingle them verie well together with much sha­king, and so let her drinke it. This medicine will mitigate and lenifie the passage of the throat, and Trachaea Arteria, which haue been heated, and stretched with crying, and groning: And likewise it will help to prouoke the purgings, and hinder the pangs and gripings from being so violent.

2. The second is, to cause a sheep to be fleaed, and to wrap the womans backe and belly in the skin yet warme, thereby to strengthen and com­fort, all those parts, which haue been as it were disiointed, and pull'd one from another, with much striuing in her trauaile. Auicen thinks it enough to lay vpon the womans belly, a Hares skin newly stript from the Hare being aliue.

[Page 102]Then the Midwife (if she be not busied about the Child) or some other that looketh to the wo­man, shall applie beneath to the entrance of the naturall part, and about the bottome of her belly this medicine.

After the skinne hath layen there two or three daies, the Midwife, or her nurse shall take it away, and swath her belly, rubbing and anointing it first, with oile of Saint Iohns wort, sweet Almonds, and Roses, mingled together. For this swathing serues to keepe the Matrice in his place, and to driue downe gently her after-purgings, and also is a meanes to keepe out the aire, which otherwise might cause the woman to haue great paines and gripings.

The fashion of the swath. The swath must bee made of linnen cloth foure times doubled, of the bredth of all ber belly; which must be put round about her backe & belly smooth without any pleat and wrinkle. And while they be about this, they must take an especial care, that the [Page 103] woman catch not cold, nor that the aire get not in­to her wombe, which being emptied of such a bur­then, will easily receiue it, They must beware of ta­king cold. and this might bee a meanes to make it swell, and puffe vp, and to shut the orifices of the veines, by which her purgings should flow: the suppression whereof doth cause paines, gripings, suffocation, an ague, and many o­ther accidents.

Now when the woman shall be thus accommo­dated, she must be kept from sleeping, though shee bee very desirous thereof, and let her in the meane time be entertained with some discourse, and let her nurse looke to her brests, applying such things thereunto, as shall be set downe in the third booke in their proper place.

After the woman hath beene kept three or foure houres from sleeping, you may giue her some broth made with a knuckle of Veale, or a Chicken, The woman in child bed must bee in quiet. or in stead thereof, a couple of yelkes of egges, and so let her take her rest: and if she haue any desire to sleep, shee may, which must bee some three or foure houres after her deliuery, the dores and windowes of her chamber, being close shut, not making any noise.

And so let this suffice, for the naturall trauaile or deliuery; wherein there hath beene no difficulty: the woman beeing neither much troubled, Gen. 3.15. nor ha­uing had any greate paines, but those that are or­dinary, and such as God hath, which is, that In sor­row a woman should bring forth.

Of a painfull, and difficult deliuery with the causes thereof. CHAP. VIII.

WOmen are brough a bed very hardly, and with much paine, vppon diuers reasons, which is an occasion that many repaire vnto Phisitians, and Chirurgions, to haue their helpe, since there be few Midwiues found skilful, that can giue them much aide or succour in these cases.

Causes of dif­ficult deliueryA Chirurgion beeing called thither, ought dili­gently to inquire, what may be the cause, and con­sider carefully thereof: now the cause may be refer­red to foure things, either to the mother: or to the child: or to things that are annexed vnto the child: or else to outward things, and so accordingly must they frame the remedy.

Cause from outward things.In the number of outward things I comprehend those persons, that are about the woman in trauail, who if they be displeasing vnto her, are to be intre­ted gently to withdraw and absent themselues. Whether it be by reason that the woman hath a­ny feare, apprehension, or any mislike and loathing vnwillling to haue them so neare her, when shee is in her trauaile, and anguish; or else being ashamed to see her selfe in that case.

Lib. 28. cap. 6.2 Pliny writeth that the ancients held an opini­on that the deliuery might bee hindred and prooue [Page 105] difficult: Opinion of Plyny. Story of Alc­mena. if there were any in the womans cham­ber, which held her fingers lockt, or shut one with­in another: and produceth for an example Alcme­na; who could not be deliuered of Hercules, but with much difficulty.

3 Likewise the outward aire being too cold, may hinder the deliuery because it cooleth the woman, Coldnes or heate doth hinder the de­liuery. shutting vp her body, and especially those parts, which ought to be inlarged, and dilated. As also the aire being too hot, spendeth the spirits, and makes the woman lose her strength, remaining weake and feeble, and as it were fainting, without any power, or courage. And therefore the aire must be temperate, yet rather hot, then cold.

4 Pleasing smels, (as of Muske, Ciuet, Effect of sweet smels. Amber Grise, or the like, if she haue such about her, the vapour whereof, may strike vp into her nose,) doe hinder the deliuery: because they draw the wombe vpward.

If the cause of difficult deliuery be in the mother her selfe, it comes, either by reason of her person, Causes from the Mother or her age, or her naturall disposition, or of some o­ther accident she hath had or may haue: or by be­ing deliuered before, or after her time.

1 Her person or body may be the cause thereof: as if shee be too fat and full: for in such women I haue seene great store of fat come down into their naturall parts, which stopped the passage. Fatnes [...] ▪ And in others I haue seene the caule come downe, which did so presse, and crush together both the inward and outward necke of the wombe, that it could ve­ry [Page 106] hardly open it selfe, yea, and being dilated, and inlarged, did euen close & presse it together againe.

In some I haue seene and felt part of the blad­der present it selfe at the entrance of the wombe. The Bladder.

A woman that is too leane and bare: as also one that is too little, Leanenesse. may likewise bee deliuered with much difficulty. And when this happeneth, it cannot be remedied, as one would desire.

2 Now concerning their age: both they that are too yoong as being too straight: and also they that are old, hauing also their naturall parts too much shrunke together and dryed, and the bones too closely ioyned together, & the cartilages very hard which cannot so well yeeld, and bee dilated, as in youth; I say both of these bee deliuered with very much difficulty.

From her dis­position.3 Their naturall disposition likewise may bee a cause that they are deliuered with much paine.

1 As if they be weake of constitution, nice, ten­der, timerous, and afraid of paine: which makes them, that they will not force themselues, nor make their paines and throws effectuall: and when the child is euen ready to come forth, they shrinke in themselues, with the very feare they haue to feel such paine.

2 Hippocrates saith that women, which haue an Ague when they are with child, Hippocrates. and become very leane without a manifest cause, doe bring foorth their children with great difficulty, paine, and dan­ger: And if they doe miscarry or abort, then they are in danger of their liues. The same Author saith, [Page 107] that those women which giue but little nourish­ment to their children, are sooner deliuered, Lib. de natura pueri. and contrariwise they that feede too much, are longer ere they be brought a bed.

3 They that haue beene troubled with any sick­nesses; as the bloudy fluxe or other fluxe of the belly, Convulsions, fluxe of bloud: or that haue any tumor, vlcer, or scarre which hath happened by being heeretofore badly deliuered; or any other accident that hath made the necke of the wombe hard, close and straight, which is a meanes that it cannot be dilated, and inlarged, or else which haue the entrance, or passage stopt with some flesh or membrane, that is naturall vnto them: that is to say which they haue had from their birth: All these (I say) are deliuered with great paine, and difficulty, yea and oftentimes doe lose their liues thereby.

Now some will thinke it very strange, and almost incredible, to find a woman that should bee with child, and yet a maide, A thing wor­thy to bee ob­serued. there being euen from her birth a membrane that stoppeth the passage, and hindreth the man from entring. Where as it is ne­cessary for conception, that a woman should haue the entire fruition or company of the man, and that he should not onely enter within the outward pas­sage of the womb, but euen to the inner necke ther­of, to carry thether the seed, and there to mingle it with the womans. But stories in this kinde make vs beleeue the contrary; seeing there is no such neces­sity that the mans seede should be carried, and cast so deepe. For in some Women the wombe is so [Page 108] greedy, and lickerish that it doth euen come down to meet nature, sucking, and (as it were) snatching the same, though it remaine only about the mouth and entrance of the outward orifice thereof.

A story of A­uerrhoes. Auerrhoes tels a story of a woman that became with child, onely by drawing in (as she bath'd her selfe) the seed of a man that was bathed in the said Bath.

A true story.The yeare 1607. in May, Master de la Noue the Kings Chirurgion in Ordinary, and sworne in the Chastelet of Paris, was called to search a yong Wo­man the wife of a Gold-smith, who had beene ci­ted by her Husband to appeare before the Officiall of Paris: alleadging, that she was not capable nor fit by nature, to be married: which was an occasion that Germane Hassart a Midwife, and my selfe were sent for to search her. Where wee found, that in the very entrance of the wombe, there was a mem­brane so strong, hard, and thicke, that a mans fin­ger, (and much lesse the other part) was not able to breake it open; he hauing oftentimes made triall to doe it, whereby he had incurred a Paraphimosis: And therefore it was concluded, that her husband had a iust cause to cite her, but yet for all this, that it was curable.

Whereupon her Husband thought good to call Master de Levrye, and Pietre, sworne Chirurgians at Paris: then we all there concluded with a generall consent, to make an incision, of the said Membrane, which was done; and dressed and healed, to her Husbands content: onely he was somwhat doubt­full [Page 109] of that, which the said de La Noue had obser­ued, and told him, that his wiues belly was big, and that she was qualmish and distasted, vomiting eue­ry morning, which made him suspect that she was with child: whereupon a Midwife tolde him that there was no likelihood, nay it was impossible to thinke that a yong woman of eighteene yeares of age should be with child, her husband hauing ne­uer entred within her maiden cloister: and that with threshing onely at the barne doore, she could not be full. Whereupon Master Pietre, was sent for, who though at first he could not be induced to be­leeue it, yet at length, hauing well considered ther­of, gaue his iudgement, that shee was with childe, which proued true, for about some foure Moneths after the incision was made, shee was happily deli­uered at her full time of a faire daughter.

Mad. Scaron sent for me, to helpe a Farmers wife, Another sto­rie. that was great with childe, and ready to lye downe, who had had the outward orifice of her womb, for the space of foure or fiue yeares, so perfectly closed, glued and ioined together, that it was impossible to put a little probe therein: the which had happe­ned vnto her, by beeing ill deliuered, by meanes whereof, the entrance of the outward necke of the wombe, had beene exulcerated, and the vlcers ci­catriz'd, and the sides of the said necke ioined toge­ther: and yet for all this she proued with child. At the time of her deliuery, by the aduise and councell of Master Riolan, and Charles the Kings professors in Phisicke, and Regent Doctor in the faculty of Phi­sicke [Page 110] at Paris, Brunet, Paradis, Riollan, Fremin, Rabi­gois: and Serre (Queen Marguerites Chirurgion) Mit­ton, and Choffinet, Maister Barber Chirurgions at Paris, Honore the Kings Chirurgion, and my selfe, I say by the aduise of all these, there was an incision made, then presently the Speculum dilatatorium was so wel applied, that al the Cicatrizes were inlarged, which succeeded so prosperously, that within three houres after, she was deliuered with much ease.

The deliuery that is too soone or too late, doth prooue diffi­cult.4 The trauaile may likewise proue difficult, and painfull, when the woman is deliuered before or af­ter her time; before her time, as when it comes in the sixth, seuenth, or eighth Moneth: which hap­pens when the wombe is too moist and weake, or else full, and as it were stuft with much slime, which doth so moisten the necke therof, that it is inlarged and dilated before the limited time. As also the ves­sels, to the orifices whereof, the after burthen is fast­ned, do begin to be relaxed, which causeth that the child cannot be supported nor remaine in his natu­rall situation. By which change, finding the inner orifice loosened, and inlarged: and the membrane wherein the waters are contained, and in which the child swimmeth, to be very small, and thinne: it begins to breake, which maketh the child out of order, and so causeth difficult deliuery. As also too much drynesse, Effect of too much drines. as it were, want of nourishment, when the mother is not well nourished, hauing not wherewith to sustaine the child, which makes the said child, not hauing sufficient nourishment, to turne and winde himselfe seeking about for it, and [Page 111] casts it selfe downe, and vnloosneth his bed (which is the after-burthen) from the sides of the wombe: and in the end breakes the membrane wherein the waters are contained, and striueth to come foorth, for the most part out of order. The like hapneth to them, that go till the tenth, or eleuenth moneth: because the child through the length of time, that it stayeth in the mothers wombe, doth grow, and waxe bigger, though the parts of the mother, wher­by the child (being thus big) is to come forth, and passe through, are not increased or inlarged at all; which causeth (the passages being not able to bee sufficiently dilated and widened) great anguish, and paine, to the mother especially, shee beeing weakned in all her parts, that serue for the expul­sion, and bringing forth of the child: which among the rest, are the Matrice, and the Muscles of the vpper belly; which being stretched beyond mea­sure, through the greatnesse and bignesse of the child, do inlarge the fibres, which cannot afterward be so easily drawen together, hauing lost their pro­per force, and strength.

And this may be manifestly perceiued, A good ob­seruation. in those that cannot make water; the bladder being too full, that although the passage be opened by a probe, yet the Chirurgion is constrained to presse the belly, so to help the fibres of the bladder, to close, and fould themselues together. Besides, the child filling vp all the space that is in the wombe, cannot help it selfe so well in thrusting forward, be­ing, as it were, fettred, and lock't fast therein.

[Page 112] Causes from the child.3. The like hindrance of deliuerie may proceed from the child, who hauing attained vnto the ninth moneth, is not able to come into the world, either through weaknesse, and feeblenesse; or because he is not perfected, and ripened as he should, and so hath not sufficient strength to dissolue the liga­ments, and vessels: and to break asunder the mem­branes, wherein he is inclosed: which causeth, that after he hath striued in the ninth moneth, and attempting it againe in the tenth, A double conflict of the child. he is not able to striue so lustily for his comming foorth, hauing been weakned with forcing himselfe the moneth before. And it is most certaine, that the childs staying, in the wombe after the ninth moneth, doth proceed onely from want of vitall heat, which is in the heart; Why the child is staid from com­ming foorth. or that he hath it not in sufficient quantitie to desire the Aire, which we draw in to coole vs: or that all the parts of his bodie, are not strong, and able enough, to draw vnto them suf­ficient nourishment.

Another cause of difficult deliuerie.This difficultie of deliuerie happens also, when the child is either sicke, or dead; and is not able to help it selfe: as likewise, when he is too big in all his bodie, and chiefly in the head: or if he be a Monster, hauing two heads, two bodies, foure armes, or legs: or if they be Twins; th'one hindring the others comming foorth: Diuers situ­ations of the child. which will be euident by the bignesse of the Mother: or if he be ill placed to come foorth, putting formost an arme, or a leg, or both; the shoulder, buttockes, side, or belly comming formost.

[Page 113]4 Now concerning that which is annexed to the child, the deliuerie proues difficult, Cause from things an­nexed to the child. if the mem­branes, that containes the water, wheron the child doth floate, and swim, be firme, solide, and hard, that it cannot, but verie hardly be broken: or that the said membrane be so thin, that it breakes too soone, and before the child be well turned, and ready to follow the said water, which serues to car­rie him, and make him come foorth the easier: For the child that remaines drie, commeth into the world with much paine.

Likewise, if the after-burthen offer it selfe first, and that it stop the passage: or if there be a Mole, or false Conception; As also if the woman haue not been lately at stoole, or made water: The retenti­on of excre­ments hin­ders the de­liuerie. the which is cause, that the great gut being full, may close the necke of the wombe: as likewise the bladder being full may presse it downe, because it is placed be­tweene them both. Whence it is commonly said in the prouerb; Que l'enfant est situé enter le boire, & le manger, which is; That the child is seated, between the meat, and the drinke. And therefore, all the a­foresaid accidents must be remedied accordingly.

The meanes to help Women that are deli­uered with difficultie. CHAP. IX.

THat a Woman, Direction for the Chirurgi­an. which is deliuered with difficultie, and much paine, may be help'd: the Chirurgian ought to know, what is the cause thereof, and from [Page 114] whence this difficultie doth proceed: that he may the better cure it.

If it be, because the Mother is to grosse, or fat, and chiefly in her naturall parts, as also if there be any store of fat offer it selfe; (as I haue seen it of­tentimes happen in great striuing, and throwes,) yea, and that in such sort, that it did euen stop the passage of the child; Then the Chirurgion, (as gently as he can possibly) must thrust backe, and put aside with one hand, the said fat, not tearing or hurting it, Meanes to help them that are too fat. least it be spoiled and corrupted after­wards; holding it still downe on the one side, till the child be come foorth of the wombe, keeping it alwaies from falling downe into the passage, and among the bones, when the child is readdy to come foorth.

Considerati­ons for the Bladder.But when part of the bladder, is sunke downe and relaxed, and is manifestly perceiued in the en­trance of the wombe: then must he do the like, as he did to the fat, holding it aside vpward, with the flat of two or three of his fingers, vntill the childs head be past the Os Pubis. If he find then (as it may so come to passe) that the said bladder be full of vrine: the woman in trauaile not hauing made water, The woman must be pro­uoked to make water. a good while before; then must he cause her to make water, by putting a fit instrument gently into the bladder. For it is seen in some, that the fibres, An Obser­uation. which doe contract the bladder, and make it driue out the vrine, are so weakned, and also the whole bodie thereof, that the vrine cannot come foorth.

[Page 115]Some women haue been deceiued, A thing wor­thy to be no­ted. by taking the said bladder, thus full with vrine, for the waters which come before the child, causing the said blad­der to be broken: the which is worthy of great con­sideration. Also the said necke of the bladder may be stop't, by reason of some Carnositie, Inflamma­tion, or stone, A notable storie. which I haue seen an honest wo­man, there being a stone fallen down into the necke in her bladder, that stopt her vrine, which being put aside by the probe, she made water: Neuerthe­lesse, when the child was ready to come foorth, the stone returning in to the said necke of the bladder againe, did so fret and hurt it, through the long stay, that the childs head made in the passage, that it grew to an Impostume and suppuration, which made a little hole, through the which she hath long time made her water, not being able to hold or retaine it; which is a storie worthy to be mark'd. But as the vrine may be sometimes stop't, so like­wise the excrements of the great gut may be retai­ned: which hapning, it will be more then necessa­rie for the cure thereof, to giue the woman a Cly­ster, that may both vnload her, of her excrements, The excre­ments must be voided. and likewise help and make her deliuerie the more easie.

I my selfe was present at the trauaile of a poore sicke woman, Another storie. that had not been at stoole in ten daies before, whose great gut was so fild and stuft with excrements, as hard as a stone, that it was im­possible for her to receiue a Clyster; and we were constrain'd, before she could be deliuered, to get [Page 116] out all the said excrements, otherwise it had been impossible, to haue taken foorth the child.

To help and succour one that is lean and barren, or else of little stature, as also such as are either too old, or too young: they must haue recourse long before hand, vnto medicines that shall mollifie, moisten, and relaxe; not onely the membranes, which ought to be dilated and stretch'd, that they may be made more souple and gentle; But like­wise you must annoint the Cartilages, and Liga­ments that ioine the Os pubis, Sacrum, Os Coccygis, and Ilium, which must be done with oyntments al­ready set downe, and euen in the verie houre of the deliuerie, annoynt all the said parts therewith.

Some mislike not, about the end of the ninth mo­neth, to bathe the woman, either with a generall or particular bath, as we haue heretofore appoin­ted; as likewise to giue her, euery morning, eight or ten daies before her lying in, this Drinke.

The which I haue oftentimes tried in many wo­men, and among the rest, in Madame Capp, who be­fore had been many times deliuered with much paine and sorrow, of her children, dead. But since I counsell'd her to vse this medicine, she hath been deliuered (thankes be to God) verie fortunately of many children liuing. The same remedies do like­wise serue for them, that haue any Callositie, or hardnesse, in the passage of Nature.

[Page 117]The weake and dainty women must be fed with yelkes of egges, cullis, a tost with wine and sugar, Remedy for the dainty. or Hyppocras: and that a little at a time, and often, you may also giue them a little confection of Al­hermes dissolued, either in wine or Hippocras: Ci­namon water also that is well made, and not too strong, is very fit and good.

And if the feare of the paine doth hinder the de­liuery, then the woman must be incouraged, Fear of paine. tel­ling her that shee shall bee quickly freed from this sicknesse, and that it is common vnto all women, to haue such paines, cherishing her with good hopes, assuring her that her trauaile will bee very easie, and promising her, A good de­ceit. that she shall haue either a sonne or a daughter, according as you know she desires, as we haue said before, flattering and soo­thing her as much as you can, without chiding or giuing her any crosse speeches at all.

The most grieuous and troublesome accident, Cause of the most troublesome deliuery which a Woman can haue, that is in trauaile, is when there happens vnto her, any fluxe, of bloud, or Convulsions; for either of them kill both the Mother and the child instantly, especially, if the fluxe of bloud continue long: because through the great losse of bloud (which is the liues treasure) the spirits and heate are dissolued.

And concerning Convulsions, Why Con­uulsions are dangerous. they are very dan­gerous; because the braine beeing hurt, it cannot affoord such store of spirits as are needfull, for the respiration of the Mother, and the child, who breath's onely by meanes of the spirits, that are im­parted [Page 118] vnto him by the Arteryes of his mother, which causeth him to bee choked and stifled. Be­sides, the great convulsion, makes the Midrife, and the muscles of the vpper belly, moue so violently, that the child is much shaken, and puts both him and his mother in danger to be stifled, and die.

What must bee done in fluxes and convulsions.Eyther of these accidents happening, or else both together, the mother and the child must bee succoured without any delay, which shall bee done (to speake in a word) by deliuering her. And this ought to be done, either by the helpe of a Chirur­gian, or else of a very skilfull Midwife.

Lib. de super faetatione. A good sen­tence of Hy­pocrates. Hippocrates well obserued it, when he saith. If in a difficult trauaile there happen a great fluxe of bloud, without any paine before the trauaile, then is there danger lest the child come forth dead, or that he will not liue, and therefore she must bee so­dainely deliuered, the which wee haue oftentimes seene (to our great griefe) happen vnto diuers wo­men, that haue died, through the obstinasy of their friends and kinsfolks; yea and some also through their Phisitians and Chirurgians feare, who de­layed the time, thinking, and hoping that the fluxe would stay: telling them that the child came naturally, being well placed, with his head forward and that the mother should bee deliuered euen of her selfe.

I know there be many, both Phisitians and Chi­rurgians, that will appoint diuers inward, and out­ward medicines, yea to make reuulsion and altar the course of bloud, will cause a vaine to bee ope­ned [Page 119] in the arme once or twice: rather then con­sent to this practize. But yet of all their medicines, I could neuer see any that did good, but that in the end they were constrained to vse the hand: the which I counsell to be done speedily, and chief­lie if the mother be at her full time, and ready to lye downe; which may be both knowne of the wo­man, and also perceiued by the throwes shee hath, or which went before: as also by the dilatation of of the inner orifice of the wombe, which will be open: and likewise feeling with the finger, that the waters are gathered and ready to come and issue forth. A good ob­seruation. And when the water shall bee broken and come away, then so much the rather must the child be taken out; though the woman haue not gone a­boue foure, fiue, sixe, seuen, or eight moneths. Sometimes the waters must bee let forth. And ye must note that if the said water be not broken, and that the fluxe of bloud bee very great; then you shall let forth the water, by dilating, and stret­ching gently the inner orifice of the womb: thereby to draw forth the child, as we will shew heereafter.

But because many women are subiect to a fluxe of bloud, in their fourth, fifth, sixth, seuenth, Caution con­cerning the fluxe of bloud or eighth moneth of child-bearing: being not as yet ready to bee deliuered: therefore the Chirurgion must obserue from what place this bloud is sent, the which may be from the entrance or Vagina of the wombe, and not from within the body thereof, where the child is contained, and inclosed, which may bee easily perceiued, if the woman haue no throwes, or if the inner orifice of her wombe be not [Page 120] open, but close shut: then there is no likelihood of any deliuery towards, for bloud may issue and come from the said outward necke, When they must not bee deliuered in a fluxe of bloud or Vagina, both in maide and woman with child: If it bee so, then it will not be needful, to meddle with such women, or to force them at all, but onely you must proceed to medicines, that shall stay the said fluxe of bloud. As wee will shew in the chapter of the after pur­gings that flow immoderately in women newly de­liuered.

A worthy sē ­tence of Hip­pocrates. Lib. 1. de Morb. Mu­lier.It may also happen because the woman is ple­thoricall, and full of bloud: In this case we must fol­low the opinion of Hippocrates, who saith, that if a woman that is in trauaile, cannot be deliuered, and that her paines continue many daies: if shee bee young, lusty, and full of bloud you may let her bleed in the foot, if her strength will beare it.

Other acci­dents that may hinder the deliuery.But if she be troubled with any vlcer, tumor, ex­crescence of flesh, Hemorrhoides, inflammation, chapps, or the like, which may chance in the necke of the wombe; then shall she be handled, as we will shew in their proper places. All the which indispo­sitions may make the deliuery difficult, and cause, that the parts cannot be dilated, according as it is sit and necessary, for the childs comming forth.

For remedying the deliuery, that is too soone, or too late: we must haue regard vnto the cause, and according thereto it must bee cured, and chiefly that, which shall concerne the mother; whereof we will treat, when we come to speake of the Abort­ment: it being my purpose in this place, to speake [Page 121] onely of those things which are fit, and ought to bee done in the time, and at the houre of the de­liuerie.

Now for the comforting of a woman, Cure when the fault is frō the child. and easing of her trauaile, when the difficulty doth proceede from the child; as when he is weake, tender, sickly, or dead: as likewise if he be too big, or a monster hauing two heads, or if he be ill turned, and that he offer himselfe amisse: then the Chirurgion in this case shall helpe, and set to his hand in this manner.

First, if it be through the weakenesse, or tender­nesse of the child being sicke: the Chirurgion must not delay one minute of time, When the de­liuery must be hastned. to hasten the deliue­ry, and he must incourage the woman to doe the like. If the head come first, then shall hee proceed therein gently, as in the naturall deliuery: applying beneath, and chiefly about the fundament, and os Pubis, which are the two vtmost parts of the natu­rall passage, some ointments with the fingers ends, Ointments made for the purpose. hauing his nayles pared very close. For this annoin­ting wil prouoke and stirre vp the Matrice, to thrust out the child. The oyntment is this.

He for his part must incourage the mother, gi­uing her a little Confectio Alkermes, and likewise let her take this Clyster.

Shee may also take this drinke, which I haue knowne to doe good to many.

Amatus Lusitanus doth much commend this medicine. Amatus Lusi­tanus.

Another.

L'obolius approueth this drinke, and saith that it will euen expell, and bring forth the dead child.

[Page 123]Another.

Of diuers deliueries wherein the operation of the hand is vsed. And first what the Chirur­gion ought to consider before hee sets to his hand. CHAP. X.

WHen the Chirurgion shall bee called to deliuer a woman that is in trauaile and cannot bee deliuered naturally: before he venter to doe any thing, he must consider two things: Two things must be considered in these deliueries. the first is to know whether the mother haue strength enough to endure the violence of Manuall operation: and hauing found that she is able, he must then search, whether the child be dead, or aliue, for sometimes the child is taken dead, and sometimes aliue out of the mothers wombe.

Now as concerning the Mother: Considerati­ons concer­ning the mother. First the Chi­rurgion must behold her face, heare her speake, ob­serue her doings, countenance, &behauiour, then presently must he feele her pulse, which if he find to be equall, strong, not intermitting, and that she bee not much changed from her wonted disposition? and likewise if the poore woman, her friends and kinsfolkes doe intreate him to helpe her, assuring him, that she will courageously endure; all that he [Page 124] shall doe vnto her: then following the aduise of her kinsfolkes and friends, The mother doth hazard her life in the deliuery. he must go about it: foretel­ling them neuerthelesse; that this kind of practise is very dangerous, and that the mother venters her life, seeing that the child is either dead; or else like­ly to die, if he be not already.

But if the Chirurgion find, that her face and speach is decayed, and weakned, her countenance changed, her pulse small frequent, sometime inter­mitting and formicant: and that shee hath often swounings, Remedyes must not bee dis [...]amed. Convulsions, and cold sweats: then hee must forbeare for feare least hee be blamed, and thereby discredit those meanes which should haue profited, and may also doe good vnto others.

Signes of the childs being aliue.Now you may know by these signes whether the child be aliue, or dead. If the child stirre it is a signe he is aliue; which the Mother may coniecture, and also the Chirurgion, by laying his hand vpon her belly. And for the better assurance heereof, hee must slide vp his hand into the Womans Matrice, and search for the childs Nauell. If, in holding it betweene his fingers, he feele a beating of the Ar­teries, as also, if by laying his hand vpon the childs temples, or else handling the wrist or sole of his foot he find, that the Arteries doe beate, and likewise, if in putting his finger into the childs mouth he per­ceiue that he either sucke, or wag his tongue, it is a signe that he is aliue.

Signes that the child is dead.Contrariwise, if the foresaid things doe not con­curre, and that the mother feele a heauinesse, and that in turning of her selfe, (whether it bee on the [Page 125] right side, or the left) the child doth fall like a boule, if her belly be cold, and that there comes an ill sent from her, if her breath smell strong, and her coun­tenance look wanne, and of the colour of lead: and that the childs Nauell, or after birth offer it selfe formost, besides, if the chirurgion, putting his hand vp, findes the child to be cold, without pulse, nei­ther sucking, nor mouing his tongue: then I say it may be iudged, that the child is dead.

But as the child may offer himselfe, being dead, The child commeth af­ter diuers fa­shions. in diuers positions, or fashion; So likewise must we vse diuers considerations and meanes to draw him forth: as wee will more particularly shew heere­after.

The meanes to helpe a woman in trauaile, hauing with­all a fluxe of bloud, or Convulsions. CHAP. XI.

WE haue shew'd you before, that a wo­man being in trauaile, and hauing either a fluxe of bloud, or Convulsi­ons, she must be speedily helped, be­cause the deferring or delay thereof, will endanger her life.

Wherefore you must proceed heerein after this manner. And since that in euery deliuery, the situation is a matter of great consequence, Situation fit in al deliue­ries. to make it the more facile and easy: therefore you must be­gin in this sort.

[Page 126] The right pla­cing of them.First the woman must be laid ouerthwart a bed, both for the better conueniencie of the Chirur­gion, or Midwife, that shall deliuer her, and also that she may be held, and stayed behind the faster, by some strong bodie, The commo­ditie thereof. so that she neither slip for­ward, nor backward, in the operation or drawing forth of the child. Likewise, there must be one on each side of her to hold her knees and thighs firme, and to keep them asunder one from another: her knees must be bow'd, and her heeles drawen vp­ward, (as we haue said before in the Naturall deli­uerie,) her head must be laid vpon a boulster lying crosse the bed; her backe being a little raised, and her hips lifted somewhat higher, with pillowes laid vnder them, and her hinder parts must lie within halfe a foot of the beds side. She must haue a lin­nen cloth three or foure times double laid vpon her stomacke and belly, that may reach downe ouer her knees, euen to the middest of the leg: So that neither wind, nor cold may offend her, nor any of the assistants see what the Chirurgion tou­cheth, or doth: and likewise, that the woman be not afraid of him, when he shall be about his bu­sinesse. And therefore Hippocrates for this reason, would haue the womans eyes shut or couer'd.

When the woman is thus placed, the Chirur­gion must put vp his hand (being first annointed) into the first entrance of the naturall parts, The clots of bloud must be taken a­way. that he may take foorth all the clots of bloud, which he shall find there.

Then he must consider, whether the inner necke [Page 127] be wide enough for him to thrust in his hand, and to turne the childe, if it be needfull: Now if the inner necke be not sufficiently dilated, The inner neck may be dilated. then shall he, as gently as possibly he can, and without any violence (hauing first annionted all the parts there­of with fresh Butter, or some ointment) stretch it by little and little, till he get in his hand: if the water be not broken, he need not be afraid to let it out: then presently if the child come with his head formost, he shall turne him gently to find his feet, which he may do more easily, then if the wa­ters had been let foorth before: because, that much moisture doth make the child slide, and turne bet­ter, then when he is drie. And when he hath found one of his feet, he must draw it gently without vi­olence, and tie about it a piece of riband, with a sliding knot, How the feet may be found that he may put the foot in againe (leauing the riband hanging out) to make the more roome for his hand to goe in and search for the other foot, which may be done by sliding his hand al along the childes thigh. And hauing found them both, he shall draw them out gently in a di­rect line, giuing the woman a little breathing, and bidding her to straine her selfe when she feeles any throwes, or paines, then the Chirurgion (hauing in a readinesse a fine linnen cloth warme, he must wrap it about the childes thighs, for feare least he slip out of his hand, if he tooke him naked) and so pluck gently, vntill his buttockes appeare, and the body with the head doth follow; obser­uing neuerthelesse, that his belly and breast be tur­ned [Page 126] [...] [Page 127] [...] [Page 128] downeward, as we will shew hereafter more particularly.

Experience will make it manifest vnto vs, by the stories following, how necessarie it is to deliuer a woman with child, when a fluxe of bloud, or con­uulsions do continue: and that she cannot be saued by ordinarie medicines.

A storie.The yeare 1599. Madam Simon yet aliue daugh­ter to Mr. Pareus, Counsellour, and chiefe Chirur­gion to the King; being ready to lie downe was sur­prised with a great flux of bloud, hauing about her Mad. la Charomie for her Midwife, and likewise Mr. Hautin the Kings Phisition in ordinarie, and Mr. Ri­gault Doctors of Phisicke in Paris, and because of great swounings that tooke her euery quarter of an houre through the losse of bloud she had: Master Marchant my son in law and my selfe were sent for; But I finding her almost without pulse, hauing her voice weake, The Chirur­gion must foretell the danger. and her lips pale: I told her mother and her husband that she was in great danger of her life, and that there was but one way to saue her, which was, to deliuer her speedily: the which I had seene practized by the late Mr. Pareus her Fa­ther, who had caused me to do the like, vnto a Gen­tlewoman of Mad. de Seneterre. Then her mother, and her husband earnestly intreated vs to helpe her, and that they would put her into our hands to dis­pose of her. And so sodainely, following the aduise of the Phisitions, she was very happily deliuered of a liuely child.

Another sto­rie.The yeare 1600. I was commanded to goe and [Page 129] visit a great Lady, that was taken with a great and violent flux of bloud, through a fright she had of a great thunder clap: being come vnto her, They must rest in a flux of bloud. I found that her flux was much mitigated: but she being constrained to goe twelue, or fifteene leagues from Paris, and fearing least that the said flux should continue, she was brought thither by my sonne in law Mr. Marchant by water: where she was no so­ner arriued, but her flux of bloud tooke her againe, which made him dislike it, and iudge that it would proue ill, contrarie to the opinion of Master de la Riuiere, the Kings chiefe Phisition, who was there at the same time: Whereupon, I was presently sent for in post together with Master Renard the Kings Phisition. We being come thither, found things in better estate; and the said Master de la Riuiere, tooke leaue to goe towards the King. But on a so­daine the said flux began a fresh, which made them send for M ^r. Marescot, and M ^r Martin, the kings Physitions, who notwithstanding were not come before her deliuerie: which the kinsfolks & friends of the said Ladie, and likewise M ^r Renard, M ^r Marchant, and my selfe, were of opinion to hasten, because of the great losse of bloud she had, and the often swounning that tooke her: but as soone as she was deliuered, the flux of bloud ceased.

The yeare 1603, Madame Danzé, or Chece, The third storie. be­ing in trauaile, was taken with the like flux of bloud, which held her from morning till eight or nine of the clocke at night; hauing with her the Queenes Midwife, Mad. Boursiere, Master le Fieure, Riolan, [Page 130] Le Moine, regent Doctors in the facultie of Physicke at Paris, and M ^r de Sainct Germain master Apo­thecarie, were called to looke vnto her; and be­cause she lost much bloud, they called M ^r Honoré the kings Chirurgion, who being vnwilling to at­tempt any thing without my aduise, I was likewise sent for. And as soone as I was come, my opinion with the rest of the companie was, to deliuer her: which was done by the said Honoré, the child li­uing.

The fourth historie.Of late memorie, Mad. Coulon (being assisted in her trauaile by Mad. la Charonne, a verie skilfull Midwife,) hauing a great flux of bloud; after that M ^r Martin, Hautin, Cornuty, Pietre, the kings Phy­sitions, and Doctors of Paris, had giuen her many things for the staying of the said flux, in the end for feare least by loosing her bloud, she might also loose her life, falling into a syncope: with their ad­uise she was deliuered, by the said Honoré, and pre­sently her flux was staied.

An Admo­nition for young Chi­rurgions.But as these women and children aforesaid haue been saued, by being deliuered in time: So like­wise these following, lost their liues, because they were not succoured, as Art and experience did re­quire, their kinsfolks and friends being vnwilling to haue any go about it in due time: whereof these two histories may beare witnesse.

Another storie. Mad. Vion being readie to be deliuer'd, fell into a great flux of bloud, and though some were of opinion, to deliuer her without further delay; yet this being deferred vpon the counsell of others, [Page 131] who hop'd to stay the flux with ordinarie medi­cines, they suffered her to loose her bloud, by little and little, and at last to loose her life. The same chance hapned to Madame Gasselin, who not ha­uing help in time, dyed euen as it was foretold, it would come to passe; hauing lost all her bloud, be­fore she would giue her consent to be deliuer'd: which will be a good occasion, to admonish a young Chirurgion, neuer to defer this worke when he is called, and sees a great euacuation of bloud. It is now fiue and twentie yeares, since I saw this practized, by the late M ^r Pareus, and M ^r Hubert, of whom, we are bound to acknowledge, and wil­lingly confesse, that we haue learned both this and many other experiments.

Mad. de Mommor, Another sto­rie agreeing with this purpose. being about fiue and twentie yeares of age, and neere her time of deliuerie, one day found her selfe ill, about foure or fiue a clocke in the morning, neuerthelesse she rose and went to Church, which was neere her house, her paine by fits began againe, and she fell into a continuall flux of bloud: At three daies end she was deliue­red with great ease, without any help of the Mid­wife: and presently after, followed the after bur­then: Neuerthelesse she died the same day, at night: and was kept a prettie while by her friends, who could not perswade themselues, that she was dead: At last being opened by M ^r Pineau, the kings sworne Chirurgion at Paris, in the presence of M ^r Faber, and M ^r Baillou, regent Doctors of the facul­tie of Physicke, at Paris; her wombe was found [Page 132] broken, and rent, right in that place, where the veine and arterie hypogastricke, ascend toward the mid'st thereof; which likewise were dissolued, and gaue way to all that issue of bloud.

As for the convulsions which commonly happen through the childs great striuing, when hee desires to come forth; and (not being turned aright) doth so extend the womb that the said convulsions, follow thereupon: here it is to be feared, least all within, wil be torne and broken, Stories con­cerning con­vulsions. and therefore it is conuenient to deliuer the woman, with all possible speed, which hath beene practized both by my selfe, and of late by Master Binet a sworn Chirurgion of Paris, a man of great experience, who being sent for by Doctor Bouuart, to deliuer Opportune Guerreau, the wife of Siluester the Printer: which had beene in labour from eight a clock in the morning, till nine at night: and finding her pulse very weake and small, as also the woman depriued of all sence and motion, The Chirur­gions wisdom at the first he was somwhat fearefull. But being intrea­ted by her Husband, and fearing least shee might either die suddenly, or else fall into convulsions: he putting his hand into her wombe, found the childs head, (the water not being broke) which he let out, and presently deliuered her with much ease, and shee is yet liuing. Therefore wee need not expect, till the said convulsions grow stronger, for fear least the wombe be broken, and torne through the great striuing of the child, when hee is not able to come foorth, as wee may plainely see by the stories fol­lowing.

[Page 133]The yeare 1607. the said Master Binet was sent for, together with de le Moine, A wonderfull story. and Alton Master Barber Chirurgion at Paris, to cut vp the dead bo­dy of Ione du Boys, and hauing opened her nether belly, found the child vpon the guts, who had bru­sed & broken the wombe, and passed quite through it, there being store of bloud shed in the capacity of the said belly.

Master Pineau, Guerin, Another sto­rie. and Launay sworne Chi­rurgians of Paris, can beare me witnesse, that in o­pening a poore woman, that died in the Hospitall of the Citty: we found her child swimming among the guts in her belly, the bottome of her Matrice being rent and torne.

The meanes to helpe a woman when her after-bur­then comes for most. CHAP. XII.

IF the after-burthen offer it selfe formost, When the af­ter burthen comes for­most, there is a fluxe of bloud. the most sure and ready way to helpe the Woman is to deliuer her speedily, be­cause most commonly there follows, a continuall fluxe of bloud. For that the orifices of the veines are opened, which are spread in the sides of the wombe, and there meet with the vessels of the afterburthen: and when the Matrice doth strain and force it selfe, to put forth the child, then doth it thrust out both the bloud that is contained ther­in, and that which is drawne thither, either by any [Page 134] heat or paine. Besides, when the child is inclosed in the wombe, and the orifice thereof, stopt with the after-birth: then hee cannot breath any longer by his Mothers Arteryes, How the child is stifled. and so for want of helpe, he will be quickly choked, and euen swallowed vp in the bloud, which is contained in the wombe, and which issueth from the veynes that are open therein.

But before you attempt any thing, these two points must be obserued: First, whether the after­burthen bee come foorth but a little, or else very much: if it bee but little (when the mother is well placed) it must be thrust, Obseruatiōs to draw forth the after bur­then. and put backe againe with as much care, as may possibly be. And if the head of the child come first, let it bee placed right in the passage, thereby to helpe the naturall deliuery, but if you find any difficulty, or if you perceiue that the childs head cannot easily bee brought forward, or that the child, or his mother, or both together bee weake, foreseeing that the trauaile will bee long, then without doubt the best and surest way is, to search for the feete (as we haue said) and to plucke him forth gently by them.

Another ob­seruation.The other point to bee obserued is, that if the said after-birth be much come foorth, and that it cannot bee put backe againe: as well by reason of the bignes of it, as also of the fluxe of bloud, that commonly companies it: and likewise if the child follow it close, When the af­terbirth must be drawne forth. staying onely to come into the world: then must the after-burthen be puld away quite, and when it is come forth, it must be laide a­side, [Page 135] without cutting of the string that cleaues vnto it. For by the guiding of the said string, you may ea­sily find the child, who whether hee bee aliue or dead, must be drawn out by the legs, with as much dexterity as may be. And this must be done onely in great necessity, that the child may bee quickly drawne forth: as it may be easily iudged by the sen­tence of Hippocrates, who saith, Lib. 1. de mor­bis Mulier. The after-birth must come last. that the after-bur­then should come forth after the child, for if it come first, the child cannot liue, because he takes his life from it, as a plant doth from the earth.

Sometime it chaunceth, that a part of the after-birth, as also the membrane which containes the waters doe offer it selfe like a skin, and comes forth sometimes the length of halfe a foote, which hap­pens to such women as haue the skin wherein the waters are contained swelling out to the bignes of ones fist and more, which breaking foorth of them­selues, leaue the skinnne hanging forth, and yet the child not following it, which happening, It must bee puld gently. it must not be violently puld away: because the afterbur­then oftentimes, is not wholly loosened from the sides of the wombe. So that in drawing that, you shall likewise draw the saide after burthen, and so consequently, the womb, or else part therof, which commonly brings the woman into extream paines, and fainting, yea, and oftentimes to death: Which hapned (to my great griefe) vnto a Gentlewoman, A story. that died as soone as shee was deliuered, who put­ting her selfe into her nurses hands, who tooke vp­on her to be a Midwife: and was so ventrous, as to [Page 136] plucke and draw forth the said Membrane, and part of the after-burthen, which came to light by means of her Chamber-maid, who had kept it, and shew­ed it vs after her decease: we being very inquisitiue to know the cause of her death.

The remedy.But when this happens, it must not be puld away but rather gently be thrust in againe, or else you may put in your hand, betweene that, and the neck of the wombe, to find the childs feete, and so draw him forth, as we haue shewed before.

I haue set downe this story more at large, by rea­son of the great sorrow I tooke; for this Gentlewo­mans death, whom I had deliuered twice before, with mine own hands, comming not soone enough to helpe her the third time.

The meanes to deliuer a woman when her child is dead, in her wombe. CHAP. XIII.

WHen it is certainly knowne, that the child is dead, the woman must bee placed in the same manner, as it hath beene shew'n, where wee spake of the taking forth of the child, when there is a fluxe of bloud.

What must be done whē the childe coms ill.If he put forth an arme, shoulder, backe, belly, or other part of his body first, hee must be turned with all diligence, and drawne forth by the feete, as we will more particularly declare, in euery seuerall de­liuery, according to the sundry fashions, wherein he may come, either aliue or dead.

[Page 137]If he come dead, with his head forwards, The woman must be spee­dily helped. and that there is no hope at all of the womans deliuery with­out helpe, and that her strength begins manifestly to decay: the surest way is to apply the hand. And then the Chirurgi­on shall thrust gently his left hand beeing wide opened, betweene the childs head, and the necke of the wombe: and with his right hand he must put between the said head, and flat of the hand, an Iron Cro­chet, such a one as you see heere fi­gured vnto you.

Which must bee fastned to the side of the childs head, as about his eare, or bone of the Temples, or in some other place if it may bee done [Page 138] conueniently, as within the hollow of the eye, or the hinder bone of his head, the Chirurgion kee­ping his left hand in the same place where he put it first, and therewith he shall wagge and stirre gent­ly the childs head: Skill in draw­ing forth the child. and at that very instant, with his right hand wherin he holds the crochet, so fastned, in any part of the head, must he draw and bring out the child: bidding the woman striue and force her selfe, as though she would be deliuered alone. And it is to be noted, that the Chirurgion must take his time, to draw him forth, when the woman falls in­to throws, for while the throws continue, the child slides forth the easier.

Oftentimes it chaunceth, that the Crochet can­not be put high enough at the first, to draw foorth the head all at once, Obseruation in vsing the Crochet. so that after it is come forward and drawne out in part, they are faine to take away the Crochet, from the place where it was first fast­ned, and put it in againe to take new hold higher in another place, which the Chirurgion may doe very fitly, as it hath beene shewed already. Like­wise, if the Crochet be not well, and surely fastned at first but that it slip, and lose the first hold, then it will bee needfull, to fasten, and put it in a surer place.

The child may be surely drawne out by the shoul­ders.Hauing drawne forth the head, and the Crochet beeing taken out, the Chirurgion shall slide in his fingers, very cunningly vnder the childs armepits, that he may draw forth the shoulders, and the rest of his body, for by this meanes hee shall bee easier drawne out then by the head: which must be done [Page 139] very leasurely, without any violence, giuing the woman leaue to gather her strength, and expe­cting till her throws come vpon her.

While the Chirurgion is about this worke, they must giue the poore Woman, a little wine, or else let her sucke a tost sop't in wine, or Hippocras: per­swading and incouraging her, that she shall quick­ly be deliuered.

This manner of drawing the dead child out of the mothers womb, is safer, and speedier, Safe way to draw the child by the feete. then that which is vsed by turning and putting backe the childs head, to finde his feete, and so pull him out thereby. For whensoeuer the childs heade is much entred within the os Pubis it is impossible to thrust him vpward, Inconuenien­ces to turne the child. and turne him without much indaun­gering the Mother: and causing great contusion in the wombe, from whence proceeds diuers acci­dents, and sometime death, as I haue seene it often happen.

I know some will alledge, that they haue taken foorth children aliue, which were thought to haue beene dead, in the Mothers wombe, with the saide Crochet: and that they haue presently died, onely with the hurt they receiued by the Crochet, and certainely this is a cruell kind of practize. Whereto I answere, that we must diligently looke, and consi­der, whether the child be aliue or dead, before wee put in the Crochet, Considerati­ons in vsing the Crochet. and if there be any appearance of life, wee must deferre the taking of him foorth therewith, as long as we may: But being dead, I see no reason but wee should take the child forth; with [Page 140] the said Crochet for the causes heeretofore menti­oned. Questiō whe­ther the Cro­chet may bee vsed. But if the child be aliue, it is a great question whether he ought to be puld forth by the Crochet, presupposing that the Mother, hauing lost her strength, is ready to dye, except this meanes bee v­sed: it beeing more expedient to loose the Mother then the child, who would both dye, if that were deferred any longer: and whether to saue the Mo­ther, (who is more deare, then the saide child) this practize may be ventured. But as I thinke, there are none, that goe about this businesse, but with some touch of Conscience, which being a point of Diui­nity, I leaue to be decided by them, that are more conuersant therein, then my selfe.

The meanes to draw forth a child, that is swollen, and puft vp: in his mothers womb, together with the manner of drawing the head, when it stayes behind. CHAP. XIIII.

IF the dead child continue long in the mothers wombe, The dead child swels and is puft vp. he may easily be putrified, and not onely his head, breast and nether belly, swolne and fild with wind, and water, but likewise his legges and feet will be puft vp.

This swelling, and puffing vp, may also happen through all the childs body, The child that is aliue may likewise be swolne. though he be aliue, ha­uing eyther the Hydro cephale, or swelling of the head, or the dropsie, either of the lungs, or belly: [Page 141] or else beeing Leucophilegmaticall. This accident happening when the child is aliue, hee must be hel­ped as being aliue, not deliuering the Woman to the childs losse. But if he be dead, and ye perceiue that his head, brest, or nether belly is swoln, or fil'd with wind, or waterish matter, then the Chirurgion must put vp his hand carrying in the hollownesse of it a little crooked knife, very sharp, made after this fashion, & with the saide knife hee shall deuide, and cut the part wherein the wind and water shall bee inclo­sed, (whether it bee the head, breast, or belly) which beeing let foorth, the childe will grow lesse, and afterwards, hee may the more easily be taken out.

It may so happen, that the childs arme com­ming formost through the long stay it makes with­out, as also because it hath been pul'd by violence, [Page 142] will be swolne, yea, and euen gangren'd, that it cannot possibly be thrust backe againe, that the child may be drawen foorth by the feet: If it fall out to be so, then the arme must be pul'd out, as far as it can, and if it may be done conueniently, let it be cut off at the ioint of the shoulder, or else as neere vnto it, as may be; the bone shall be cut off with sharpe cutting pincers, or else sawed off verie euen, the skin and muscles being put aside, that so the bone may be couer'd, with the said flesh, muscle, and skin, which will fall ouer it; and also, that the bone, through his roughnesse, and hardnesse, may not hurt the sides of the wombe, the stumpe that was cut, or sawed being put backe againe.

Sometime the childs head will not follow the bodie, either because of the bignesse thereof, or else, because the child is ill turn'd, that in drawing him foorth, he chances to haue his belly, stomacke, and face lying vpward: which causeth, that the bodie being wholy come foorth, while they would also draw foorth the head, the chin takes hold of the Os pubis, and being pul'd violently, the bodie onely is drawen, and the head not moued, sticketh fast.

For the remedying whereof, that the head stay not behind: the bodie must be gently turn'd, pla­cing the face downward: (as we said before,) for by this situation, the head being moued vp and downe, will be easily drawen foorth with the rest of the bodie; by holding the bodie with one hand, [Page 143] and putting a finger of the other hand into the childs mouth.

And when the head stickes, the Chirurgion must thrust his left hand into the wombe, and put his fore finger into the childs mouth, to stay the head, which by reason of the roundnesse of it, and moisture of the wombe, roules and slideth vp and downe, not being easilie staied; then with his right hand, let him put in the Crochet, which must be hook't or fastned, either in the temples, hole of the eare, hollow of the eye, or else in the mouth; and then let him draw the head gently, both with the Crochet, and also with the left hand, hauing his fore-finger in the childs mouth, and so bring him foorth as cunningly as he can: taking his time alwaies when the Mother is in some paine, that so the child may be the easier drawen foorth.

The meanes to help a Woman in her trauaile, when the child comes with his head formost, but hauing his necke awrie, and his head aside. CHAP. XV.

BEing now to speake of Births that are contrarie to nature, we will be­gin first with the Head, as being the worthiest, and most notable part of all the bodie. Sometimes the child comes (as he doth naturally) with the head formost, but it is placed amisse, which [Page 145] may be after foure seuerall fashions; In how many fashions the head may be placed. either the head lying vpon the backe: or vpon the stomacke: or else vpon the edge of the shoulders, inclining towards one of the Mothers flanckes, which makes that the child cannot come foorth straight, and in a direct line: because his necke is bow'd, and stands awrie. He being thus turn'd, it is verie hard, yea, euen impossible, that the Mother should be deliuer'd, either through any indeauour of the childs thrusting his feet against the bottome of the Matrice: nor by any labour of the woman, forcing likewise and straining her selfe, as much as she can possibly, by holding in her breath. But contrari­wise, the more the child striues to come foorth, When the Mother & the child striue in vaine. and inioy the outward ayre, the more he intangles and wreath's his necke, so that at last, both his strength, and the Mothers, are together much weakned, through the paine they both suffer; the child being in danger, by reason of the great com­pression that must needs follow the wreathing of his necke, and also by the hindrance of respiration, How the child breaths. though he breaths onely as yet by the Arteries of his Mother, vntill the after-burthen be loosened, for then he takes breath at his owne mouth. The Marrow also of the backe, and the sinewes (being the instruments of motion) may thereby be so pres­sed together, that the animal spirits may be inter­cepted, which depriueth the child of all motion, and consequently of life: wherefore, it will be ve­rie necessarie to help him speedily, which ought to be done in this sort. First, let the Mother be placed, [Page 146] and held after the same order we prescribed for the helping of them, that are troubled with a great Flux of bloud. Then the Chirurgion, hauing his hands annointed (as we said before) shall put vp his right hand, being open, as gently as he can pos­sibly, How to find which way the childs head leaneth. to find on which side the head doth leane, and is turn'd: if the childs head lean vpon his breast, his hand will meet first with the backe; if it be turned toward the backe, then he shall light vpon the breast: or if the head leane vpon one of the shoulders, then he shall find the other first, which will also be inclining somewhat toward the womans flancks; which when he hath found, be­fore he go about to remoue the head, and bring it into his naturall situation, which is to place it di­rectly ouer against the necke of the Matrice, he must first with the ends of his fingers, thrust vpward the bodie of the child, either by the shoulders, or backe, or by the breast: for by this meanes the head of the child, will not leane so hard against the sides of the wombe: Way to bring the head straight. so that his necke will euen come of it selfe to the right place. And for the better help, the Chirurgion at the same instant shal slide in his other hand, (yet not taking out the for­mer) wherewith finding the place where the head doth rest, and leane: he may easily draw his hand towards the side of the childs head, and so shall he bring it gently to the naturall place: and by this meanes, the childs head will rest betweene his hands, to be set right. The like also may he do, by putting his hand gently, toward the hinder part of [Page 147] the head, and so set it right, hauing first thrust the child vpward, either by the backe, or breast: the which is seldome done, Another way. because it is a surer and readier way, to thrust him vp by the shoulders: and to say the truth, the childs head is oftner turned, toward the Mothers flancks, then either toward her belly, or her backe.

The meanes to help a Woman in trauaile, when the child comes with the hand and arme together, with the head formost. CHAP. XVI.

THe child should come into the world, with his head forward, and if there be any thing that comes with it, it is con­trarie to nature. If the hand, and arme, offer themselues, and come foorth of the wombe, this trauaile is contrarie to nature, and therefore dangerous: because the arme takes vp the roome, The hand comming foorth, hin­ders the de­liuerie. the head should haue, & hinders it from comming right; according as it is turned, either to the right side, or to the left; or else vpward; the head leaning vpon the backe: or downward, being placed vpon the breast: (as we shew'd in the last Chapter, when the necke stands awrie,) which vnlesse it be help'd in time, it will be verie hard for him to come safe into the world. For the hand, and arme, comming foorth, by reason of their tendernesse, and softnesse, being neuer so little crush'd, or held in the ayre: [Page 148] they are quickly alter'd, and spoil'd, and will be swolne, and puft vp exceedingly: yea, and some­time fall into a Gangrene, The arme comming foorth, fals into a Gan­grene. which I haue often seen come to passe: and therefore it will be verie neces­sarie to redresse it speedily.

But especially, the Chirurgion must take heed of pulling the said hand, or arme; because it is im­possible, Inconueni­ence of dra­wing the child by the arme. he should draw him out thereby: For how much the more the arme is thrust, whether it be by the Mothers, or the childs striuing, or else by the Chirurgion, who labours to pull it out: so much the more will it make the head and necke to bow, and bend; either toward the stomacke, backe, or sides: it being impossible that the head and arme should come foorth both together, because the said head is so infolded, and ingaged, in one of the said places: and therefore this order must be obser­ued heerein.

The practize.First, the Mother must be laid vpon her backe, her head and necke lying somewhat low, and her hips somewhat raised: then the Chirurgion, ha­uing his hands oil'd (as before) shall annoint, all the womans parts with that hand, which is most fit, according to the diners situation of the child. If the hand onely come foorth, he shall take it, at the top of the wrist, and so thrust it backe, as high as he can, guiding it all along the sides and flancks of the child: and hauing plac'd it there, he must pull backe his hand to giue place to the childs head, which at the same instant, with his other hand, must be brought and put, right against the necke [Page 149] of the wombe: And the better to set it aright, he must with both his hands being spred abroad, and placed on each side the head, thrust the shouldert vpward, with the ends of his fingers, (as we shew'd in the former Chapter) that the childs head may be set in the mid'st: which will be easie for him to do, in taking the childs temples of his head, be­tweene both his hands, and by that meanes set it straight. And when this is done, The woman must be hartned. let him suffer the woman to rest her selfe a little, assuring her, that her child is well plac'd, and that by and by, he will come naturally into the world: The rest shall be performed, as we haue shew'd in the naturall De­liuerie; placing the woman after the same order, as hath been said. But if it chance, that the child be dead, and that the arme be gangren'd, and so swolne, that it cannot be put backe, then must it be help'd in the same manner as we haue shewed before, which ought to be done with all speed: for feare of the putrifaction, that may happen vnto it.

The meanes to help the trauaile, wherein the Child comes with both his hands, armes, and head formost. CHAP. XVII.

MAny men are of opinion, Comparing of the two sorts of de­liueries. that the trauaile wherein the child puts formost both his hands, and armes, is not so dangerous, and difficult, as the former, when there is but one: Be­cause [Page 150] cause when both the armes come, thus stretched out, the head is found iust in the mid'st of the pas­sage.

But since that both armes must be put backe againe, as in the former, before the child can come into the world, (it being verie hard, and dangerous to draw him foorth by the armes) it hath made me alwaies thinke, that this kind of deliuerie is more troublesome and dangerous, then the former.

The deliuery where both armes come formost is not so dangerous.Notwithstanding this may bee said to bee lesse dangerous for the child, because howsoeuer hee striue to come forth, and for all the throws that the Woman can haue, yet the child cannot wreath or turne his necke aside. But yet to say the truth, it is [Page 151] more troublesome, both for the Mother, and the Chirurgion, yea; and sometimes for the childe also.

But the best way to proceed heerein is, The practise. that the Chirurgion, after he hath placed the woman (as is aforesaid) hauing his hands annointed, as also the parts of the Woman, he shall gently put in his right hand, and bring one of the childs armes to his due place, by stretching it out at length, along by the flankes and thighs; and presently with drawing that hand, he shall thrust in his left, to bring the other arme into his place, as he did the former. This be­ing done, he shall marke, whether the head of the child be placed right, in the meane time suffering the woman to take some ease, not holding her so much backe, as when hee placed the armes of the child. Then shall he place her, as in a naturall birth, but if hee find that the head of the child be turned aside, and be not set direct against the passage, as it vseth to be in a naturall birth, then shall he gent­ly put in both his hands ioyned together, and pre­sently opening them, he shall touch onely with the ends of his fingers, both the shoulders of the child, and put him backe easily toward the bottom of the Matrice: and beeing so put backe, the head of the child will come betweene his hands, which he shal easily place aright against the passage (as is afore­said) by taking both sides of his head, or temples betweene his hands, and so the deliuery shall be performed naturally.

The meanes to helpe the mother when the child comes with one, or both feete formost. CHAP. XVIII.

WHensoeuer the child, comming into the World, doth put one or both his feete formost, the Chirurgion shall place the Woman (as it hath beene oftentimes told,) & hauing his hands annointed, let him chuse whether he will draw the child forth by the feete: or else if he thinke it better, to put backe either one or both the feete, and so turne him, and bring his head straight to his pas­sage. For my part, I thinke it the better & safer way to draw him foorth by the feete, then to turne him vpside downe, and lift his feete vpward, thereby to bring his head downward to the passage. And ther­fore, What must be obserued concerning the child. whether he come with one, or both his feete forward, the greatest care must be to know how his whole body is placed, & lyes in his Mothers womb: as whether his face and belly be turned toward the mothers backe, and his shoulders, backe, and but­tocks towards her Nauell: likewise whether his armes bee separated from his thighs, flankes, and sides, which ought also to be diligently obserued in all births that are contrary to Nature, especially, in those, when the child is drawne forth by the feete: For when you draw him out of the wombe, [Page 153] with his buttockes, backe, and hinder parts of the head, turned toward the backe of the Mother, and his face toward her Nauell, and belly, then without doubt the feet, buttocks, body and shoulders, of the child being drawn forth, when the head commeth to the os pubis, it will hang therein: which beeing so catched it will be very hard, nay impossible, to draw forth the child: and if you draw him too vio­lently, it is to be feared least you breake his necke, especially if the child be too big, or his head great. Therefore when you haue drawne him by the feete till he is come forth, as farre as the buttocks, and wast, before you draw him any further, you must marke diligently the position of the body, whether the belly brest, and face, be vpward, or no. For if he be so placed, before you draw him any further, you must turne him vpside downe, which you shall per­forme, if you hold him fast by the buttockes, and hips, with both your hands, and turn the whole bo­dy (withall drawing it gently) and so bring the bel­ly, breast, and face downeward, which being done, you shall draw him forth with ease, without daun­ger of staying, or carrying the head vpon os pubis: which must needs happen, if the child were drawne with the face vpwards. And this haue I well obser­ued, being called to the deliuery of some women, where this chance, (for want of good heed taking) hath happened, the head sticking within, and put­ting vs to great trouble, to draw it foorth. Beside, An obserua­tion when the two arms are stretched out. when the body is thus situated, if both the armes be stretched out aboue the head, you shall bring [Page 154] downe one of them close to the side, and let the o­ther stay stretched out, that when the shoulders, are come foorth, the said arme may be as it were a stay, or splint to the necke, for the passage of the head, to hinder the passage from shutting or clo­sing vp, and fastning about the necke of the child, and so hinder che child from comming foorth, not­withstanding oftentimes, the child is so slender and little, that so soone as the shoulders are come out presently the head follows after, and needeth not, the helpe of an arme, to bee a rest for the necke.

Now the Chirurgion when hee hath thus obser­ued, and marked the situation of the child, or else hauing after that manner put him backe if he find the child may be easily turned by lifting his feet vp­wards, and bringing his head downeward, he may gently make triall of it. The safest way is to draw the child forth by the feet. But if he find that there is a­ny difficulty therein, then the best and surest way is to draw him forth by the feete. Therfore, if but one of his feet come forth, he shall tye a ribband about it, that if it be needfull, to put it backe againe, to search for the other, he may the sooner find it, and draw it forth. For it were enough to teare the child asunder, and so kill both him and his mother, to draw him forth by one foote. Therefore, whether the first foote hang out, or whether it be somwhat put backe againe, let it serue for a guide to find the other, the Chirurgion putting his hand all along [Page 155]

the said leg and thigh euen to the Perinaeum, How to find the childs feet neere the which hee shall be sure to find the other thigh, and afterward the leg and foote, (vnlesse you meet with them first, as commonly it fals out). But the surest way is to do it the first way (that is to find the thigh first) because oftentimes there are two chil­dren, which if it should so happen then might you [Page 156]

take one foote of the one, and another foote of the other: and thinking, that they were the feete of one child onely, without doubt in drawing them foorth after that manner, you would kill them both, and put the mother likewise in great danger of death, because it would be impossible to draw them forth both together. And you must obserue, that to draw a child well out of his Mothers wombe, you must haue a Napkin, or some other linnen cloth, that you may not hold the child naked, You must not hold the child naked. either by the feete, thighs, or other part of the body: but let it be with a warme cloth, for your hands beeing annointed, and greasie, and the child being also moist, hee will easily slip from betweene your hands, and you shall [Page 157] not take so strong hold as is fit, for to bring him foorth. And yet it may happen, An Obserua­tion. that the inner neck of the Matrice, may not be so wide, as to giue way to the Chirurgions, or Midwiues hand, without great difficulty and paine: the passage beeing not bigger then to admit two or three fingers, by which neuerthelesse, it is found in what manner the child commeth. If you obserue that one foote or both come formost, you must proceed according to this example.

Being at Moret with Count Charles, I was called, A story. together with the late Mons: de la Corde, one of the Kings Phisitions, to deliuer a poore woman, which had beene in trauaile two daies and two nights: the waters beeing broken, and the child left dry, the necke of her Matrice was closed, she being no more vrged with paines or throwes, which I obserued by slipping vp my hand, vnto the said necke, and get­ting two of my fingers therein, where feeling one of the childs feete, I perswaded my selfe that I should deliuer her well, which I did in this sort.

First, when I had placed her well, I annointed my hands with butter and hogs grease melted to­gether, and with store thereof, I annointed the in­ward necke of the Matrice, as well as possibly I could: and when I had somewhat dilated the saide necke, with three of my fingers I cast a ryband with a sliding knot, vppon the childs foote, fastning it gently: and then dilating againe the said necke, I found out the other foote, vpon which I slipped a­nother riband, as I had done vpon the former: Then [Page 158] did I draw both the ribands, and brought the two feete together, which when I had drawne out, vn­to the buttocks, I began againe to annoint, as before, then taking a napkin, lest it should slip, I bad the woman force her selfe, as much as shee could possibly, especially when shee felt her paines and throws comming: and then drawing sometimes di­rectly, and sometimes to the one side, so to enlarge the passage, I drew on the child gently turning the belly thereof downward; that the chin might not catch in the ospubis, as I haue noted before.

Sometimes the child comes not with his feet but

with his knees forward, and in this case, the Chirur­gion shall vse the same art, as before, considering [Page 159] first, whether it be fitter to bring the childs head formost, or to draw him out by the feet. If he will draw him out by the feet, he shall bring him into the foresaid situation, that is, to let the face of the child be turn'd toward the Mothers backe, and his backe, toward her Nauell: then shall he vnfold, or vnloose the legs, that were bow'd and bent; and shall draw them foorth first, and then the rest of the bodie, in this sort. How to draw him foorth. He shall slide his hand from the knee of the child, along the shine, till he come to the foote, which he shall draw foorth, and tye a small ryband about it, and put that foot in againe, letting the ryband hang out: The like shall he doe to the other foot, and so shall he easily draw out the two feet. Then let him draw foorth the thighs, and buttockes, and if the child lie with his belly, breast, and face downward, and his buttockes, backe, and shoulders vpward; let him instantly, draw gently out the rest of the child, (as we haue said before.) But if he be placed contrariwise, The child must be tur­ned. he must turne him gently, the face downward, least otherwise the head take hold vpon the Ospubis, by the chin, as we haue said before.

I haue often repeated, this fashion of drawing out the child, for feare least the young Chirurgion erre, in performing it otherwise; which if he should doe, he will be much troubled in drawing out the head, which may sticke by the way, as I haue seen it happen.

The meanes how to help a Woman, when her child commeth, with both the feet, and both the hands together. CHAP. XIX.

THe child comming into the world, may offer himselfe to the necke of the Matrice, in diuers [Page 161] fashions: as (beside those that haue been spoken of,) with both the feet and hands formost; the but­tocks, backe, and head of the child, being so bent, and bow'd against the bottome of the Matrice, which doth presse, and thrust him downward, that the said hands and feet, A terrible kind of de­liuerie. come foorth with such vio­lence, that it is a fearefull thing to see, and full of danger, because of the difficultie to remedie it; the Matrice bearing downe it selfe in such sort, and to no vse; it being impossible, that the child should be borne, whil'st he is thus situated. And therefore it will be necessarie in this case, to giue help with as much speed, as may be: The practize whereof is in this manner.

First, you shall place the woman as we haue said before, Meanes to helpe the trauaile. then the Chirurgion hauing his hands an­nointed, as is required: if the child be aliue, he shall trie first with his right hand to put the feet into the Matrice, making them slip vp, as easily as he can to the bottome of the said Matrice, and with his left hand, shall he stay the hands that they come not foorth further: the feet being thus thrust backe, pre­sently, he shall either put one of his fingers, into the childs mouth, or else take him by the hinder part of the head, to bring it direct against the pas­sage: in the meane time putting backe with his left hand, the childs hands and armes, that they may fall close to his sides: then taking the head between the palmes of his hands, he shall place it iust against the passage. Which being done, the birth will suc­ceed naturally, both by the help and striuing of [Page 162] the child, and also by the indeuour of the Mother, when she feeles her throwes come vpon her.

A surer way to draw forth the child.But when the Chirurgion shall find, that the feet, legs, and hands, cannot be put backe, and that the Matrice doth beare downeward, and shut it selfe not suffering the feet to slip vp, then must he, with all the Art he can, put back with his left hand, the childs hands, and with his right hand draw the feete gently, taking heede that the childs face and belly may bee downeward, and so draw out the child, as hath beene shewed before.

Likewise if the Chirurgion find that the child be dead, he must draw him forth by the feete, without troubling himselfe to bring the head of the child, to the passage. For euery dead child, because he is not able to giue any helpe to the birth, but that all the labour is to come from the Mother, is oftentimes the cause of her death. And therfore the surest way is to turne him so, that he may be drawn but by the feete, or else with the Crochet.

The Authors opinion.As for my selfe, I am of this opinion, that it is bet­ter, whether the child be dead or aliue, (if he come with his feete, and hands formost) that the Chirur­gion bring him foorth by the feete, then to turne him, and bring his head formost, and so expect a naturall birth: for in this striuing, the Mother ha­uing been much wearied, and the chid much weak­ned, the deliuerie (though it be naturall) will proue verie long, and difficult, in regard that neither the Mother, nor the child, can haue much strength left them: Whereas if you draw him foorth by the [Page 163] feet, neither the Mother, nor the child being much weakned, the birth will be more easie, and fortu­nate; As I haue alwaies had experience.

The meanes how to helpe a Woman, when her child comes double, putting formost, either the Sides, or the Backe, and Shoulders, or else the Buttockes. CHAP. XX.

BEside the former deliuerie, which is, when the child comes double, putting his hands and feet formost: there likewise happen diuers other births that are no lesse difficult, and [Page 164] dangerous: For when he comes side-long, with his Sides, Backe, or Shoulders next the passage, his feet must needs be on the one side of the Matrice, and his head on the other, lying quite crosse; so that the child, beating on both sides, with his head and feet against the wombe, doth extend, and stretch it to no purpose, wherby the Mother growes weake and faint: which neither she, nor the child can long indure without danger of death; because his striuing helps not at all for his comming foorth.

A dangerous situation.The like may happen, when the child puts out his thighs, and buttocks formost: which kind of birth is verie painefull and difficult, because the child [Page 165] fils all the Matrice: Which the Chirurgion percei­uing, he shall consider, whether it be better, to turne the child, and bring formost his head, or else his feet: if he can easily bring the childs head vnto the passage, he shall proceed in this sort.

First, he shall put in his right hand (being an­nointed as before) to turne the child, and hauing found the shoulder, with the palme of his said hand, he shall lift the child vpward, that his feet or knees may be toward the bottome of the Ma­trice, whil'st the head fals and slides downward: and shall hold it fast at the orifice of the wombe, with his left hand, being put in at the same instant; and by this meanes shall bring the Armes close to the thighs, and sides of the child that the Woman may be naturally deliuered. But if the Chirurgion finde any difficulty, to lift the body vpward, for the bringing of the head downward: then shall he slide his right hand vnder the childs armepit, and so draw him gently, yet not making the arme come foorth, to place the head right against the passage.

But if the Chirurgion find any hindrance in brin­ging the head downeward, and that hee thinkes he can more easily guide and bring the feete to the o­rifice of the wombe, then the best and surest way is to draw him foorth in that sort, by the feete: and certainly when the child comes with his buttocks formost, his head being vpward, then may you soo­ner meete with his feete, and bring them easier to the orifice of the Matrice, to bee drawne foorth as wee haue shewed before. But when hee puts his [Page 166] shoulder or backe formost, then may you the more easily lift him vp to make his head slip downeward, or else take him by the Armepit, and so bring gent­ly his head to the necke of the wombe, to deliuer him naturally.

The manner of helping the deliuery, wherein the child comes with his belly and breast formost. CHAP. XXI.

THe most troublesome, and painfull situation of a childe in his mothers wombe, is when he comes with his belly formost, putting out his nauell, his legges and armes being turned backwards. For when hee is placed in this manner, and striues to come foorth, hee thrusts against the sides of the Wombe with his hands and feet, and so boweth backward, and bends the backe bone that hee brings himselfe as it were into a circle, whereby hee endur's and suffers much paine, and likewise is weakned exceeding much, vnlesse hee be speedily helpt: and besides, by his compressi­on and striuing, hee causeth the Mother to endure much paine, and anguish without any profite at all both which doth require to be speedily redressed, which maybe performed in this sort. First the Chi­rurgiō [Page 167]

shal place the woman in good order (as hath beene said) Meanes to help the child. and then shall he slide vp his right hand (beeing first annointed) to obserue and feele what part of the childs body is neerest, which hee shall perceiue both by his feeling, and by wagging and stirring the child vp and downe: If the breast be [Page 168] next, he shall take with the said hand) the child by he shoulders and top of the Arme, bringing him thereby gently downeward, afterward lifting vp his hand, that the childs head may fall right towards the passage, putting in presently his left hand to re­ceiue and set straight the childs head, which may be turned on the one side, and that being done, the deliuery shall bee afterwards performed Natu­rally.

Another con­sideration.But if the head cannot be easily brought down­ward, or that the belly and top of the thigh be nee­rer vnto the passage, then the Chirurgion shall put his right hand along the childs thigh to find one of his feete, which being found, hee shall cast about it a riband, with a sliding knot, and then shall he seeke for the other, and bring them both gently to the passage, and so draw him forth by the feete, taking hold of him with a warm napkin, between both his hands: obseruing alwaies that his face and belly be downewards; for feare least when the shoulders are come forth, the chinne catch vpon the os pubis, as we haue shewne more at large, in the chapter of deliuering the childe with the feete formost, to which place I referre you, shunning often repe­tition.

The meanes to help the birth, when there be twins the one com­ming with his feete, the other with his head formost. CHAP. XXII.

IT cannot well bee perceiued alwaies, whether a woman beares two children, though she be in [Page 170] trauaile: for I my selfe was present not long since, at the deliuery of an honest woman, One may bee safely deliue­red of two children. who brought two children: and when she was deliuered of the first, the Midwife (not expecting that there was a second) was ready to draw out the after burthen, but that I perceiued another offer it selfe at the passage, which as it came naturally, so was shee deliuered thereof very fortunately. But if it so fall out that the twins do come, the one with his head, the other with his heeles formost, then the Chi­rurgion shall behaue himselfe in this sort.

How he must deliuer the woman when the twins come ill.First he shall consider, which of the two children the woman may be easiest deliuered of. If the head of the one come not so forward, as the feete of the other: it will be easie to draw foorth that child by the feete, putting the others head a little aside, and when he hath brought that foorth, he must present­ly set the head of the other right against the pas­sage, and incourage the woman to bee deliuered, which will the easier bee done, because the other hath prepared the way.

And if it happen, that in deliuering the first by the feete, the second should change his situation; then the Chirurgion shall looke after the feet, and draw him foorth, as he did, the former. And when the head of the first, is very forward: then shall hee thrust backe the feete of the second, to giue way to the others head, that he may come naturally.

The way to deliuer a wo­man of two twins.If the heads of both the children come together to the passage, the Chirurgion must take great care for it is impossible for him to make them come [Page 171] foorth both at once, (except they be very little.) And therefore hee shall put vp his hand to try, whe­ther both the heads are placed in one, and the same line, and point of distance (as commonly it hap­pens) or else whether the one is further forward then the other: And especially hee must obserue whether the two children be monsters, and vnna­turall, or no. As whether there be two heads vpon one body: or if they be ioyned together, either by the backe or by the belly, as it is often seene; which he may easily perceiue, by sliding his right hand o­pen, betweene the two heads, putting it as high as he can, to feele the diuision; and then drawing his hand down againe gently between the two heads, hee shall thrust aside the one to giue place to the other, which hee must bring right to the passage, leauing the second neuerthelesse in his naturall si­tuation. And when the woman feeles her throws come vpon her, then shall he by all meanes bring forward, the former that he would receiue, hol­ding downe the other, with two or three fingers of his left hand (least he should offer to come foorth) and shall endeuour onely to bring the first into the world. Which beeing done; if the second bee not well situated, he shall bring the head forward right to the necke of the Matrice, and being brought thi­ther, he may easily come foorth, because the way hath beene prepared, and made ready by the for­mer. But you must obserue, that the first beeing come foorth, hee must be taken from betweene his mothers legges, for feare least he indanger his life; [Page 172] but you must first tye the nauell, His Nauell must be tyed. as we haue shew­ed. And besides it will be very necessary and fitte before it be cut, to tye the rest of the nauell string, that is fastned to the after-burthen with a large and strong thred, that it may therby be the easier found and drawne foorth afterwards. For the thred that binds the Nauell, being left too short it may slippe into the womb, and thereby much trouble the mo­ther: When the second child is come foorth, the Chirurgion must search whether there bee two af­ter-burthens, or no. And if it happen that after the second deliuery, the two after-burthens should not come away so soone as they ought: The afterbur­then must bee taken away speedily. then must they bee prouoked for feare least the Matrice beeing emptied of two children, might chaunce to sinke downe, and shut it selfe close together, thereby as it were to retain the said after-burthens, and by this meanes hinder the deliuery of them, which must be remedied, as wee haue shewed before. If the two children should haue but one body, I am of opini­on that for the performing of this deliuery, it would be a more easie and safe way, to turne the head vp­ward, and draw him foorth by the feete, than to make him come foorth with the head formost ha­uing an especiall care, when he comes foorth as far as the buttocks, that you guide and draw them foorth with all the Art you can possibly: at which kind of deliuery, I my selfe was neuer present.

The meanes to help a Woman in trauaile of Twins, their feete comming formost. CHAP. XXIII.

AS two twins may chance to offer them­selues with their heads, so likewise some­times they may happpen to come with their feete formost.

When this chaunceth, the Chirurgion ought to obserue, whether the twins be separated, (as wee said before) or whether they be vnnaturall, as ha­uing [Page 174] foure legs, one or two bodies, and likewise one or two heads. Now the best way to find it is, that the Chirurgion hauing his hand annointed (as be­fore) slip it vp gently wide open, Meanes to know whe­ther the child be a monster or no. as high as he can, and finding that the twins are not ioyned together, but diuided and distinguished, he shall bring down his hand betweene one of their thighs, and pulling it a little lower, shall take hold of one of the twins feet, (that which he thinks may bee easiest drawne foorth) and tye about it a riband, with a sliding knot, towards the Ankle: then shall he put his hand along the said legge, and so euen to the buttockes that thereby hee may find the other legge of the same child, and ioyne them together, and not bee mistaken (taking one legge of the one twinne, and another of the other: For if he should doe so, then without doubt in drawing of them forth, he would teare them both asunder:) but beeing certaine by this meanes, that both the legges and feete, bee of the same child, you may draw them foorth gently, (as wee haue shewed before) taking care that the childe come with his face downeward. Whē the first is come hee must be taken away. When you haue thus drawne foorth the first, you shall in the same manner, proceed to the second: hauing first taken away (as is saide before) the other, from be­tweene the mothers legges. And if it happen that one of the twins come naturally, with his head for­most, and the other with his feete: and that his feet are more forward then the others head: then the safest way will be to draw him foorth first, that hath his feete formost: hauing first of all put the other a­side [Page 175] that offered himselfe at the passage. But if the head of the one be right against the passage and the feet of the other on the one side, then shall hee put backe the feete gently, and deliuer the woman first of him that had his head formost, and afterwards draw the other foorth by the feete.

It may also happen in each of the former births, It must be knowen which is aliue. that one of the twins may be dead, and the other li­uing. Howsoeuer they are placed, the Chirurgion must be very certaine which of them is dead, or a­liue. The meanes to know it. Which hee shall know by feeling them about the Nauell, Temples, or region of the Heart, Hand­wrists, or Ankles, where if he find no pulse, or beating of the Arteries, then he may be sure that the child is dead, as also if he be lesse hot then the other: and when you put your finger into his mouth, he neither sucke it, nor wag his tongue. But if you find all these signes concurre, How you must draw him out. then there is some likelyhood that he is aliue: and therefore it will be best to bring his head right against the pas­sage, that so the woman may be the sooner deli­uer'd, which will be done the more easily, because the liue child can better help himselfe, then he that is dead. But if the Chirurgion thinke, that he shall hardly bring the head to the said passage, and that he find the feet are neerer, and readier; then I would aduise him to bring the child foorth by the feet, and when the woman shall be deliuer'd of th'one, let him draw foorth th'other in the same fashion.

Of the staying of the after-burthen, after the deliuerie. CHAP. XXIIII.

OFtentimes it happens, after the woman hath been deliuer'd, whether it be na­turally, or by the Chirurgions helpe: that the bed whereupon the child lay, (commonly called the After-burthen) as being a second burthen, The After-burthen may be stop't. or deliuerie of the woman; be­cause, when that is come away, the Mother is wholy deliuer'd, doth remaine fastned to the sides of the wombe, and cannot verie easily be sepera­ted from it, and though it be loosened, yet often­times it cannot be put foorth: The which may pro­ceed, either from the drynesse of the Matrice, and after-burthen, Causes of the retention of the after-bur­then. being destitute of their moisture, or because, that it is swolne, and stretch'd, or else be­cause the expulsiue facultie of the wombe, hath been much weakned by a long and painfull tra­uaile: Whereunto may be added, that oftentimes the Mother hath been so wearied, and brought so low, and become so faint, weake, and feeble, that she is not able to straine, or force her selfe at all.

Now it is most certaine, that after the child hath left his Mothers wombe, the said after-birth is a thing contrarie to nature, which must needs be ta­ken away and sent foorth: And therefore one of these two accidents must needs follow, either that [Page 177] the quicke (which is the wombe) thrust foorth the dead, (which is the after-birth:) or that the dead kill the quicke: And surely, that being retayned, it doth breed in the Mother, most pernicious, and dangerous Symptomes, as swounnings, oppres­sion, and suffocation: yea, and sometimes be­ing corrupted and putrified, it is an occasion of death.

For the preuenting whereof, there must be great care and diligence vsed in the bringing and draw­ing of it foorth: which must not be done rashly, but leasurely, by often shaking and mouing it. In the meane time, taking heed that neither the Mo­ther, nor the wombe, take any cold, for feare lest it be sodainly clos'd and shut vp: and therefore, first of all, if the woman be weake, you shall giue her, either some Broth, Gelly, yelke of an egge, or else a tost and suger. And you must likewise put in pra­ctize, that which we haue formerly spoken of: as to make her Cough, sneeze, and blow, in her hands holding salt therein: and beside you must giue her medicines, that are proper to expell and driue forth the said after-bith; which are, such as we formerly prescribed, in Difficult trauaile: as

‘℞. Troch. de Myrrhâ, Gall. Mosch. an. ℥ j. Cina­mon. ℥ ss. Dictam. cretens. Succin. rasur. ossium dactylor. an. ℈ ij. Piper. Croci an. ℈ j. fiat pul­uis, capiat pro dosi ℥ j. cum vino Saluiatico, vel cum aqua Arthemissiae.’

[Page 178] Gesner in an Epistle he writes to Gasserus saith, That the stone of a horse, dried in an Ouen, being made into powder, and taken the quantitie of a dragme, or foure scruples, is an excellent medi­cine.

Other expe­riments. Horatius Augenius reports in his Epistles, that he hath made often triall of it, and saith, that he had it, of his father, for a secret.

If the afterbirth comes not away for all the fore­said medicines, then must you come to handy­worke: and for that purpose the Chirurgion shall place the woman in the same fashion he did, in the drawing out of the child: then shall he put vp his hand, (annointed as before) holding the Nauell­string, which will serue him for a guide to find the after-birth; and when he hath found it, he shall obserue and trie diligently, whether it sticks to the sides of the wombe, or no: If the said after-bur­then cannot come foorth, because the passage of the Matrice is to straite, it being shrunke together, and swolne with paine: Then shall he vse medi­cines that relaxe and mollifie, as the liniments ap­pointed in the naturall deliuerie, and also such as shall be set downe hereafter, together with fomen­tations and iniections: And when he perceiues that the passage is open and free, and that the af­ter-birth staies onely through the womans feeble­nesse and weaknesse, in these two cases he shall draw it foorth gently.

But if he perceiue that it doth sticke to the wombe, and likewise finds it soft and moist, then [Page 179] shall he separate as gently as may bee, with his fingers, (his nayles, being first pared very close and e­uen) from the sides of the womb, beginning at that end which he thinks, doth best cleaue or stice ther­to; and so draw it by little and little, shaking it som­times, on the one side, and sometimes on the other, not drawing it violently directly forward; for feare (as Hippocrates saith) least the Matrice should fall downe and follow the after-birth, whereto as yet it is fastned: putting still betweene the sides of the Matrice, and the said part of the after-burthen, ey­ther fresh butter, or some of the liniment wherwith he annoints his hands, that it may helpe by molli­fying and relaxing, to separate it the more easily.

And you must take an especiall care that you draw it not foorth suddenly all at once, least it should sticke to many places of the wombe, and so you thinking to pull it along, might shake & bring down with it the body of the womb, which would cause a Praecipitation or falling downe thereof: Or else, if you should separate it by violence, some ves­sell or part of the wombe is in danger to be broken, which may procure a fluxe of bloud, or some vlcers, wherof may follow a Gangrene, yea and oftentimes death.

If the Chirurgion perceiue that there is any dif­ficulty, or danger to seuer and bring foorth the said after-birth, it sticking very fast by reason of drynes, or that the Matrice is very painfull and swolne, then shall he vse these medicines following.

First he shall giue these Pilles.

You may mingle with the saide Dose, halfe a Dragme of Pilulae Cochiae, to prouoke and stirre vp the expulsiue faculty of the belly & so consequent­lie, that also of the wombe.

You must likewise prouoke her to sneese, which may bee done, Sneesing ex­pels the after-burthen. according as Aëcius appointeth, with Castoreum and Pepper made into powder, you may also vse which is stronger.

But ye must note, that when her sneesing is rea­die to come, The manner of doing it. shee must stop her nose, and mouth, with her hand; that the breath in sneesing may not goe foorth all at once, and that it may thrust the more violently downeward.

There must bee vsed also this fomentation and iniection to the Matrice

This fomentation and iniection hath power to heate and comfort the Matrice, and also to make it [Page 181] more moist and fit to loosen the after-burthen. At the same time you shall giue her this Clister.

You must also cause the Woman to smell vnto bad, and stinking odors, as old shoes, Ill smells. and Partridge feathers burnt, Assa faetida, Rue.

Some after the child is borne, Bloud lettin [...] brings dow [...] the after-birth haue the veynes of the Matrice so swolne, that the after-birth can­not come foorth, by reason of the bignes thereof, and the narrownesse of the passage: then it will bee good to let them bloud in the foote, which is a me­dicine very often tried by Massaria a great practiti­oner and a professor at Padua, as he writes in his booke of womens diseases.

If the after-burthen come not away withall the foresaid medicines, then will it be necessary to sup­purate and putrifye it, which I haue seen somtimes come to passe: But in the suppurating of it, What must be done in th [...] suppurating of the after-birth. you must haue a care of two things: the first is to streng­then the Woman, and to preserue her from malig­nant vapors, that may ascend and take hold of the principall parts, as the Heart, Braine, and chiefly, the stomacke, vsing other medicines, beside those that haue beene formerly set downe. And therfore she must be comforted with these medicines.

Let her take Lozenges of Diamargarit: frigidum: and likewise of Piachodon Abbatis.

She must also haue all kind of pleasant and sweet sauours to smell to, which may recreate the spi­rits.

The second thing that the Chirurgion shall ob­serue is, that in helping it to come to suppuration, hee haue a care that there bee not bred too much corruption: and therefore it will be fit, to vse mun­difying and cleansing iniections, adding therby al­so, medicines that will comfort the womb, as those that are of a good smell.

Hip. lib. 2. Epi­dem. Hippocrates to this purpose, writes a memorable story of a Carriers wife, who had a peece of her after-birth left behind in the wombe, (that caused her to haue the Strangury) which continued there euen till she was deliuered of an other child. For at the end of foure months, she conceiued again and [Page 183] bore her fruit to the full time: which History hath imboldened me to relate this that follows.

A true story. Mary Beaurin, yet liuing, Wife vnto William Prat a Glasier, dwelling in Saint Andrews street, sent for me, (it is some sixe and twenty yeare since) to shew me a tumor that came foorth of her Womb, which was as bigge as ones fist, and more; and was like vnto a bladder: as firme and hard, as strong parchment: full of cleare water, wherein one might perceiue a pretty hardnesse: the said tumor or blad­der would slip vp easily, when shee lay vpon her backe, and lifted her thighs a little vpward, crush­ing it a little with her hand, (as they commonly doe when they put backe a rupture) which shee did in my presence, and I demaunding of her how long this accident had troubled her; she told mee it had beene so aboue two yeares, and begun at the birth of her second child: and yet notwithstanding shee said she had had a little young daughter, about sixe Moneths since, to which she then gaue sucke, and that all the time that she went with child, shee said this bladder fell not downe at all, as it was wont be­fore her last beeing with child. I counselled her to call Mon. Paraeus the Kings chiefe Chirurgion, and other Chirurgions, to giue their iudgement, what this bladder might be: And perceiuing, when they had handled it, that it was without pain, they were all of opinion after it was drawne foorth, as farre as it could possibly, to haue it tyed at the top, and then to pierce it; the which I did; leauing the thred wherewith I tyed it, somwhat long, that thereby I [Page 184] might draw it foorth, when I thought fit. The inci­sion being made, there followed great store offaire and cleere water, and presently we perceiued a lit­tle, foeuus or Pantye child of a fingers bignesse, som­what firme, and hard; without any bad smell, fast­ned by the Náuell, which was as firme and big, as a pretty string. About sixe daies after, with shaking the saide thred, (which had beene likewise gently stirred, euery day from one side to the other) he rest came foorth: hauing applied, in the meane time, many mollifying iniections to the wombe, for the loosning of it, from the parts whereto it was fastned.

Lib. 4. Obseruat. 185. Another sto­rie. Marcell. Donat. Histor. medic. mirabil. lib. 4. cap. 22. Iohn Schenekius, in his obseruations, among diuers other stories, tells a very strange one, of a Woman, named Ludouica who for her bignes, was called the great Mare, shee going with a dead child voided onely the soft parts of the saide child, being putrified, the bones staying behind: yet for all this; a while after: she being in reasonable good health, became great with child againe. And fal­ling sicke, there passed by chaunce, through the rowne where she dwelt, a certaine Mountibancke or Quacksaluer, who made an incision in her belly, and therby tooke foorth the bones of the said child, and cured her: And when the time of her trauaile came, shee was deliuered of a lusty and healthfull child.

The meanes how to take foorth a Child, by the Caesarian section. CHAP. XXV.

IT now remaines onely, that I speake of the last kind of deliuerie, which must be practized, after the Mothers decease, that thereby the child may be saued, and receiue Baptisme. This birth is called Caesarian, à caeso Matris vtero, in imi­tation of Caesar, who was rip't out of his Mothers wombe, at the verie instant she died. The which ought to be obserued in euery well gouern'd Com­mon-wealth: For, Iurisconsulti eum necis damnant, Lib. 2. §. D [...] mortuo effe­rendo, & se­pulchro aedifi­cando. qui grauidam sepelierit, non prius extracto foetu, quod spem animantis cum grauidâ peremisse videatur. The Lawiers iudge them worthy of death, who shall burie a great bellyed-woman that is dead, before the child be taken foorth, because together with the Mother, they seeme to destroy the hope of a li­uing creature.

In some women, I haue made this practize verie fortunately, and among the rest, in Mad. le Maire, M ^r Phillippes my vncle being ioined with me: And likewise in Mad. Pasquier, presently after she was dead, Monsieur Paraeus, and the Curate of S ^ct An­drew, being present.

But before the Chirurgion come to this worke, What the Chirurgion must obserue. he must obserue diligently, and be certainly assu­red, [Page 186] that the woman is dead, and that her kins­folkes, friends, and others that are present, do all affirme and confesse, that her Soule is departed: And then he must come presently to the handy­worke, because the deferring of it, might cause the childs death, and so make the worke vnprofi­table.

All the while that the woman lyes in her paine, and Agonie, the Midwife, or else some other wo­man, shall hold their hand within the necke of the Matrice, to keep it as open, as may be possible: for though we know, that while the child is in the Mothers wombe, he breaths onely by her Arte­ries; yet notwithstanding, the Aire that may enter therein, doth not onely not hurt, but doth verie much good.

Now, to know certainly, and to be assured that the woman hath yeelded vp her last breath, you shall lay vpon her lips, An experi­ment. and about her nose, some light feathers; for if she breath neuer so little, they will flie away.

And being thus assured that she is dead, the Chi­rurgion, presently without any delay, after he hath laid open her belly naked, shall there make an inci­sion, The Methode of making the incision. of the length of foure fingers, neare vnto the right Muscles, cutting both the skin, and the three Muscles of the Epigastrium, and the Peretonaeum, piercing euen to the verie capacitie of the belly. Then shall he thrust in two of his fingers, and with them shall he lift and hold vp, the said skin, mus­cles, and Peretonaeum; and betweene them, he must [Page 187] make a sufficient incision, to discouer the Matrice, and the child therein contained, which will easily shew it selfe: Then shall he instantly make an inci­sion, iust in the midst of the wombe, which he shal find a finger thicke, and more, The wom [...] is thicke. and therefore he need not be afraid of hurting the child, because I haue alwaies obseru'd, that the after-birth is situa­ted next to that place, and then the child. But if there should be any likelihood, The way t [...] open the wombe. that the said after-birth were loosened, and had changed his place, then must he be more circumspect, and warie: And therefore, he shall rather teare and inlarge th'in­cision with two fingers of each hand, being put therein, then cut it, and so make the orifice large enough, according as he thinks fit, for the drawing out of the child, which he shall take foorth of the wombe. This being done, he shall take the after-birth, and lay it vpon the childs belly, causing some bodie, to take a little wine in their mouth, and spirt it into the childs nose, eares, & mouth, which must be done often, as we haue shew'd before.

Some hold, that this Caesarian Section, The Auth [...] opinion o [...] this practi [...] may and ought to be practized (the woman being aliue) in a painfull and troublesome birth: Which for mine owne part, I will not counsell any one to do, hauing twise made triall of it my selfe, in the pre­sence of Mons. Paraeus, and likewise seen it done by Mons. Viart, Brunet, and Charbonnet, all excellent Chirurgions, and men of great experience and practize; who omitted nothing, to doe it artifici­ally, and methodically: Neuerthelesse, of fiue [Page 188] women, in whom this hath been practized, not one hath escaped. I know that it may be alleaged, that there be some haue been saued therby: But though it should happen so, yet ought we rather to admire it, then either practize or imitate it: For, One Swallow makes not a Spring, neither vpon one expe­riment onely, can one build a science.

The Caesari­an Section reproued.After Mons. Paraeus had caused vs to make triall of it, and seen that the successe was verie lament­able, and vnfortunate: he left of, and disallowed this kind of practize, together with the whole Col­ledge of Chirurgions of Paris: as likewise the dis­creeter sort, of the Regent Doctours in the facul­tie of Physicke, at Paris: at such time as this que­stion was sufficiently discussed by the late Mons. Marchant, in the two declamations he made, when he had the honour to be ad­mitted sworne Chirur­gion, of Paris.

What diet a Woman must keepe that is newly deliuered. CHAP. I.

HEeretofore wee haue spoken of the care that must bee taken of a Wo­man, so soone as shee is brought a bed, and deliuered of her after-birth: Now wee will treate of the diet shee is to keepe, while she lies in, and of the accidents, that may befall her in that time.

First shee must bee kept reasonable hot: for too much heat doth weaken, and dissolue the strength: Cold hurts the spermati­call parts. but aboue all, she must be kept from the cold aire: because it is an enemy to the spermaticall parts, and being very piercing it may get into the Matrice [Page 190] which is now empty, and there procure, great pains and torments, as also puffe it vp, and the whole bel­lie: and therefore the doores, and windows of her chamber in any wise are to be kept close shut.

Dyet.Her dyet must be thus: First she must liue tem­perately, and not fill her selfe with too much meat: and that must bee of the same kind, that is prescri­bed for them that are wounded; and indeed in some women, there happens a great Solutio continui, and not that onely which they call simple, but also that which hath a contusion ioyned with it. For in that great striuing, and passing of the child, many mem­branes are not onely bruised, and hurt: but also broken, and torne: as it hapneth in young women and in others that are farre in yeares, and neuer had any child before. Nay sometimes in these, the pas­sage of the Matrice, and that of Anus, are brought into one: yea, and some suffer great excoriations, and hurts, in those parts; which beeing neglected, in some, haue come to putrifaction, and Gangrenes: And heere I must admonish women in childbed, not to regard the words of their nurses, The nurses must not bee alwayes hark­ned to. or keepers, which continually preach to them, to make much of themselues, saying, that they had need to fil their bellies, which haue been so much emptyed, telling them how much bloud they haue lost, and do daily loose, and that at last they will grow so weake, that they will not be able to helpe themselues.

But these are friuolous reasons, for the greatest part of the bloud, which a woman voideth then, and all her month, is but superfluous bloud, and is [Page 191] good for nothing: which hath beene kept in the body a long time, euen the nine moneths, that she hath gone with child: it beeing now necessary for her health to haue it voided out of her Matrice: that so her belly, which is swolne, and puft vp with the aboundance of bloud (like a sponge that is full of water) may be quitted & discharged, and returne to the naturall proportion and bignesse. And there­fore for their healths sake, She must see sparingly. they must not feede so plentifully, the first daies, as the vulgar thinke: that by this abstinence may hinder the Ague which may happen vnto them, and likewise keepe downe the aboundance of bloud, which would flow to their breasts, and be conuerted into milke and by reason of the store there of grow clotty and curdle, and in the end apostumate.

Wherefore the fiue first daies, let her vse Broths, Her meats. panades, new egges, and gelly; not glutting her selfe (as commonly they doe) either with flesh or Almonds: In the morning let her take a supping or broth: and so likewise at dinner, with a couple of new laid egges, and some panade, and again at sup­per, let her haue the like, closing her stomacke with a little gelly: but yet, if she mean to nurse her child herselfe, shee must feede more plentifully. Let her drinke barley water, wherein a little Cinamon, A drinke. and a few coriander seeds haue been boyled. The great Ladies of Italy doe vse a water, made of Capons which is this.

Capon water for Ladyes. Take two Capons ready pul'd, and dressed: boyle them in an earthen pot, with a sufficient quantity of [Page 192] faire water, till they bee halfe sodden, then take them foorth, and cut them into small peeces, to be vsed as fol­loweth.

Take of Buglosse, Borage, and Balme, of each two good handfuls: whereof you must make a lay in a glasse, Lim­bicke, and vpon that, another of the saide Capons flesh, and so vppon that a lay of leafe gold, with a dramme of the powder of pearle, then poure in some of the broth, on the top: which you shall do, vntill all be bestowed in the same manner. This being done, you must distill it, in a double vessel or Balneo Mariae, and draw a quart of water or thereabouts, which must be reitterated so often, till you thinke that you haue enough to serue the woman in child bed, for tenne or twelue daies: But this Curiosity, is for Princesses and great Ladies. The saide water must bee drawne sixe weeks or two moneths before it bee vsed, and set in the sunne in sommer, and ouer an ouen in winter, to take away the rawnesse that remaines in it.

If the woman haue not an ague, in my opinion, she may drinke a little white or claret wine, with twice as much boyled water. But there bee some women that cannot endrue wine, and therefore let them drink water and hony boiled together, or else boiled water: Another drinke. if they desire to drink in the day time between their meals, or else in the night, giue them a little syrop of Maiden haire, with boiled water, or any other syrop, so it be not astringent, because of their purgings. When her paines; the feare of the ague, and the burning of her breasts bee past, then [Page 193] may she feed more liberally, and then she may eat at dinner a little meat, with her broth: as Capon, Pullet, Pigeon, or a bit of Veale: and at supper be­side her broth, a slise of Veale, Mutton, Chicken or any other good meate.

The eight day beeing past, about which time commonly the wombe is well purged, and clean­sed, it will not bee amisse to nourish her better, gi­uing her more solide meat, and in greater quantity, that she may grow strong againe, the sooner. All the which time she must keepe her selfe very quiet, not much mouing, or stirring herselfe, nor so much as once looking into the Aire. Let her speake as lit­tle as may be, and haue no noise made about her, Noise is hurt [...]full. nor suffer her to be much visited, but by her friends and kinsfolks, excluding all such tatling Gossips, as may tell her any thing to trouble her or make her sad. Let her sleepe rather in the night, Sleepe. then in the day time: yet, if she haue not rested in the night by reason of some paines, then let her sleepe, when so­euer it comes vpon her. And because most women in that case, are Costiue, and cannot void their ex­crements: therefore it will bee very fit to giue her some such gentle Glister.

You may also adde thereto sometimes an ounce [Page 194] of Diacatholicon. If she dislike Clisters, let her take a little broth or decoction of Sene.

I am of opinion that the Athenian women, while they were in Child-bed, did take the broth of Cab­bage, The vse of Coleworts. or Coleworts, rather to be loose bellied, then to driue away witchcraft, as Athenaeus would haue it: For heretofore the Cabbage was Catoes Phisick, and all his houshold. And therefore when the Ro­manes banisht the Phisitions, Cato saide, that the Cabbage alone, was Phisicke enough to cure all their diseases; and besides hee made a little Com­mentary vpon that subiect.

Sadnes to bee auoided.Let her banish all griefe and heauinesse, hauing regard only of her health, and to be merry, praising God for her deliuery.

What must be done to the Womans Breasts, Belly, and nether parts that is newly deliuered. CHAP. II.

NOW I haue set downe the manner of dyet, a Woman in Child bedde should obserue, it will not be amisse to shew, what is fit to bee done vnto her, before she sit vp, or rise, endea­uouring heerein, to bring all the parts of her body, which haue beene strayned, and as it were quite changed, through a long, and painefull trauaile, to their former state, that they may be recouered, and grow strong with as much speed as may be possibly.

[Page 195]If our French Ladyes, were (in this point) like vn­to those, which Vesputius Florentinus doth write of: Women t [...] are Virgins after child bearing. it would then be needles to prescribe so many me­dicines, for the restoring them to the same state they were in before their beeing with child. There are women (saith he) that dwell beyond the Antar­tique Pole, whose bodies are entire and Virgin like, euen after often child-bearing, and in whom there is perceiued no difference from them that are Vir­gins, as they that haue opened them, hauing made diligent search, doe testifie: But since there bee no such women found in our quarters, (though I dare boldly say, there be some, not much different) ther­fore will it be very necessary to haue a care what is to be done, to their belly, breasts, and nether parts. Wherefore, after the sheepes skin, or hares skin, hath staid on foure or fiue houres, let it bee taken away, and the womans belly and groine, annoin­ted with the liniment following. And then apply­ing the Cearcloth of a iust bignesse, which must be continued the first seuen daies, dressing it euery morning, and turning the saide Cearecloth, som­times on the one side, and sometimes on the other, the liniment is this,

But before you lay on the Cearecloth, you shall apply to her nauell, an emplaster of Galbanum, of [Page 196] the bignesse of two or three fingers, in the middest whereof you must put two or three grains of Ciuet, and it must bee so applied that the smell thereof strike not vp to the Womans nose: the Cearecloth is this.

Then must she be swathed as wee haue shewed before.

This beeing done, you must haue a care to her breasts; Some apply to their breasts onely, round plasters, made of some such Cearecloth as this.

The said round plasters must haue a hole in the midst for the Nipple to come through. Others vse this liniment and Cearecloth.

Wherof you may make rounds, as I said before.

Some Women take water parsly, or smallage, and boile it a pretty while with Vrine, and apply it to the breasts. An ointm [...] to keepe [...] milke from curdling. I haue often tried this ointment fol­lowing, which hinders the milk from Curdling, and congealing, the breasts being rub'd therewith.

Some put sage between their breasts, and vnder their Armepits.

Now concerning the nether parts: Fomentations for the parts. let them bee bathed gently, the first three or foure daies, with warm milke, wherin hath been boled a little Cher­uill, plantaine, and a few Rose leaues.

The daies following, vntill the eight day, let her vse this bath or fomentation.

After both these bathings, let there be applied, to the sides of her naturall parts, this Ointment, with a verie fine linnen cloth:

When the first eight daies are past, she shall weare vpon her belly the Ceare-cloth following, her belly being first rub'd with this Ointment.

The fifteene daies being past, she shall weare eight daies more (by which time three weekes of her lying in will be finished) this Ceare-cloth fol­lowing, ouer all her belly, and groine.

which must be renew'd afresh, after ter the first eight daies. In which space her neather parts must be bath'd with this fomentation.

[Page 199]And when three weekes of her time are expired, she hauing been, neither troubled with Ague, paines, or gripings, nor any other accident extra­ordinarie, and being likewise well clensed from all her after-purgings, before she go abroad, it will be verie good for her to bath, cleanse, and wash her selfe, being first gently purg'd, with some easie medicine, according to the Physitions direction.

Of the accidents which happen to women newly deliuered. And first of their af­ter-throwes. CHAP. III.

WE haue hitherto treated of the or­dering of a Woman in Child-bed, as also of the time when she shall bee ready to walke abroade and bee churched. But because there doe be­fall them, many accidents, in the time of their lying in, I thought good to write thereof briefe-lie, and to shew the meanes whereby they may be helped and cured.

And since that the chiefest, symptome that hap­pens vnto them, and which comes soonest, is the after-throws: therefore I am determined to speake of them first.

As soone as a Woman is deliuered of her childe and after-birth, for the most part, she is taken with paines of her belly, which oftentimes are so great and violent, that she thinkes her very belly, would bee rent, and cut asunder in diuers places, from whence the french word that signifieth these pains and torments, Tranchees. was deriued.

The first cause.The cause of these gripings or paines, may bee threefold. First, either because the Matrice & those parts thereabouts haue bene sore troubled through the deliuery, by striuing to bee vnburthened and [Page 207] freed of the child: or else, The second because the bloud that runs, and gathers it selfe to the Wombe, (being re­tained) growes thicke and slimy, that it cannot ea­sily flow, and so makes a distention of the Matrice, it being not able to come away, but in great clots, and hard matter, like vnto a false Conception: and likewise when it is altogether retained and stopt, it causes a great extension of the wombe.

Againe, it is oftentimes so cleere, thin, and sharpe, that it flowes aboue measure, and through the acrimonie and biting thereof, doth gripe and torment, as it passeth along: The third. The third cause may proceed from the outward aire, which is enter'd, and got into the wombe, at the comming foorth of the child and the after-birth.

Hippocrates hath obserued, Sentence of Hippocrates. that women in this euacuation, are troubled with gripings & paines of their first childmore then of any after: the reason is, because their veines are not accustomed to disbur­then themselues in this fort. Experience neuerthe­lesse teacheth vs the contrarie; for a woman com­monly of her first child, hath verie few of these paines, and gripings, and the more children she hath, the more she is troubled with them. The reason whereof seemes to bee this: because the bloud, which in youth, is sweet and milde, in pro­cesse of time gets a bitter, salt, and adust qualitie, which passing through the veines, procureth this paine: For we find by experience, that the flesh of beasts, or fowle, when they are old, grow's vn­pleasant, as being hard, and harsh to the tast.

[Page 208]But what euer the cause of these paines be, we must seeke to asswage them, and to free the wo­man from them, aswell as we can. If then these paines be small, and that the after-purgings come moderately, we may leaue the worke, wholy to nature: onely giuing the woman in child-bed the drinke we prescribed before: of Oile of sweet Al­monds, or of Walnuts, which of late hath been found by experience, to be better, then the Oile of Almonds, so that the Nuts be sound, and white, not rancide, and the oyle drawne without fire.

This Oyle is much commended, for the gripings which comes by the acrimonie and sharpnesse of the bloud: and in this case also, some easie fomen­tations of warme Milke, or fit vpon the belly and lower parts: Fomenta­tion. Fomentations also with Mallowes, March Mallowes, Parietarie, Mugwort, Camomile, Melilot, and Linseed, boiled in Milke, are verie pro­fitable.

When these paines and pangs proceed of thicke slimy bloud, which cannot easily flow: or of windy matter, which being shut vp, cannot be discussed, if the paine continue, beside those aforesaid, you may vse these remedies following.

A Drinke.A Drinke easie to be taken.

Or else she may vse this powder, of which good proofe hath been made:

Some in this case take halfe a spoonfull of Ci­namon water with the yelke of an egge: others with the saide yelke of an egge, take two graines of Amber greese.

If the paines continue, vse the Cataplasme fol­lowing.

Of the falling downe of the Funda­ment, and Matrice. CHAP. IIII.

THere are some Women, which are deli­uer'd with so much difficultie, and are so long in trauaile, that to free them­ues from this miserie and anguish, they are constrained to straine, and force themselues in such sort, that the Fundament, or the end of the great gut commeth foorth: for a woman, in her deliuerie must straine and force her selfe, euen as one doth at the stoole: It may happen also that the Matrice, may follow the child, and after-birth; which is the precipitation, or comming downe of the wombe: the ligaments being loosened, and sometimes broken, either through much striuing, or because that the Midwife, or Chirurgion, in drawing foorth the child, or after-birth, draw the Matrice together with it: which may be done, and yet not they in fault.

When the Fundament commeth foorth, it is to be put vp after this manner: First, the Chirurgion must put vp the gut with a fine linnen cloth warme, as gently as possiblie he can: The Cure of the Funda­ment fallen. But if he find any dif­ficultie herein, because of some humour, with is come to it, by abiding in the Aire, all the time of the trauaile: or by any fluxe of humours, which the paine hath caused: then must he bath and foment [Page 211] it, with a little Milke, wherein Red Roses, white Mullen, Camomile, and Meliot haue been boiled: and when he shall see that the swelling is gone, and it is come to it selfe, then by little and little, he shall put it vp, not vsing any force, or violence at all. Foment. He may also (if the paine be asswaged) foment it with red Wine, in which Plantaine, white Mullen, Red Roses, and Balausts, haue been boiled, and then presently, he shall gently put it vp. The Matrice also being fallen downe, shall be put vp after the same manner: but we will speake more at large, of this and of the causes thereof, in an other place.

Of the hurts, and Excoriations, which happen in the lower parts, by Child-bearing. CHAP. V.

ALthough neither the Midwife in the naturall birth vse any violence, in bringing the child into the world: nor the Chirurgion either in turning, or drawing foorth the child, handle or touch the woman, but with all gentlenesse, and tendernesse that may be; yet oftentimes do some contusions, or other hurts happen, in the lower parts of the woman, yea, and excoriations, toge­ther with chaps and clifts, about the part called [...]inaeum: in respect that so great a morsell hath [...]s'd through so narrow a place: Besides that, some women are verie straight and close, either be­ing [Page 112] verie young, or verie old: or because they haue vsed medicines, to make those parts straite and nar­row; besides that, in some women the child proues verie big.

For all these accidents, it is good to vse at first, (as we haue said before) Oile of S ^t Iohns wort, and Oile of Roses, beaten with whole Egges all to­gether. If the sides of those parts be brused, you may vse this Fomentation, which will resolue it gently.

This Fomentation must be applied onely to the entrance, and orifice of the Matrice, lest the ordi­narie courses be hindred: and the foresaid medi­cine of Oile of S ^t Iohns wort, shall be prepar'd without the whites of Egges, and applied vpon fine lint, or cotton, leauing the passage of the wombe open: both to giue way to the purgings, and ven [...] to such vapors, as may proceed out of the Matrice

For the excoriations and chaps, you may vse this Ointment.

Although these kind of vlcers are easilie healed, as being but small, S [...]c morb. Mu­lier. Lib. 1. (as Hippocrates noteth) notwith­standing, they must be carefully handled, being in a part of delicate and exquisite sence, and full of Nerues.

[Page 213]Of the medicine last described, you shall make small plasters, and applie them fitly, vpon the exco­riations, and chaps: And because, (as I haue no­ted) there often happens a rent, or breach about the Perinaeum, neare to the fundament, and that when the woman makes water, she feeles there a great pricking, and paine; it is necessarie that her Nurse, or keeper, applie to that part two or three little linnen clouts, spred with the aforesaid Oint­ment, to keep the vrine from touching and galling there. But if the breach or clift be great, you shall applie there little boulsters of lint, dipt', and dress'd with this baulme.

After that you haue applied this Balm, you shall lay vpon it, the plaster before described, of waxe, and oyle of sweet Almonds.

Somtimes it happens that the whole Perinaeum is diuided and rifted, euen vnto the fundament and that both the passages are brought into one: which accident I haue seene and for want of help, the sides of the wound being hardned with a scarre, both the passages haue continued as one. For remedy wher­of, I being once called, and finding the Woman to bee with child, I gaue her counsell to stay till shee were brought a bed: and about sixe weekes after, she was deliuered, being sent for to cure her, I pro­ceeded in this manner.

First, with a crooked rasor, very sharpe, I cut a­way [Page 214] way the scarre, and skinne which was growne on both sides, as the common practise is, for an hare lip which I haue showne in my workes of Chirur­gery: which worke I began from the naturall parts, and so went on to the fundament, not taking away much flesh, but onely the skinne: which beeing taken off, and as it were flead away, I suffered the part to bleed well: both to shun an inflammation, and also to make the stitches with my needle, more conueniently. About the midst of the clift, or diui­sion, I passed my needle through both sides, thereof (hauing first laid them euen, as well aboue and be­low, as in the middle) and I tooke good hold of the flesh on both sides, there leauing my needle, about which I did turne and wind the thred on both sides, as vseth to be done in the cure of the hare lip: then at both ends of the clift I gaue a stitch, somewhat close, such as is commonly made in simple wounds, and vpon it I laid a little clout dipt in a balm, which I haue heere described, and vppon that a plaster of Diacalcitheos.

This clift or breach was well healed within fif­teene dayes: in which time I gaue her two Clisters, beside that which she tooke first, to prepare her bo­dy. But afterwards this woman prouing with child againe, and beeing in trauaile there happened a [Page 215] fresh breach, neare to the old scarre, but not so long as the other: by reason of the helpe and care of the Midwife, whom I had instructed to annoint and rub the Perinaeum with this liniment.

Of the Hemorrhoides. CHAP. VI.

WHen the Orifices of the veynes neare the fundament doe swell, and rise, eyther more & lesse, according to the quantity of the humors, which doe fill them, the Greekes call this disease, the Hemorrhoides. Of these there are two sorts, the one inward and hidden with in the fundament: the other outward, and apparant The cause heere of is store of humors, which com­monly are grosse, and melancholicke, sometimes flegmaticke or Cholericke, which filling the saide veines, afterward flow downe to the ends of them: which humors not finding way to issue out, doe ex­tend the veines, in such sort, that sometimes they become as big as Pigeons, nay sometimes Pullets egges.

Many woman as soone as they be deliuered, Why women are subiect to the Hemorr [...] des. are troubled with them, by reason of the great paine which they haue suffered. There may bee two rea­sons giuen heere of, the one the great striuing and [Page 216] straining to bring the child into the world, which maketh the bloud come into the said veines, and di­lateth them; the other, retention of their naturall courses which being stayed, the bloud and humors which should haue come foroth, chaunge their course, and being deriued into the veins of the fun­dament, procure the Hemorrhoides.

The differen­ces of Hemor­rhodes.The Hemorrhoides doe differ, according to the nature of the humor, of which they are bred, for if they proceed of a flegmaticke, and watrish bloud, because of their colour, and the likenesse that they haue to a bladder full of water, they are called Vesi­cales, or vuales: Vesicales or v­uales. and these are white, soft, and not painefull, if they breede of a grosse & thicke flegme then they are called Verrucales, Verrucales. and ficales: and these are hard, and painfull, especially if there be any hot humor mixed with the matter of them, which may be known by their rednes. If they proceed of bloud and choller, together with some part of Melancho­ly, being vneuen, and rough, like a mulbery, then they be called Morales, these are very sensible, and painefull, Morales. and in colour neere to a deepe darke red.

Women are subiect to all these kinds of Hemor­rhoides, but especially after they be deliuered: But my purpose is not to write so generally of all these kinds, but onely of those which are swolne, big, and painfull, which chiefely happen to women in child-bed, and bleed very little or not at all.

The cure consists in three things, that is in dyet, in diuerting of the humor, which flowes to the part, & in euacuating that humor which is contained in [Page 217] it: which beeing done, the paine will bee easily appeased.

For the dyet, Dyet. it shall be such as we haue already prescribed for women in child-bed: the humor shal be diuerted by letting of bloud, first in the arme, & then in the foote, in the veine Saphena, and lastly by applying of Cupping glasses, to the side of the thighs, and that for two purposes: the one to bring downe the purgings, which beeing stayd may bee thought to be some cause of the Hemorrhoides, the other to diminish the quantity of bloud, in the cru­rall veine, which beeing emptied, will draw to it some part of that bloud, which flows to, (and it may be, some of that which is contained in) the Hemor­rhoide veynes. As for the third point, which is to e­uacuate that bloud, which is now setled in the he­morrhoide veynes, that may bee done, by medi­cines which haue power to resolue and digest and also to asswage paine of which kind is this follow­ing, which I haue vsed with good successe, and Vigo before me.

After that she hath receiued the fume of this de­coction or otherwise bathed the fundament here­with [Page 218] a pretty while, let this liniment bee applied.

The chiefe Medicine which is commonly appli­ed, is this.

If the paine bee great, you may adde heereto a scruple of Opium. I haue made often proofe of this medicine, An experi­ment of the Authors. to take all the white of a few Leekes, and cut them small; and then boyle them with milke till they come to the forme of a pultesse, and then lay it hot to the Hemorrhoides.

Rhasis me­dicine. Iohn de Vigo, alloweth of the authority of Rhasis, who counselleth to take a white Vnion, and to fill it with butter, then to bake it in an ouen, or in the embers, and so beate it and apply it, like a plaster, which I haue diuers times made triall of. This pla­ster also is much commended-

An approued remedy.I haue had good experience also of this Medicine, Take twelue red snailes without their shels, of mille­pedes, [Page 219] or Wood-lice 20. or 30. infuse, & parboyle them a little in Linceed oyle, and make a liniment here­of, and with it annoint the Hemorrhoides.

Another to be ma [...] Take of the aforesaid wood-lice, thirty, Cheruil a little handfull, boyle them in milke, or oyle of Violets, then beate them together, and make thereof a kind of plaster, at the last, vse this fomentation.

A fome [...] Boyle White mullen, Scrophularia, and Cheruil to­gether: Take a pint of this decoction, halfe a pint of red wine, Common salt, and white frankinsence, of each halfe an ounce, boyle them altogether againe, till there bee but two third parts, or there abouts left, and so vse this decoction to the Hemorrhoides, fo­menting them with little soft spunges.

Whilest these medicines are vsed the belly must be kept loose, either with Cassia, or Manna, The bel [...] must be [...] or else with Clysters (if the pipe will enter in easily) that so the excrements may come foorth the more readily, and may not burthen, or molest the part with their hardnesse, and waight.

It will be very conuenient also, to let her take of the powder of white mullen, in a little milke, or else in Lozenges, made with suger, because of the con­ceit some haue, that this herbe so taken takes away the Hemorrhoides. Some prepare Pils of Bdellium, Galbanum, and the powder of white Mullen; and here­of giue the weight of a french Crowne. If the He­morrhoides heale not for all these meanes, I would giue counsell to open them with a Lancette, thin­king it better to lance, and open them, so to let out the bloud, then to apply leeches vnto them, be­cause [Page 220] they sucke, and bring downe, as much bloud to the part as they empty, and draw foorth.

And because these Hemorrhoides, haue often­times a great hardnesse with them this plaster or Pultesse may be fitly applied.

Another.

Take Bdellium melted, dissolue it with goose grease, ducks grease, and oyle of Peach Cernels.

Oftentimes the Hemorrhoides, by reason of their hardnesse, cleaue, and so come to vlcers, and chaps.

Of the after-purgings, which come downe too aboundantly in Women newlie deliuered. CHAP. VII.

IT happens to Women newly deliuered, that their after purgins somtimes come downe too immoderately, other times, that they are suddenly staide. These two accidents are very troublesome, [...]e Morb. muli. and breede many inconueniences. Comment. in. lib. j. Aphorism. Hippocrates writes, that both these bring many symptoms with them, whiche Galen also witnesseth saying, If the purgings flow in too great aboundance, and aboue custome, it brings women [Page 221] into diuers diseases, as Cold, Distemper, Dropsy, and Convulsions: and if the same be stayed, and do not flow at all, then some inconuenience happens to the Matrice, as inflammation, Erysipelas, scyrrhus and at last Cankers. So that we may easily see how fit and necessary it is, that these purgings or cour­ses should come away moderately, and in an indif­ferent quantity. This the Chirurgion should know by obseruing the time, and the quantity, which is li­mited for them, set downe in diuers places by the ancient writers: And first, How long t [...] purgings should flow Hip. de Natu [...]pueri. for the continuance of time, that these purgings should flow; Hippocrates, doth proportion the time, in which a woman in child-bed should be purged, according to the time wherein the child is shaped or formed: which is 30. daies for a man-child, and 42. at most for a woman child.

This time may bee also measured according to that ordinary time of purging, that is omitted in the nine moneths, she goes with child, as the bloud should bee purged in euery one of these nine mo­neths, as in euery one of them, the space of three or foure daies (which put together amount to twenty seuen or thirty sixe dayes) so in recompense heerof, when a woman is deliuered, she must bee purged, 27. or 36. daies.

It is written in Leuiticus, Leuit. chap. 12 that when a woman hath brought foorth a man child, shee shall continue in the bloud of her purifying three and thirty dayes, but if she beare a maid child, then shee shall conti­nue in the bloud of her purifying 66. dayes.

[Page 222] Lib. de morbis Malier.As for the quantity and proportion of these pur­gings Hippocrates is of opinion, that the purgings which a woman should haue euery moneth, should bee a pint and a halfe, or thereabouts. And in his booke de natura Pueri, hee would haue a woman in childbed at the beginning should purge about thirteene or fourteen ounces, or a pint, and so the whole space of thirty daies for a man child, and forty two daies for a maiden-childe, euery day diminishing the quantity till it wholly leaue her.

Signes to know whe­ther a woman in child-bed be in health or no.As for the quality of these purgings, if the bloud be red, as in a beast new killed, and doe presently congeale, and thicken, then it is a signe that shee is in good health, and will continue so all the time of her lying in. But when these purgings come in little quantity, and of an ill colour, and do not congeale suddenly, it is a signe that the woman is not well, nor will not finde her selfe so all her month as the foresaid Author well obserueth.

But it is not to bee expected that all women should haue their purgings in like quantity, for wee must respect the habitude of the body, the course of life, the temperament, & other particular things which in diuers women, Comment. in. 6. Epidemior. are diuers. Therefore Ga­len saith, that these purgings continue long in wo­men that haue thinne and subtill bloud; De mor. Mulier. Hippocrates saith that women that are of full bodies, are purged more exactly, and againe hee writes, that women, that are more in yeares commonly haue more of this euacuation then they that are younger.

There may be two causes assigned of this abun­dant [Page 223] euacuation, the one, outward, as some fall, blow, or painefull trauaile, which a woman may suffer, either in bringing foorth her childe, or the after-birth: It may also arise from pasions of the mind, or from the vnseasonable vse of bath's, or from some other ill gouernement in her child-bed.

The inward causes may bee two: Inward causes. either the strength and vigor of the mother, which expelleth and putteth foorth so much bloud, as is trouble­some, and burdensome vnto her; and in this kind there is no great danger, because she that is so strong, to expell in this sort, will be also able to re­taine, so much as will be conuenient and necessarie for her. Or else contrariwise, this may proceed from the weaknesse, and faintnesse of the woman, who is not able to retaine, and keep, that bloud which nature hath prouided for her: and this hapneth chiefly when the orifices of the veines continue open, after the deliuerie, not being able, Hippocrat. morbis Mul [...] (as Hip­pocrates saith) to shut, and gather themselues toge­ther.

The other cause is referred to the bloud, which offends either in quantitie, or qualitie, or both: In respect of the quantitie, those women haue store of these after-purgings, which are full of bloud; be­cause the Liuer breeds more bloud, then is necessa­rie: which afterward is voided by the Matrice.

The qualitie of the bloud, is cause heerof, when it is too sharpe, piercing, thin, watrie, putride, or venimous, so that Nature desires to be rid of it.

[Page 224] The Cure.As for the Cure, you must fit that according to the cause, and yet there be some generall remedies, which may serue for all immoderate euacuations; and of this kind, Dyet. is Diet, which must be cooling, and moderately drying. Let her feed vpon good meats not salt, nor spiced, nor of strong tast; rather roast, then boiled: and of boiled meats, let her chuse, to eat of the heads, & feet. She may vse french Barley, new laid Egges, and Gellies made with astringent herbes. If she take any Broth's, let them be prepa­red with Borage, Buglosse, Le tuce, Purcelaine, Bar­ley, and the cold seeds: Let her shun anger, melan­cholie, griefe, and other such passions of the mind: Let her keep her selfe quiet, not much stirring, or troubling her bodie. Let her drinke Barley water, or water wherein Steel hath been quenched. You may giue her also (if she haue not an Ague) a little Wine, allaied with the said waters.

Diuers reme­dies.Let her make her abode in a temperate place, not too hote; Let her lie vpon a Mattresse, or straw bed, and not vpon a feather-bed.

It will be good to bind her armes hard toward the shoulders, but not the thigh's, although Aui­cen prescribe it. Cupping glasses applied vnder the paps, and vpon the region of the Liuer, will be verie sit, as Hippocrates teacheth: and likewise vpon the arme-pits, and shoulders, as Auicen counsaileth. The most singular, An experi­ment seen by the Au­thour. and presentest remedie is to let bloud in the arme, which I haue seen tried by the most learned Physitions of our age, with very good successe: For there is no meanes, that makes bet­ter [Page 225] revulsion, and drawes the bloud sooner from the place, to which it floweth, then opening of a veine. You shall applie vpon the raines, the Os sacrum, and the parts thereabouts, a cloth dip'd in Vineger, and water, and likewise betweene the legs; but first vse this Cataplasme.

Vnguentum Comitissae of it selfe is verie good, as likewise this Ointment following which is appro­ued.

You shall giue her to drinke, a dram of Trochis­ques of Spodium, with Plantaine water, or a deco­ction made with Horse-tayle, Roses, Knotgrasse, and Balaustia. Hollerius giues this, as a singuler me­dicine.

Some in this case giue three or foure ounces of the iuice of Plantaine. Galen. Galen affirmeth, that he hath staid the immoderate flowing of the monthly sicknesse, with the foresaid iuice of Plantaine, when nothing else would do good.

Ludouicus Mercatus commends these two medi­cines aboue all other.

He likewise commendeth this medicine follow­ing, as being verie certaine, and approued, and of great vertue to stay the sicknesse.

Lib. Exper. Galen teacheth vs this medicine, which may be both iniected, and also taken inwardly.

This iniection following, may also be verie good.

You shall also make vse of this pessarie, if there be need.

With this you may annoint your Pessarie made fit for the purpose, either of cotton, or linnen cloth.

Of the Retention, and stopping of the After-purgings in Women newly deliuered. CHAP. VIII.

AS a Woman newly deliuer'd is sub­iect to many accidents, by the ouer­much flowing of her naturall cour­ses: So is she likewise subiect to more dangerous and deadly chances, Porrhetic. Sect. 2. What L [...]c [...] are. if they be suppressed and staid. Galen saith, that these after-purgings, (which he calleth Lechia) are pur­gings of ill humors, which haue been gathered in the bodie all the time, that the woman went with child: For the child drawing to it selfe, the sweetest [Page 228] and most familiar part of the bloud, leaues the worst, which otherwise, if the woman were not with child, should be voided out euery Moneth. And if the monthly sicknesse stai'd, doth bring ma­nie inconueniences to a woman, then much more these Lochia being suppressed, must breed much more danger.

A sentence of Hippocrat. Hippocrates in his first booke De morbis Mulier: witnesseth this plainly, saying; That when the Af­ter-purgings come in lesse quantitie, then is fit, then the woman in child-bed fals into a sharpe Ague, she is troubled with a paine in her stomacke, she finds her selfe ill, through all her bodie; she feeles a paine in the ioints of her hands, in her thigh's, and hips, the places about her necke, backe, and groine are sore; and there is a weaknesse in euery part: She fals into a vomiting of fleame, and also of bitter and sharpe matter: and finally, she is in danger to be lame and impotent of some of her members: The stopping of the After-purging cause death. For the Matrice hath an affinitie and connexion, with many parts of the bodie; as with the head, and stomacke. And if this matter be transported and carried to the head, breast, and lungs, and there make an abode, then the woman dyes presently; but if it be voided by the mouth, or nose, then she may escape.

Outward causes.The causes of this suppression are of two kinds, either inward, or outward: The outward causes are sadnes, griefe, suddain apprehension of some ill newes, feare, frighting, and such like passions of the mind: Likewise, cold which the woman hath taken, [Page 229] which shutteth vp the veines of the Matrice; a bad dyet, and amongst other things, Lib. de A [...]r [...]l [...] cis, & Aqu [...] drinking of colde and raw water: which hath beene noted by Hippo­crates to be very hurtfull vnto women with child.

Now concerning the inward causes, Lib. 1. de mor [...] Mulier.Inward cau­ses. the same Author writes that the vlcers which happen by rea­sen of a long and troublesome deliuery, doe cause an inflammation, and swelling, which makes the side of the wombe come together, and shuts vp the orifices of the veines thereof: from whence pro­ceedes suppression of the after-Purgins. Likewise the ouer great quantity of thicke and grosse bloud, may bee the cause, as also the weakenesse of the Matrice, the which because it hath beene sore wearied and troubled in the deliuery, and thereby lost all strength is not able to disburden and free it selfe, of the bloud whereof it is full.

Hippocrates also in the same place giues another cause, which is, Hippoc. loco ci­tato. when the mouth of the said womb is shrunke, or turned awry, or else, because the sides of it are sunke downe, shut together and in­flammed.

For the Cure heereof, shee must obserue an or­der of dyet, which shall be moistning, and opening. Dyet. Her meate and drinke must be such, as we haue for­merly prescribed, for one newly deliuered. Shee shall take operitiue Broths, thereby to open the ori­fices of the veines, which are much stopt: and ac­cording to the cause, so the remedies must be fitted as if it come by any sudden apprehension, griefe, or anger, then must she be plasant, and make her selfe, [Page 228] [...] [Page 229] [...] [Page 231] as merry as she can. If it proceed of any inflamma­tion or heate, that hath thickned the bloud, then must she vse medicines, that shal moderately, cool, & moisten, as Apozemes made with the leaues and rootes of Succory, Burnet, Endiue, Agrimony, May­denhaire, Couchgrasse, or Gramen, Hoppes, rootes of Persely, and Asparagus, Violet flowers, with the sirups of Maydenhaire, and de quinq. radicibus. If it be need­full to attenuate, and cut or to euacuate any grosse and clammy humors, which shut vp the orifices of the veines: it will not be amisse to vse this fomenta­tion, so that there be no great inflammation of the part.

Of the foresaide ingredients, you may likewise prepare fumes, halfe baths, and also iniections for the Matrice.

If the said after-purgings are suppressed because the inner orifice of the matrice is closed, or turned aside, then will it be very necessary for the Chirur­gion, The meanes to set the wombe right. (after he hath considered that there is neither paine, nor distemperature) to set it right againe, by putting vp pessaryes, which shal prouoke and bring downe the after purgings, as this following.

You shall first frame a pessary, and then it shall be couered, with the said cloth; or else dipped and couered with the said medicine.

You may also make little round bags of a fingers length, in the forme of a pessary, which you shall fill or stuffe with the herbe Mercury, first brused or beaten, and this may serue for a pessary; this herb is very much commended. If it be needful to haue the pessary stronger, you may put thereto a little Mug­word, Sauine, and Balme.

It will be very profitable to bind the thighs hard and to rub the legges and thighs, Ligatures and frictions. especially on the inside, all along the crurall veyne: you may also ap­ply great Cupping glasses, in the saide places. Let her legges, and thighs be washed, with that decoc­tion which was set downe before for the fomenta­tion. The same decoction also may serue for Cly­sters, dissoluing therein Hiera, or Benedict. Laxatiua and mel. mercuriale.

But we must preferre before all these medicines, Opening a veine in the foote, is the most soue­raign remedy that which is the most soueraigne, which is letting of bloud, in the foote, out of the Saphena, or in the Poplitica; which is in the bending of the gartring place: For by this meanes we shall manifestly meet with the cause of the sicknesse: And heerein wee shall follow the example of Hippocrates, who cau­sed the woman seruant of Stymargus to be let bloud be cause her sicknesse, or purgings were stayed after [Page 232] she was deliuered, and by this meanes she was well discharged of them, although before, she had bene in great, and generall Convulsions.

De Morbis mu­lier. lib. 1.The same Author saith, that a woman, that hath these purgings staide, must haue present helpe, for feare, least there happen some great inflammation to the part, so that except she be presently let bloud, she is in danger of death. Her belly also must be kept loose by Clisters, and if she can vomit easily, she must be helped that way also.

Epidem. 6. Galen saith that hee hath brought downe these purgings in women that was pale, leane, and weak, by letting her bloud in good quantity.

I haue not heere set downe any medicines to bee taken by the mouth, because I haue written many of this kind, in the Chapters going before, wherein I haue treated of the meanes how to make the child or after-birth come foorth, when they bee staide, which medicines haue power also to prouoke the courses or after purgings.

Of the false Conception stayed, and abiding in the woman after her deliuery. CHAP. IX.

IT may happen to some women, that after they haue been well deliuered of their children, there may stay with them one or more false concepti­on. Some of these false conceptions sticke fast to [Page 233] the wombe, some are vnfastned, and loose. Difference o [...] false concep­tion. If they be small, they come foorth together with the pur­gings; but if they be big, they oftentimes stay, and abide within. And in this case the Chirurgion must be carefull, for if they bee bigge, and cleaue to the wombe, they may bring much inconuenience to the woman, by their long staying behind. So then it will be necessary for him to know, whether there be any of this kind, and of what nature it is, which he shal learne of the Mother, by demanding of her, how she found her selfe all the time shee went with child. First then let him enquire of her, whether she were very big, at that time, and if she had any hard­nesse, in any part of her belly, whether shee hath beene vsed to any such accident, with her other children: for there are women, which at euery birth haue of these false conceptions, and amongst o­thers Mistris Brague-longue, A story. hath shewed the proofe hereof: For she going with her second child, could assure me, that then she had a false conception, be­cause she had one with her first child: which shee came to know by reason of a certaine hardnesse, which she had vpon her left side, neere to her short ribs, where she felt a great paine, yea, and her ribs seemed to be borne vp, or thrust outward: And in­deed, this Gentlewoman, after she was deliuered, brought foorth one bigger then ones fist, and be­fore she could be rid of it, her belly was swoln with paine and murmurings about her Nauell, and to­ward her loins: she was often troubled with throws: Signes. as if she should be deliuered againe, by reason the [Page 234] nature did striue, to put and send that forth, which was vnnaturall.

Beside these simptomes, women that haue false conceptions somwhat bigger, and cleauing fast to the wombe, are troubled with great paine about the nauell, with vnquietnes, watring of the mouth, vomiting, and heauinesse downeward. The pulse is small, and frequent, and some women in this case haue the strangury, because the false conception doth presse the necke of the bladder: and to con­clude almost the same accidents are here, that hap­pen, when there is a mole or dead child.

The progno­sticke.Those false conceptions that are small, though two, three, foure, or more in number (as there may be many) they come forth easily, & are conuaied a­way with the ordinary purgings, but if they be great and hard, they are voided with much difficulty, es­pecially if they stick to the womb, and then there is daunger that they will turne into a mole: which must speedily be preuented: Hip. lib. de ste­rilibus. although Hippocrates wisheth that this should be done with prediction. Now this may be preuented (as he saith) by these three meanes; first by the vse of resoluing bath's, which haue power to moisten the whole body, Cure. and so to dilate and inlarge the passage of the Matrice, that it may come foorth: the second is by Clisters and purgations, which may purge foorth excre­ments, and also bring downe the naturall courses a­fresh. Thirdly, by iniections, which may prouoke and stirre vp the expulsiue faculty of the Matrice, to expell the purgings and with them the false con­conception [Page 235] contained in the wombe. But because all these remedies haue beene handled in the last chapter I refer the Chirurgion thither.

Of the falling downe or precipitation of the Matrice. CHAP. X.

THe ancient writers haue obserued, that the matrice moueth and changeth his place, diuersly: and as Hippocrates saith, De Morbis mul. lib. 2. the Matrice causeth great paines in di­uers places, according as it setleth, and placeth it selfe.

If it rise toward the head, Hippocrat. lib. 2. de morb. mu­lier. de natura mulieb. et.2. E­pidem. then the veines which are in the nose, and vnder the eies, suffer paine, the head is heauy, and sometime the woman fometh at the mouth. If the said Matrice moueth toward the liuer, presently the woman is depriued of her speech, her teeth are set, and her colour grows wan and pale. If it incline toward the ribs, then the wo­man falls into a cough with pain of her side: and the matrice hard and painfull to be touched, as if there were some vlcer, & shee is troubled also with short­nes of breath, and sometimes, with Convulsions: and if she continue thus long, she will grow lame: Againe if the Matrice turne to one side, there will be a paine felt, right against the place, to which it inclines, together with a paine in the backe: and at last shee becomes lame of that side as Hippocra­tes, [Page 236] and Aetius do witnesse: when it beareth down towards the groine, Hippocrat. Epi­dem2 and passage of the Vrine, then the pain is more violent, together with a dulnesse, & numnesse of the thigh: and suppression of vrine: as likewise if it be cast backe, toward the great gut, then the excrements of the belly are stopped; If it fall downe lower, euen to the thighs, then there wil be a Convulsion or crampe, of the great toe; and the hips and thighs, will be pained. And therefore not vnfitly did Plato compare the matrice to a li­uing creature, Plato. which was as it were ingrafted, vp­on an other liuing creature. For the Matrice hath voluntary motion, toward euery part, and certain­ly Scimus vterum naturaliter, vt semen excipiat, hiare, et ipso suscepto constringi.

How the ma­trice moueth.But these situations, and changings of place must not be vnderstood, in an exact sence. For it is vnlike­ly, nay impossible, that the Matrice, should so run from one side of the body to another, that it should altogether leaue his owne place. And this hath Ga­len very well noted, Gal. in lib. 3. de Articul. com. saying, that sometimes the ma­trice ascendeth vpward, and sometimes it is turned aside: not that of it selfe it leaues his naturall place but because it is drawne by some thing else: that is, by the ligaments which hold it vp, How the ma­trice chaun­geth place. and by the ner­ues, arteries, and veines to which it is annexed. To this authority of Galen I will adde farther, that the Matrice may be shut vp, and gathered into it selfe, and so draw with it those parts, to which it is fast­ned, offending & affecting them, by some spirits, va­pors, or wind, which it may communicate vnto thē.

[Page 237]But I will leaue this curious speculation to Phy­sitions, and will onely meddle with that, which be­longs to Chirurgions, concerning the precipita­tion, or falling downe of the Matrice, of which there are three kinds.

The first, The first fal­ling of the matrice. when the necke thereof (which is cal­led Vagina) sincketh and falleth downe, euen to the entrance of the naturall parts, and drawes, a little with it, the bodie of the Matrice: Hipp. Lib. de natura Pueri. And this we may easily learne of Hippocrates, who saith, that the Ma­trice commeth downe in such sort, that you may applie a liniment thereunto: And againe, that it commeth nearer to the entrance, than is needfull. Hipp. Lib. de natura Muliebri. The second kind.

The second kind is, when the bodie of the Ma­trice falleth into the outward necke, called Vagina, and is thrust a little out of the entrance, of the na­turall parts, and then the inward necke, which is sunke downe, shewes it selfe to the light, in the forme of the top of a mans yard: Hipp. Lib. de Sterilibus de morb. Mu­lier. Which Hippocra­tes also affirmes, when he saith, that the wombe commeth by little and little, out of the naturall parts.

The third kind is, The third kind. when the bodie and necke of the Matrice is all sunke downe, and turned the wrong side outward: as one should turne the crowne of his hat: and then it commeth cleane out of the naturall parts, and hangs betweene the thigh's, in the bignesse of a mans fist, or more, not vnlike to the cod or purses of a mans priuie parts, Gal. lib. 14. de vs [...] partium as Galen writes.

The generall cause hereof is, because the liga­ments, [Page 238] which should hold and fasten it, are resolued and broken, which may proceed either of an in­ward, or an outward cause.

Outward causes.The outward cause may be, some fall, or blow, or for that the woman hath lifted some heauy bur­then; or hath been in some rage, or choller; or had a violent Cough: running also, dauncing, leaping, riding in a Coach; taking cold of her feete, sitting vpon a cold stone, and ouermuch cooling of the Matrice, may be causes thereof.

Inward causes.The inward causes are, abundance of moisture, which hath relaxed the ligaments: or else a longing desire which a woman may haue, for the companie of a man; which may also happen to maides, and barren women; Hippocrat. Epidem 2. as Hippocrates writeth: Another cause may be, the long suppression of the naturall courses, which sometimes makes a woman grow Viril, Hippocrat. Epidem 6. or mankind, as Hippocrates witnesses of Phaë­tusa, wife of Pitheus, who became like a man, with a beard, and a mans voice.

Hipp. de Na­tura Mulier.2.The said Hippocrates giueth another reason, con­trarie to the former, which is because she hath had the companie of her husband too soone after her deliuerie, while her sicknesse is yet vpon her.

But commonly this falling downe of the Matrice doth come (as Hippocrates noteth) by being ill de­liuered: Hippocrat. de Eiectione Foe [...]us. To which also Galen subscribeth, making a similitude of it, to two that wrastle together, one of which falling to the ground, Gal. de facult. Natur. lib. 3. drawes his fellow with him, and makes him fall also; euen so, the Matrice striuing to put foorth the child, doth thrust [Page 239] foorth it selfe also; especially if the ligaments, A Compa­rison. which should hold it to the backe, bee natu­rally loose, and weake. It may also happen, that while the Midwife drawes foorth the child, or the after-birth, the Matrice may follow it toge­ther.

In this case, although Hippocrates in his booke before cited, seem to be of opinion, Both old and young may be cu­red hereof. that there is no remedie, but for young women, leauing elder women without helpe. Yet I haue cured them, euen of all ages, with verie good successe.

For the Cure therefore, The Cure. we haue three intenti­ons: The first, to bring the Matrice into his owne place: the second, to keep it there: the third, to strengthen it, being there keept. For the first, let the Chirurgion place the woman in this sort: Let her lye vpon her backe, with her legs higher then her head, and her feet drawne vp in such sort, that her heeles may almost touch her hinder parts, with her thigh's and knees spread abroad.

If the Matrice be fallen downe, The way to put it vp. but a little it may easily be put vp, nay, it will euen go vp of it selfe: But if it be much fallen downe before it be put vp, it must be suppled and softned, that so it may returne more easie, and with lesse paine: Let it be annointed therefore, with the cooling oint­ment of Galen, or else with some such liniment as this.

[Page 240]For a shift, you may take fresh butter, and oyle of Roses mingled together: and then vse this fo­mentation warme.

After that you haue vsed this fomentation, put vp the Matrice gently, with a soft linnen cloth, and when it is put vp, let the woman draw vp her breth as we vse to bid them, that haue a Hernia, or bur­sting, to be put vp, and by this meanes the Matrice will be brought to his place, the more easily. Beside you must remember, that if there bee any tension, hardnes or inflammation in the Matrice, to soften and souple it, with the aforesaid liniment, and fo­mentation, and so will the inflammation be asswa­ged. A good ob­seruation. And if you find that the bladder or great gut bee full of excrements (as I haue seene, not long since in a poore Woman of Masson, by meanes whereof the Matrice was shut, and kept out) then first you must make way for the Vrine by a Ca­theter, and also voide out the excrements by Cli­tters.

The second meanes to help vp the matriceFor the second intention, which is to keepe the Matrice in his place, when it is well put vp and pla­ced, the best and surest meanes is to thrust vp a pes­sary, such a one as is here described, which hath this power to keepe the Matrice vp, and yet not put it to any paine.

[Page 241]

Beside, it will not hinder the Matrice from pur­ging out such euacuations, as a woman newly de­liuer'd hath, or any other humour, which may be contained in the wombe: For this Pessarie hath a hole in the midst of it, to giue such excrements free passage and issue.

[Page 242]The Pessarie being put vp, let it abide there two or three daies, when you take it out, put vp a fresh one, keeping that to serue another time. There must also be a little string tyed to it, so to be fastned to a girdle, or some other thing, least it fall downe to the ground: The figure heere set downe doth shew the manner of it.

When astrin­gent medi­cines are to be shun'd.If the woman be newly deliuer'd, and in her sicknesse; you must not vse any astringent medi­cine, for feare least you stay that; but it is suffici­ent to keep the pessarie there.

When the time of purging is past, then must there a care be had of the whole habit, and consti­tution of the bodie. Hipp. de natura Muliebri. Hippocrates wisheth that she eate little, and drinke lesse, the first seuen daies; after which, she may take some sustenance; and when she would disburthen nature, let her sit vp in her bed, but not rise from thence in fortie daies. After that time accomplished, shee may walke gently; but in no wise bath her selfe. If she be full of bad humours, let her be purged, if she hath not had her courses, or purgings sufficiently, and if she be full of bloud, it will be conuenient to open a veine. And because the ligaments, which tie, and hold the Matrice, are oftentimes much moistned, and relaxed with slime, and fleame, which fals vp­on them; it will be necessarie to drie them, by eua­cuating, and drawing away the humour, which is the cause heereof. Hipp. de morb. Mulier. lib. 2. To this purpose, Hippocrates doth much commend vomiting, because it riddeth away such flegmaticke humours, Vomiting is necessarie. as commonly are [Page 243] in the stomacke, by turning them another way. Besides that, the stomacke while it heaues it selfe vpward, lifts, and drawes vp the Matrice with it; but this must be done considerately, because strong and violent vomiting shakes and troubles the Dia­phragme and guts, making them presse downward, and by this meanes keep downe the Matrice.

Heere also will it be auailable to applie large cupping glasses, on the top of the hips, Cupping glasses. vnder the paps, and vnder the Nauill: as also to bind the vp­per part of the arms, somwhat hard. Moreouer you shal let the woman haue good sents to smell to: She must hau [...] sundry smels as also some things of an ill sent, to put vp beneath.

Liniments and plasters, may likewise be applied vpon the backe, belly, and groine, such as we haue set downe, in the Chapter of Abortment.

As for the third intention, The third meanes to strengthen the mother. which is to strengthen the wombe, you must vse to this purpose, Pessaries, Parfumes, Suffumigations, and Iniections put vp, and applied to the part.

Let the Pessarie be of the same fashion prescri­bed before: but onely let the waxe, with which it is couered, be compounded in this manner.

With this waxe, thus prepared, you may couer the pessaries made of Corke, in the same fashion as is alreadie described.

Let the perfumes be made, of the Ingredients [Page 244] aforesaid, Ill smels to be put into the Pessaries. putting thereto a little Ladanum, and Assa foetida, because the Matrice flyeth from any thing that is of a bad sauour; and let the woman receiue this fume beneath, sitting in a chaire, with a hole in it. For moist suffumigations they shall be made thus.

Hippocrates counsaileth, to put heerein some things of an ill sauour as Assa foetida: You may also iniect this decoction, but then let it not be made altogether so astringent; or else let this serue for an Iniection.

Hipp. Lib. de natura Muliebri. Hippocrates commendeth a fomentation, made With a mans vrine, and afterwards one made with the leaues of the Masticke tree.

Of an affect, where the sides of the necke of the wombe, are vnited, and ioined to­gether. CHAP. XI.

THere is another troublesome acci­dent, which chanceth to some Wo­men after their deliuery. The cause. which is the vniting, and sticking together of the necke of the wombe: and this hap­pens through hard trauaile, which hath torne, and excoriated the sides thereof: or else by reason of some inflammation, or vlcer, which hath there hap­ned, through some sharp and biting humor, which hath corroded and exulcerated the said part: which beeing neglected and ill cured, the sides not being healed and scarred, it happens, that they are ioined, and grow together, and so be come one body.

Galen hath made mention of this accident: Gal. lib. de [...] sectione vter [...] and wee haue sometimes seene the experience of it.

As for the cure heereof the woman must be pur­ged, and let bloud, Cure. then bathed for diuers daies to­gether: and the bath must bee made of emollient things: likewise there must be many remollient fo­mentations vsed, to her lower parts, and after them diuers liniments, such as we haue prescribed in di­uers places: when the parts are sufficiently softned, then must you place the woman in the same man­ner, as is described, when shee is to bee deliuered: [Page 246] then when you perceiue the smalnes and straight­nesse of the passage, The practise. you shall apply a Dilatory in­strument made in the forme of a speculum Matricis, and by little and little you shall dilate & stretch the parts so ioyned together, which will part and seuer one from another, without any effusion of bloud: And this haue I practised with good successe, of late daies vpon a tenant of Madame Sacon as I haue declared before, and this I did when she was ready to lye downe, and yet no ill accident happened vp­on it.

But if so be the callosity should be so hard (as by continuance of time it may be) that the said parts should grow together again, and could not be soft­ned, then will it bee necessary first to make an inci­sion, that so it may bee dilated, more easily. And this hath Mons. Pineau and my selfe practised, vpon a Gentlewoman, as I haue more at large set down, in my book of the nursing and gouernment of chil­dren, in the Chapter of those that haue their natu­rall parts shut vp, and without passage.

Must take heed of leting it grow toge­ther againe.The rest of the cure must bee performed in that manner which I haue set downe in the place last cited: and heerein must a speciall care be had, that the parts ioyne not, nor knit together again: to pre­uent the which, the woman shall weare a pessary continually vntill such time as the skarrebe perfect­ly growne, and confirmed: And to this purpose let the speculum Matricis be often vsed, to inlarge the part: For it is certaine, that all such Membranes as haue beene ioyned and grown together, when they [Page 247] are diuided and seuered, doe hardly come to that length, and bignesse that they were of at the first. And this I haue often obserued and amongst other places in the mouth, wherof Mons. Pigray and Mons. Pincau the Kings Chirurgions in ordinary, & sworn at Paris, will bear me witnesse, that I together with them cured an honest man, who had one side of his checke grown fast to his iaw, A story. which made him that hee could not open his mouth, nor speake plaine. I cut and separated the membrane, a good way, which did knit and tye these parts together, but while I went about to cicatrise both sides which I had deuided: had I not had the greater care to haue hindered it, the parts had grown together againe, that I was con­strained to make a new se­paration three di­uers times.