In this section, I must first tell you what I mean by the parts proper to a child in the womb; and they are only those that either help or nourish it; and whilst it is lodged in that dark repository of nature, and that help to clothe and defend it there and are cast away, as of no more use, after it is born, and these are two, viz., the umbilicars, or navel vessels, and the secundinum. By the first it is nourished, and by the second clothed and defended from wrong. Of each of these I shall speak distinctly; and first,
_Of the Umbilicars, or Navel Vessels._
These are four in number, viz.:--one vein, two arteries, and the vessel which is called the urachos.
(1) The vein is that on which the infant is nourished, from the time of its conception till the time of its delivery; till being brought into the light of the world, it has the same way of concocting the food we have. This vein ariseth from the liver of the child, and is divided into two parts when it has pa.s.sed the navel; and these two are divided and subdivided, the branches being upheld by the skin called _chorion_ (of which I speak by and by), and are joined to the veins of the mother"s womb, from whence they have their blood for the nourishment of the child.
(2) The arteries are two on each side which proceed from the back branches of the great artery of the mother, and the vital blood is carried by those to the child being ready concocted by the mother.
(3) A nervous or sinewy production is led from the bottom of the bladder of the infant to the navel, and this is called _urachos_, and its use is, to convey the urine of the infant from the bladder to the alantois. Anatomists do very much vary in their opinion concerning this, some denying any such thing to be in the delivery of the woman, and others on the contrary affirming it; but experience has testified there is such a thing, for Bartholomew Carbrolius, the ordinary doctor of anatomy to the College of Physicians at Montpellier in France, records the history of a maid, whose water being a long time stopped, at last issued out through the navel. And Johannes Fernelius speaks of the same thing that happened to a man of thirty years of age, who having a stoppage at the neck of the bladder, his urine issued out of his navel for many months together, and that without any prejudice at all to his health, which he ascribes to the ill lying of his navel, whereby the urachos was not well dried. And Volchier Coitas quotes such another instance in a maid of thirty-four at Nuremburg in Germany. These instances, though they happen but seldom, are sufficient to prove that there is such a thing as anurachos in men.
These four vessels before mentioned, viz., one vein, two arteries and the urachos, join near the navel, and are united by a skin which they have from the chorion and so become like a gut or rope, and are altogether void of sensibility, and this is that which women call the navel-string. The vessels are thus joined together, that so they may neither be broken, severed nor entangled; and when the infant is born are of no use save only to make up the ligament which stops the hole of the navel and for some other physical use, etc.
_Of the Secundine or After-birth._
Setting aside the name given to this by the Greeks and Latins, it is called in English by the name of secundine, after-birth or after-burden; which are held to be four in number.
(1) The _first_ is called placenta, because it resembles the form of a cake, and is knit both to the navel and chorion, and makes up the greatest part of the secundine or after-birth. The flesh of it is like that of the melt or spleen, soft, red and tending something to blackness, and hath many small veins and arteries in it: and certainly the chief use of it is, for containing the child in the womb.
(2) The _second_ is the chorion. This skin and that called the amnios, involve the child round, both above and underneath, and on both sides, which the alantois does not. This skin is that which is most commonly called the secundine, as it is thick and white garnished with many small veins and arteries, ending in the placenta before named, being very light and slippery. Its use is, not only to cover the child round about, but also to receive, and safely bind up the roots of the veins and arteries or navel vessels before described.
(3) The _third_ thing which makes up the secundine in the alantois, of which there is a great dispute amongst anatomists. Some say there is such a thing, and others that there is not. Those who will have it to be a membrane, say it is white, soft and exceedingly thin, and just under the placenta, where it is knit to the urachos, from which it receives the urine; and its office is to keep it separate from the sweat, that the saltness of it may not offend the tender skin of the child.
(4) The _fourth_, and last covering of the child is called amnios; and it is white, soft and transparent, being nourished by some very small veins and arteries. Its use is, not only to enwrap the child, but also to retain the sweat of the child.
Having thus described the parts proper to a child in the womb, I will next proceed to speak of the formation of the child therein, as soon as I have explained the hard terms of the section, that those for whose help it is designed, may understand what they read. A _vein_ is that which receives blood from the liver, and distributes in several branches to all parts of the body. _Nerve_ is the same with _sinew_, and is that by which the brain adds sense and motion to the body. _Placenta_, properly signifies _sugar_ cake; but in this section it is used to signify a spongy piece of flesh resembling a cake, full of veins and arteries, and is made to receive a mother"s blood appointed for the infant"s nourishment in the womb. The _chorion_ is an outward skin which compa.s.seth the child in the womb. The _amnios_ is the inner skin which compa.s.seth the child in the womb. The _alantois_ is the skin that holds the urine of the child during the time that it abides in the womb. The _urachos_ is the vessel that conveys the urine from the child in the womb to the _alantois_. I now proceed to
SECT. II.--_Of the Formation of the Child in the Womb._
To speak of the formation of the child in the womb, we must begin where nature begins, and, that is at the act of coition, in which the womb having received the generative seed (without which there can be no conception), the womb immediately shuts up itself so close that the point of a needle cannot enter the inward orifice; and this it does, partly to hinder the issuing out of the seed again, and partly to cherish it by an inward heat, the better to provoke it to action; which is one reason why women"s bellies are so lank at their first conception.
The woman having thus conceived, the first thing which is operative in conception is the spirit whereof the seed is full, which, nature quickening by the heat of the womb, stirs up the action. The internal spirits, therefore, separate the parts that are less pure, which are thick, cold and clammy, from those that are more pure and n.o.ble. The less pure are cast to the outside, and with these seed is circled round and the membrane made, in which that seed that is most pure is wrapped round and kept close together, that it may be defended from cold and other accidents, and operate the better.
The first thing that is formed is the amnios; the next the chorion; and they enwrap the seed round like a curtain. Soon after this (for the seed thus shut up in the woman lies not idle), the navel vein is bred, which pierceth those skins, being yet very tender, and carries a drop of blood from the veins of the mother"s womb to the seed; from which drop the vena cava, or chief vein, proceeds, from which all the rest of the veins which nourish the body spring; and now the seed hath something to nourish it, whilst it performs the rest of nature"s work, and also blood administered to every part of it, to form flesh.
This vein being formed, the navel arteries are soon after formed; then the great artery, of which all the others are but branches; and then the heart, for the liver furnisheth the arteries with blood to form the heart, the arteries being made of seed, but the heart and the flesh, of blood. After this the brain is formed, and then the nerves to give sense and motion to the infant. Afterwards the bones and flesh are formed; and of the bones, first of all, the vertebrae or chine bones, and then the skull, etc. As to the time in which this curious part of nature"s workmanship is formed, having already in Chapter II of the former part of this work spoken at large upon this point, and also of the nourishment of the child in the womb, I shall here only refer the reader thereto, and proceed to show the manner in which the child lies in the womb.
SECT. III.--_Of the manner of the Child"s lying in the Womb._
This is a thing so essential for a midwife to know, that she can be no midwife who is ignorant of it; and yet even about this authors extremely differ; for there are not two in ten that agree what is the form that the child lies in the womb, or in what fashion it lies there; and yet this may arise in a great measure from the different times of the women"s pregnancy; for near the time of its deliverance out of those winding chambers of nature it oftentimes changes the form in which it lay before, for another.
I will now show the several situations of the child in the mother"s womb, according to the different times of pregnancy, by which those that are contrary to nature, and are the chief cause of ill labours, will be more easily conceived by the understanding midwife. It ought, therefore, in the first place to be observed, that the infant, as well male as female, is generally situated in the midst of the womb; for though sometimes, to appearance a woman"s belly seems higher on one side than the other, yet it is so with respect to the belly only, and not to her womb, in the midst of which it is always placed.
But, in the second place, a woman"s great belly makes different figures, according to the different times of pregnancy; for when she is young with child, the embryo is always found of a round figure, a little long, a little oblong, having the spine moderately turned inwards, and the thighs folded, and a little raised, to which the legs are so raised, that the heels touch the b.u.t.tocks; the arms are bending, and the hands placed upon the knees, towards which part of the body, the head is turned downwards towards the inward orifice of the womb, tumbling as it were over its head so that then the feet are uppermost, and the face towards the mother"s great gut; and this turning of the infant in this manner, with its head downwards, towards the latter end of a woman"s reckoning, is so ordered by nature, that it may be thereby the better disposed of its pa.s.sage into the world at the time of its mother"s labour, which is not then far off (and indeed some children turn not at all until the very time of birth); for in this posture all its joints are most easily extended in coming forth; for by this means its arms and legs cannot hinder its birth, because they cannot be bent against the inner orifice of the womb and the rest of the body, being very supple, pa.s.seth without any difficulty after the head, which is hard and big; being pa.s.sed the head is inclined forward, so that the chin toucheth the breast, in which posture, it resembles one sitting to ease nature, and stooping down with the head to see what comes from him. The spine of the back is at that time placed towards the mother"s, the head uppermost, the face downwards; and proportionately to its growth, it extends its members by little and little, which were exactly folded in the first month. In this posture it usually keeps until the seventh or eighth month, and then by a natural propensity and disposition of the upper first. It is true there are divers children, that lie in the womb in another posture, and come to birth with their feet downwards, especially if there be twins; for then, by their different motions they do so disturb one another, that they seldom come both in the same posture at the time of labour, but one will come with the head, and another with the feet, or perhaps lie across; but sometimes neither of them will come right. But, however the child may be situated in the womb, or in whatever posture it presents itself at the time of birth, if it be not with its head forwards, as I have before described, it is always against nature, and the delivery will occasion the more pain and danger, and require greater care and skill from the midwife, than when the labour is more natural.
CHAPTER IV
_A Guide for Women in Travail, showing what is to be done when they fall in Labour, in order to their Delivery._
The end of all that we have been treating of is, the bringing forth of a child into the world with safety both to the mother and the infant, as the whole time of a woman"s pregnancy may be termed a kind of labour; for, from the time of the conception to the time of her delivery, she labours under many difficulties, is subject to many distempers, and in continual danger, from one affection or other, till the time of birth comes; and when that comes, the greatest labour and travail come along with it, insomuch that then all the other labours are forgotten, and that only is called the time of her labours, and to deliver her safely is the princ.i.p.al business of the midwife; and to a.s.sist therein, shall be the chief design of this chapter. The time of the child"s being ready for its birth, when nature endeavours to cast it forth, is that which is properly the time of a woman"s labour; nature then labouring to be eased of its burden. And since many child-bearing women, (especially the first child) are often mistaken in their reckoning and so, when they draw near their time take every pain they meet with for their labour, which often proves prejudicial and troublesome to them, when it is not so, I will in the first section of this chapter, set down some signs, by which a woman may know when the true time of her labour is come.
SECTION I.--_The Signs of the true Time of a Woman"s Labour._
When women with child, especially of their first, perceive any extraordinary pains in the belly, they immediately send for their midwife, as taking it for their labour; and then if the midwife be not a skilful and experienced woman, to know the time of labour, but takes it for granted without further inquiry (for some such there are), and so goes about to put her into labour before nature is prepared for it, she may endanger the life of both mother and child, by breaking the amnios and chorion. These pains, which are often mistaken for labour, are removed by warm clothes laid to the belly, and the application of a clyster or two, by which those pains which precede a true labour, are rather furthered than hindered. There are also other pains incident to a woman in that condition from the flux of the belly, which are easily known by the frequent stools that follow them.
The signs, therefore, of labour, some few days before, are that the woman"s belly, which before lay high, sinks down, and hinders her from walking so easily as she used to do; also there flow from the womb slimy humours, which nature has appointed to moisten and smooth the pa.s.sage that its inward orifice may be the more easily dilated when there is occasion; which beginning to open at this time, suffers that slime to flow away, which proceeds from the Glandules called _prostata_. These are signs preceding the labour; but when she is presently falling into labour, the signs are, great pains about the region of the reins and loins, which coming and retreating by intervals, are answered in the bottom of the belly by congruous throes, and sometimes the face is red and inflamed, the blood being much heated by the endeavours a woman makes to bring forth her child; and likewise, because during these strong throes her respiration is intercepted, which causes the blood to have recourse to her face; also her privy parts are swelled by the infant"s head lying in the birth, which, by often thrusting, causes those parts to descend outwards. She is much subject to vomiting, which is a good sign of good labour and speedy delivery, though by ignorant people thought otherwise; for good pains are thereby excited and redoubled; which vomiting is excited by the sympathy there is between the womb and the stomach. Also, when the birth is near, women are troubled with a trembling in the thighs and legs, not with cold, like the beginning of an ague fit, but with the heat of the whole body, though it must be granted, this does not happen always. Also, if the humours which then flow from the womb are discoloured with the blood, which the midwives call _shows_, it is an infallible mark of the birth being near. And if then the midwife puts up her fingers into the neck of the womb, she will find the inner orifice dilated; at the opening of which the membranes of the infant, containing the waters, present themselves and are strongly forced down with each pain she hath; at which time one may perceive them sometimes to resist, and then again press forward the finger, being more or less hard and extended, according as the pains are stronger or weaker. These membranes, with the waters in them, when they are before the head of the child, midwives call _the gathering of the waters_, resemble to the touch of the fingers those eggs which have no sh.e.l.l, but are covered only with a simple membrane. After this, the pains still redoubling the membranes are broken by a strong impulsation of these waters, which flow away, and then the head of the infant is presently felt naked, and presents itself at the inward orifice of the womb. When these waters come thus away, then the midwife may be a.s.sured the birth is very near, this being the most certain sign that can be; for the _amnios alantois_, which contained these waters, being broken by the pressing forward of the birth, the child is no better able to subsist long in the womb afterwards than a naked man in a heap of snow. Now, these waters, if the child comes presently after them, facilitate the labour by making the pa.s.sage slippery; and therefore, let no midwife (as some have foolishly done) endeavour to force away the water, for nature knows best when the true time of birth is, and therefore retains the waters till that time.
But if by accident the water breaks away too long before the birth, then such things as will hasten it, may be safely administered, and what these are, I will show in another section.
SECT. II.--_How a Woman ought to be ordered when the time of her labour is come._
When it is known that the true time of her labour is come by the signs laid down in the foregoing, of which those most to be relied upon are pains and strong throes in the belly, forcing downwards towards the womb, and a dilation of the inward orifice, which may be perceived by touching it with the finger, and the gathering of the waters before the head of the child, and thrusting down the membranes which contain them; through which, between the pains, one may in some manner with the finger discover the part which presents itself (as we have said before), especially if it be the head of the child, by its roundness and hardness; I say, if these things concur and are evident, the midwife may be sure it is the time of the woman"s labour, and care must be taken to get all those things that are necessary to comfort her at that time. And the better to help her, be sure to see that she is not tightly laced; you must also give her one strong clyster or more, if there be occasion, provided it be done at the beginning, and before the child be too forward, for it will be difficult for her to receive them afterwards.
The benefit accruing therefrom will be, that they excite the gut to discharge itself of its excrements, so that the r.e.c.t.u.m being emptied there may be the more s.p.a.ce for the dilation of the pa.s.sage; likewise to cause the pains to bear the more downward, through the endeavours she makes when she is at stool, and in the meantime, all other necessary things for her labour should be put in order, both for the mother and the child. To this end, some get a midwife"s; but a pallet bed, girded, is much the best way, placed near the fire, if the season so require, which pallet ought to be so placed, that there may be easy access to it on every side, that the woman may be the more easily a.s.sisted, as there is occasion.
If the woman abounds with blood, to bleed her a little more may not be improper, for thereby she will both breathe the better, and have her b.r.e.a.s.t.s more at liberty, and likewise more strength to bear down her pains; and this may be done without danger because the child being about ready to be born, has no more need of the mother"s blood for its nourishment; besides, this evacuation does many times prevent her having a fever after delivery. Also, before her delivery, if her strength will permit, let her walk up and down her chamber; and that she may have strength so to do, it will be necessary to give her good strengthening things, such as jelly, broth, new laid eggs, or some spoonfuls of burnt wine; and let her by all means hold out her pains, bearing them down as much as she can, at the time when they take her; and let the midwife from time to time touch the inward orifice with her finger, to know whether the waters are ready to break and whether the birth will follow soon after. Let her also anoint the woman"s privities with emollient oil, hog"s grease, and fresh b.u.t.ter, if she find they are hard to be dilated. Let the midwife, likewise, all the time be near the labouring woman, and diligently observe her gestures, complaints, and pains, for by this she may guess pretty well how far her labour advanceth, because when she changeth her ordinary groans into loud cries, it is a sign that the child is near the birth; for at the time her pains are greater and more frequent. Let the woman likewise, by intervals, rest herself upon the bed to regain her strength, but not too long, especially if she be little, short and thick, for such women have always worse labour if they lie long on their beds in their travail. It is better, therefore, that she walk about her chamber as long as she can, the woman supporting her under the arms, if it be necessary; for by this means, the weight of the child causes the inward orifices of the womb to dilate the sooner than in bed, and if her pains be stronger and more frequent, her labour will not be near so long. Let not the labouring woman be concerned at those qualms and vomitings which, perhaps, she may find come upon her, for they will be much for her advantage in the issue, however uneasy she may be for a time, as they further her pains and throes by provoking downward.
When the waters of the child are ready and gathered (which may be perceived through the membranes presenting themselves to the orifice) to the bigness of the whole dilatation, the midwife ought to let them break of themselves, and not, like some hasty midwives, who being impatient of the woman"s long labour, break them, intending thereby to hasten their business, when instead thereof, they r.e.t.a.r.d it; for by the too hasty breaking of these waters (which nature designed to make the child slip more easy), the pa.s.sage remains dry by which means the pains and throes of the labouring woman are less efficacious to bring forth the infant than they would otherwise have been. It is, therefore, much the better way to let the waters break of themselves; after which the midwife may with ease feel the child by that part which first presents, and thereby discern whether it comes right, that is, with the head foremost, for that is the proper and most natural way of the birth. If the head comes right, she will find it big, round, hard and equal; but if it be any other part, she will find it rugged, unequal, soft and hard, according to the nature of the part it is. And this being the true time when a woman ought to be delivered, if nature be not wanting to perform its office, therefore, when the midwife finds the birth thus coming forward let her hasten to a.s.sist and deliver it, for it ordinarily happens soon after, if it be natural.
But if it happens, as it sometimes may, that the waters break away too long before the birth, in such a case, those things which hasten nature may safely be administered. For which purpose make use of pennyroyal, dittany, juniper berries, red coral, betony and feverfew, boiled in white wine, and give a drachm of it, or it would be much better to take the juice of it when it is in its prime, which is in May, and having clarified it, make it into a syrup with double its weight of sugar, and keep it all the year, to use when occasion calls for it; mugwort used in the same manner is also good in this case; also a drachm of cinnamon powder given inwardly profits much in this case; and so does tansey broiled and applied to the privities; or an oil of it, so, made and used, as you were taught before. The stone _aet.i.tes_ held to the privities, is of extraordinary virtue, and instantly draws away, both child and after-burden; but great care must be taken to remove it presently, or it will draw forth womb and all; for such is the magnetic virtue of this stone that both child and womb follow it as readily as iron doth the load-stone or the load-stone the north star.
There are many things that physicians affirm are good in this case; among which are an a.s.s"s or horse"s hoof, hung near the privities; a piece of red coral hung near the said place. A load-stone helps very much, held in the woman"s left hand; or the skin cut off a snake, girt about the middle, next to the skin. These things are mentioned by Mizaldus, but setting those things aside, as not so certain, notwithstanding Mizaldus quotes them, the following prescriptions are very good to speedy deliverance to women in travail.
(1) A decoction of white wine made in savory, and drank.
(2) Take wild tansey, or silver weed, bruise it, and apply to the woman"s nostrils.
(3) Take date stones, and beat them to powder, and let her take half a drachm of them in white wine at a time.
(4) Take parsley and bruise it and press out the juice, and dip a linen cloth in it, and put it so dipped into the mouth of the womb; it will presently cause the child to come away, though it be dead, and it will bring away the after-burden. Also the juice of the parsley is a thing of so great virtue (especially stone parsley) that being drank by a woman with child, it cleanseth not only the womb, but also the child in the womb, of all gross humours.
(5) A scruple of castorum in powder, in any convenient liquor, is very good to be taken in such a case, and so also is two or three drops of castorum in any convenient liquor; or eight or nine drops of spirits of myrrh given in any convenient liquor, gives speedy deliverance.
(6) Give a woman in such a case another woman"s milk to drink; it will cause speedy delivery, and almost without pain.