The compleat midwife's practice enlarged in the most weighty and high concernments of the birth of man containing a perfect directory or rules for midwives and nurses : as also a guide for women in their conception, bearing and nursing of children from the experience of our English authors, viz., Sir Theodore Mayern, Dr. Chamberlain, Mr. Nich. Culpeper ... : with instructions of the Queen of France's midwife to her daughter ... / by John Pechey ... ; the whole illustrated with copper plates.

Of the suffocation of the Matrix.

THE signs of the Suffocation of the Womb, are a weariness of the whole body, with a weakness of the Thighs; a paleness and sadness of the Face; a nauseousness though seldom vomiting; oftentimes a loathing and distate of Meat, and that sometimes with a grumbling and noise in the Belly, and sometimes without.

The signs of the present Disease are, that when the Vapours are carried up to the Heart, and do there stop the vital Spirits, a light swooning follows, the Pulse changes and is little, the Body grows cold, all the spi∣rits flying up into the Heart; the Vapour being thrust up to the Head and Chaps, the Chaps are many times set fast, the Patient seeming to be stifled; the motion of the Breast and Diaphragm is disturbed and hindred, so that the breath is almost stopt, the Patient living on∣ly by transpiration. Sometimes there is joined with it a kind of Uterine fury, with talking and anger: Some∣times it causes other madness; sometimes the Woman falls into a dead sleep, which makes her seem as though she were dead.

It differs from the Epilepsie, because in that the Con∣vulsive motions are more general; nor is there any me∣mory of those things which happen about them after the Fit; the Pulse is great, and the Mouth of the Par∣ty

affected fomes with a froth: It differs from the A∣poplexy, because in that the Fit comes suddenly with∣out any notice; and the Patient is affected with a kind of snorting, and there is such a Resolution of the parts, that they feel not although they be pricked: It differs from a Syncope, in that there are no signs when the Fit will be, the Pulse ceases to the apprehension, and the Patient is troubled with cold sweats. They differ from dead people by sneezing, which may be provo∣ked by putting something for that purpose into the Nose.

The cause of this is a venemous, subtle, and thin Vapour, piercing in one moment through the whole body, and carried up from the matter in the Womb, corrupted after a peculiar manner, either by it self or from external means, such are perfumes, anger, fear, &c. and not only ascending through the veins, but also through all the other breathing holes, and secret passages of the body.

The Cure is doubtful if it have possessed old Wo∣men for a time, for it begets weakness, consumes the strength, and shews abundance of humour; or if it pos∣sesseth Child-bearing Women, either after a difficult Travel, or after an Abortion; or if it possesseth Wo∣men with Child, because it induces fear of Abortion; there is more hope, if the act of Respiration be not too much impeded, and if the Fits do not return too often.

The Cure regards first the time of the Fit, being performed first by means of interception, which may be done by binding the Belly under the Navel with a girdle made of the skin of a Hart, killed in the very act of Copulation. Secondly, by keeping the natural Spirits awaked and rouzed up by painful friction, by pulling the hairs of the Privities with violence and suf∣fumigations made with Partridge feathers burnt, as al∣so

Eel-skins, the application of Assa faetida and Oil of Tartar to the mouth. Thirdly, by way of revulsion of the humour, by Frictions and Glysters dispelling the winds, and the application of Cupping-glasses with much flame, first to the Thighs, and then to the Hips, putting sweet things into the Privities; such as are Oil of Sivet half a scruple, Oil of Nutmegs one scruple: Fourthly, by discussion of the humour, which is per∣formed inwardly by the Oil of white Amber, with the pouder of Walnut Flowers, extract of Castor; exter∣nally by an Emplaister of the fat of a black Heifer, Sclarea boiled in butter, adding to it a sufficient quan∣tity of Tachamahacca and Caranna: After the fit is past, evacuation is to be regarded, first with purgati∣on, for which purpose it will not be amiss to use these ensuing Pills: Take Siler mountain, Pennyroyal, Mad∣der, the innermost part of Cassia Pipe, Pomegranate Kernels, Piony roots, and Calamus, of each three drams; Muscus and Spike of India, of each half a dram; then make Pills thereof with the juice of Mugwort, of which she may take every day, or every other day, be∣fore Supper. If the disease proceed from the terms, let the Woman affected take an Ounce of Agarick pouder∣ed in Wine or honied water, or a dram of Agnus Ca∣stus powder'd with an ounce of Honey of Roses: The Womb is also to be strengthned by the internal and ex∣ternal application of such things as resist the malignity of the Disease; among which are numbred, Faecula Bri∣oniae, and Castor: The difference of this Disease con∣sists in this, that sometimes it happens that it is occa∣sioned by the retention of the Seed, which is known by this, that the symptoms of the Disease are more vio∣lent; and after the fit is past, there flows out of the Womb a matter like to that of the seed. It is cur'd by evacuation of the seed, such as are Rue, and Agnus Ca∣stus,

and anointing with odoriferous salves, especially if the woman be to live without the use of man.

If it come from the suppression of the terms, which is known by the Courses being mingled with a melan∣choly blood, take powdered Agaric, a dram of Pioney seeds, or the weight of a dram and a half of Triphera magna.

But take this for a secret, that for a married Wo∣man in case of the present suffocation, there is no∣thing better than for the Man to anoint the top of his Yard with a little Oyl of Gilliflowers, and Oyl of sweet Almonds together, and so to lye with her; for this assuredly brings down the Matrix again.

This Disease is very frequent, the Procatartick or external Causes of it, are either violent motions of the body, or, which is much oftner, vehement commo∣tions of the Mind from some sudden assault, either of Anger or Grief, or the like Passions. Therefore as often as Women are troubled with this or that disorder of Body, the reason whereof cannot be deduced from the common Axioms; for finding out Diseases, we must diligently enquire whether they are not chiefly afflicted with that indisposition which they complain of, when they have been disturbed in their minds, and afflicted with grief; which if they confess, we may be fully satisfied that this disorder proceeds from this Disease we are now speaking of; especially if Urine as clear as Chrystal evacuated copiously some certain times, makes the Diagnostick more manifest. But to these disorders of the Mind, which are usually the occasions of this Disease, is to be added emptiness of the stomach, by reason of long fasting, immode∣rate bleeding, and a Vomit or Purge that worked too much; and certainly this Disease proceeds from a con∣fusion

of the Spirits, upon which account too many of them in a crowd, contrary to proportion, are hurried violently upon this or that part, occasioning Convul∣sions and pain, when they rush upon parts indued with exquisite sense, perverting the functions of the Organs, both of that into which they thrust themselves, and also of that from whence they departed, both being much injured by this unequal distribution, which is quite contrary to the Oeconomy of Nature.

The Origen and Antecedent Cause of this confusion, is a weak constitution of the Spirits, whether it is na∣tural or adventitious; for which Reason they are ea∣sily dissipated upon any occasion, and their System soon broke: For as the outward Man is framed with parts obvious to sense, so without doubt the inward Man consists of a due Series, and as it were a Fa∣brick of the Spirits, to be viewed only by the eye of Reason; and as this is nearly joyned, and as it were united with the constitution of the Body, so much the more easily or more difficultly is its frame disordered, by how much the Constitutive Principles that are al∣lotted us by Nature, are more or less firm. That the said Confusion of the Spirits is the cause of Hysteric Diseases, will appear by Mother-Fits, wherein the Spirits are crowded in the lower Belly, and rushing together violently towards the Jaws, occasion Convul∣sions in every region thro' which they pass, blowing up the Belly like a great Ball, which is yet nothing but the rowling together or conglobation of the parts seized with the Convulsion, which cannot be suppres∣sed without great violence. The external parts in the the mean while, and the Flesh being in a manner de∣stitute of Spirits, by reason they are carried another way, are often so very cold, not only in this kind, but in all other kind of Hysteric Diseases, that dead

Bodies are not colder, but the Pulse are as good as those of People that are well; nor is the Womans life in danger by this cold, unless it is occasioned by some very large evacuation going before.

And the inordinate agitation of the Spirits disturb∣ing the blood, is the cause of the clear and copious Urine; for when the Oeconomy of the blood is inter∣rupted, the Sick cannot long enough contain the se∣rum that is imported, but lets it go, before it is im∣pregnated with saline particles, whereby the Citron colour is to be imparted to it, whereof we have daily experiment in those that drink much, especially of thin and attenuating Liquors; for then their Urine is very clear; in which case, the blood being over-power'd by that quantity of serum, and being wholly unable to retain it, puts it off quite clear, not yet died by the juice of the Body, by reason of its too short stay.

As to the Cold, by which the external parts are so often chilled, it is very manifest that that happens, because the Spirits forsaking their stations too officious∣ly, intrude themselves into this or that part. Nor is it to be doubted, that weeping and laughing fits, which often seise hysterical women without any occasion, are procured by the Animal Spirits forcing themselves vio∣lently upon the Organs that perform these Animal functions.

And now I suppose it is manifest, that this whole Disease is occasioned by the Animal Spirits being not rightly disposed, and not by seed and menstruous blood corrupted, and sending up malignant Vapours to the parts affected, nor from I know not what de∣pravation of the juices, and congestion of acrid humors as others think, but from those Causes we have as∣sign••d; for that the fomes of the Disease does not lurk in matter, will plainly appear by this one instance,

viz. A Woman that used to enjoy perfect health, be∣ing delicate, and of a thin habit of body, if she chance to be weakned, and exhausted by some error, or by some strong Vomit or Purge, will certainly be afflicted with some one of those Symptoms that accompany this Disease, which would rather be removed, than occa∣sioned by such Vomiting or Purging, if the fomes of the Disease was contained in matter. The same may be said of a great loss of blood, whether it is taken a∣way by opening a vein, or flows immoderately in La∣bour; or of emptiness, or too long abstinence from Flesh; all which would rather prevent hysteric Dis∣eases, than occasion them, if the fomes of them was involved in some matter; whereas on the contrary, nothing does so constantly occasion this Disease, as these evacuations▪ But tho' it is apparent enough, that the Original fomes of this Disease is not lodged in the humors, yet it must be confessed that the confusion of the Spirits produces putrid humors in the Body, by rea∣son the function, as well of these parts which are di∣stended by the violent impulse of the Spirits, as of those which are deprived of them, are wholly perverted; and most of these being as it were separatory Organs designed for the reception of the impurities of the blood, if their functions are any way hurt, it can not be but a great many feculencies will be heaped up, which had been elimmated, and so the mass of blood puri∣fied, if the Organs had performed their office, which they had certainly done, if a due Oeconomy of the Spirits had invigorated them. To this Cause is to be attributed great Cachexies, loss of appetite, a Chloro∣sis, and the White Fever in young Women, which is a species of hysteric Diseases, and the source of many miseries.

From what has been said, it is very manifest that that is the chief indication in this Disease, which di∣rects the corroboration of the blood, that is the Foun∣tain and Origin of the Spirits, which being done, the invigorated Spirits can preserve that tenure that is a∣greeable to the Oeconomy of the whole body, and the particular parts; and therefore when the confusion of the Spirits has vitiated the humors by long continu∣ance, it will be proper, first to lessen those humors so corrupted by bleeding, and purging, if the Patient has sufficient strength before we endeavour to corrobe∣rate the blood, and which indeed we can scarce do, whilst a feculent heap of humors lies in the way. But forasmuch as Pains, Vomiting, and Looseness, are sometimes so very severe that they will not bear a truce so long, until we have satisfied the first inten∣tion of fortifying the blood; therefore sometimes we must begin the Cure by quieting the effects (the cause being let alone a little while) with some anodyne Me∣dicine, and then we must endeavour to rectifie the Spirits, whose infirm constitution is the cause of this Disease, by which we may again endeavour to Cure such kind of Symptoms. And because experience teaches, that there are many stinking things that will repell the inordination of the Spirits, and contain them in their places, which are therefore call'd hysterics, we must make use of them when we would answer such intentions.

According to what has been said, I order the Sick to be blooded in the arm, and that after bleeding, she be purged three or four Mornings following. The Woman thinks her self worse of those days she is blood∣ed and purged; for these evacuations promote the con∣fusion of the Spirits, which I take care to forewarn her of, that she may not despair, the Disease of it self

being apt to incline her so to do: But however those ill humours heapt up by the long continuance of the Disease, are in some sort to be evacuated, before we can well answer the prime intention. After these eva∣cuations, some steel Remedy must be prescribed, to be taken about a Month, to comfort the blood, and so con∣sequently the Spirits, that proceed from it, and nothing will more certainly answer your intention in this case than steel; for it raises a volatile ferment in the vapid and languid blood, whereby the weak Spirits are rou∣sed, that before were kept down by their own weight; and this is very manifest, for as often as Chalybeats are given in the Green Sickness, the Pulse are presently greater and quicker, and the outward parts grow warm, and the pale and dead Countenance is changed, and be∣comes fresh and lively. But here we must take notice, that bleeding and purging must not always be used be∣fore Chalibeats, or when the Woman is weak, and al∣most worn out by the long continuance of the Disease, they may and ought to be omitted, and you must begin with steel, which must be well minded.

I think steel is most conveniently given in substance, and as I never observed, nor heard, that so taken it e∣ver injur'd any person, so I have been fully satisfied by frequent experience, that the bare substance performs the Cure sooner, and better than any of the common Preparations of it; for busie Chymists make this, as well as other excellent Medicines worse rather than bet∣ter, by their perverse and over-officious diligence. I have also heard, and if it be true, it much strengthens our assertion, that the crude Mine, as it is digg'd out of the Earth, is more effectual in curing Diseases, than Iron that has pass'd the Fire, and bin purified by fusi∣on: So the Author affirms, but I have not yet try'd whether it be so or not. This I certainly know, that

there is no excellent and powerful Remedy, which has not received its chief Vertues from Nature: Upon which account, grateful Antiquity call'd excellent Medicines God's handicraft. Next to the substance of the steel, I chuse the Syrrup of it, prepared with the fileings of Steel or Iron, infused in the cold in Rhenish Wine, 'till the Wine is sufficiently impregnated, and after∣wards strained, and boiled up to the consistence of a Syrrup, with a sufficient quantity of Sugar. Nor do I use any purging Medicine at set times, during the whole Chalybeat course, for I think the Vertue of the Steel is destroy'd by a purge in hysterical Diseases; and when the chief design is to reduce the Spirits to order, and to renew and confirm their System.

If any one objects that fileings of Steel may hurt those that take them, by sticking in their Bowels, un∣less they are purged now and then; I answer first, that I never found any such thing in any one, and it is much more probable, that being involved in the slime, and with the Excrementious humours of the parts, they should at length pass away with them, than when they are exagitated by purging Medicines, which occasion unusual compressions, twisting and contraction of the guts, whereby the particles of the steel, thrust upon the coats of the Bowels, may penetrate deeper into them. When the patient is in a Steel course, remedies com∣monly call'd Hysterics are to be used, as it were by the by, to comfort the Blood and animal Spirits; in that manner and form, which is most agreeable to the sick. But if she can take them in a solid form, they will more powerfully retain the Spirits in their office and place, than things that are liquid; for the very sub∣stance affects the Stomach longer with its savour, and works more forcibly upon the body, than either deco∣ctions or infusions. Being about to answer all the indi∣cations

I have touched upon above, I use to prescribe these few and common things, which commonly do what I desire. Let eight ounces of blood be taken from the Arm, the next Morning let her enter upon the use of the Pills of Coch. Major and of Castor, as they are mentioned in the Chapter of the Green-Sickness, and let them be repeated, as it is there ordered. Take of Galbanum dissolved in tincture of Castor, and strained three drams, Tachamacha two drams, make a Plai∣ster to be apply'd to the Navel.

Take of black Cherry-water, of Rue-water, and compound Briony-water, each three ounces, of Castor tyed up in a Rag, and hanged in a glass half a dram, of fine Sugar a sufficient quantity, make a Julep, where∣of let her take four or five spoonfuls when she is faint, dropping into the first Dose, if the Fit is violent, twen∣ty drops of Spirit of Harts-horn.

After the Purging Pills are taken, let her use the o∣ther Pills made of fileings of Steel and extract of Worm∣wood, mentioned in the Chapter of the Green-sickness, according to the directions there set down; or she may take the Bolus there mention'd, if she likes a Bolus better than Pills.

Take of choice Myrrh and Galbanum, each one dram and an half, of Castor fifteen grains, with a suf∣ficient quantity of Peruvian Balsome, make twelve Pills of every dram; let her take three every Night, and drink upon them three or four spoonfuls of compound Briony-water thro' the whole Course of this process.

But if the Pills last prescribed move the Belly, which sometimes happens in Bodies that are very easily pur∣ged, by reason of the Gum that is in them, the fol∣lowing are to be used.

Take of Castor one dram, of volatile Salt, Amber, half a dram, with a sufficient quantity of extract of Rue,

make 24 small Pills, let her take three every Night.

But it is to be noted that Steel Medicines in what∣soever form or Dose they are taken, occasion some∣times in Women great disorders both of Body and Mind, and that not only on the first days, which is u∣sual almost in every body, but also almost all the time they are taken; in this case the use of Steel must not presently be interrupted at those times, but Laudanum must be given every night for some time in some hy∣steric water, that they may the better bear it; but when the symptoms are mild, and it seems that the bu∣siness may be done without taking steel, I think it suf∣ficient to bleed, and to purge three or four times, and then to give the altering hysteric Pills above-mention∣ed, Morning and Evening for ten days.

It is to be noted that some Women do so abhor hy∣steric Medicines, that they are much injured thereby, therefore they must not be given to such.

If the blood is so very feeble, and the confusion of the Spirits so great, that steel ordered to be us'd, ac∣cording to the method prescribed, is not sufficient to cure the disease, the Patient must drink some mineral waters impregnated with the Iron Mine, such as are Tunbridge, and some others lately found out. But this is more especially to be observed in drinking of them, viz. That if any Sickness happens, that is to be refer'd to hysteric symptoms, in this Case the Pa∣tient must forbear drinking them a day or two, 'till that symptom that hindered their passage is quite gone.

But if the Disease by reason of its obstinacy will not yield to steel-waters, the Patient must go to the Bath; and when she has used these waters inwardly three Mornings following, the next day let her go into the Bath, and the day following let her drink them again; and so let her do by turns for two whole Months.

Venice Treacle alone, if it be used often, and a long while, is a great remedy in this Disease.

Spanish Wine medicated with Gentian, Angelica, Wormwood, Centaury, the yellow rind of Oranges, and other Corroboratives infus'd in it, does a great deal of good, some spoonfuls of it being taken thrice a day, if the woman be not of a thin and cholerick ha∣bit of Body.

The Peruvian-Bark also wonderfully comforts and invigorates the Blood and Spirits, a Scruple being ta∣ken Morning and Evening. But if any of the Reme∣dies above-mention'd do not well agree, which often happens in cholerick and thin Constitutions, then a Milk Diet may be used; but nothing does so much strengthen the Blood and Spirits, as riding much on Horseback every day for a long while. If the Disease be such, or so great a one, that it will not bear a truce 'till it may be cured with Medicines that corro∣borate the Blood and Spirits, we must presently make use of hysteric Remedies, as Assa-faetida, Galbanum, Castor, Spirit of Sal-Armoniack, and whatever else has a filthy and ungrateful smell.

To conclude, if some intolerable pain accompanies this Disease, or if their be violent Vomitings, or a Loosness, then besides hysteric Medicines above-men∣tioned, Laudanum must be used, which is only able to restrain these symptoms. But in quieting these pains which vomiting occasions, we must take great care that they are not mitigated, either by Laudanum, or any other Paregorick, before due evacuations have been made, unless they almost exceed all humane patience; but if the Sick has vomited a great while, you must give Laudanum without delay, and such a dose as is not only equal to the violence and duration of the symp∣tom, but such an one as is sufficient to vanquish it.