A general treatise of the diseases of maids, bigbellied women, child-bed-women, and widows together with the best methods of preventing or curing the same / by J. Pechey ...

A General TREATISE OF Womens Diseases.

CHAP. I.

Of the Hysteric Disease.

THIS Disease proceeds from a weakness and confusion of the Spirits, and is not only very frequent, but also so wonder∣fully various, that it resembles almost all Diseases Mankind is subject to: For af∣ter hard Labour, or some great disturbance of the Mind, it occasions an Apoplexy, which ends in a Palsie of half the Body. Sometimes it produces violent Convulsions very like the Falling-Sickness, and these are common∣ly call'd Mother-fits. Sometimes it posses∣ses the outward part of the head, causing

violent pain continually fixt in one part, which may be cover'd with the top of the Thumb, and violent Vomiting accompa∣nies this pain. It also occasions sometimes a great Palpitation of the Heart, and sometimes the Woman coughs without in∣termission, but spits up nothing. Some∣times rushing violently upon the region under the Heart, it causes violent pain much like the twisting of the Guts, and the Woman Vomits exceedingly, and casts up a green Matter, and sometimes Matter of an unusual Colour; and often after the Sick have been almost destroy'd by the said pain, and the reachings to Vomit, it is at length carried off by the Jaundice tinctur∣ing the surface of the Body like Saffron. The Sick is much dejected, and Despair as certainly accompanies this kind of Hyster∣ic Disease, as the Pain and Vomiting a∣bove mention'd. When this Disease falls upon one of the Kidnies, it plainly repre∣sents by the pain it causes there a fit of the Stone; and it is difficult to distinguish it from the Stone, unless perchance some un∣lucky accident disturbing the Womans mind a little before she was taken ill, shews that it was an Hysteric Disease. Nor is the Bladder free from this false Symptom; for it does not only cause pain there, but it also stops the Urin. Sometimes falling

upon the Stomach it causes continual Vo∣miting, and sometimes a Loosness when it is settled upon the Guts, but no pain ac∣companies either of these Symptoms.

And as this Disease afflicts almost all the inward parts, so sometimes it seizes all the outward parts, occasioning pain, and some∣times a Swelling in the Jaws, Shoulders, Hands, Thighs, Legs; but the Swelling of the Legs is plainer seen than the rest, and contrary to Swellings in the Dropsie, is most in the Morning; nor being pressed does it leave a pit, and most commonly it swells only one of the Legs. Nor can the Teeth free themselves from the assaults of this Disease, tho they are not hollow; and tho there is no apparent Defluction, that may occasion the pain, yet it is no whit gentler nor shorter nor easier Cured. But the pain of the Back is most common, which most certainly all feel, how little soever they are afflicted with this Disease. Moreover this is common to the foresaid pains, that the place whereon they were, is tender and akes as if it were soundly bea∣ten, but this tenderness goes off by de∣grees. And this is worth observing, that often a notable coldness of the outward parts makes way for these Symptoms, which for the most part does not go off till the fit ends; which coldness is almost

like that wherewith a Carcass grows stiff, yet the Pulse is good. Moreover all Hy∣steric Women complain of a dejection and sinking of the Spirits, and sometimes laugh excessively, and at other times cry as much, without any real cause for either. But the most proper and almost insepara∣ble Symptom, is a Urin as clear as Rock-water. Sometimes ill fumes are belched up, and sometimes the Wind that comes from the Stomach is sower just like Vine∣gar: But their Minds are more affected than their Bodies; for an incurable Despe∣ration is mixt with the very nature of the Disease.

A day would scarce be sufficient to reck∣on up all the Symptoms belonging to this Disease, and I think Demetrius reckn'd pretty right, tho he mistook the cause of the Disease, when he said, in an Epistle to Hippocrates, that the Womb was the cause of Six hundred Miseries and of in∣numerable Calamities. The external cau∣ses of this Disease are either violent moti∣ons of the Body, or which is much oftner, vehement disturbances of the Mind; to these disorders of the Mind which are usu∣ally the occasion of this Disease, is to be added emptiness of the Stomach by reason of long fasting, inmmoderate Bleeding, a Vomit or Purge that works too much.

In order to the cure, I order that eight Ounces of Blood be taken from the right Arm, and that the following Plaister be apply'd to the Navel.

Take of Galbanum dissolved in Tincture of Castor and strain'd three Drachms, of Tacama∣haca two Drams, mix them, make a Plaister.

The next Morning let her use the fol∣lowing Pills.

Take of the Pill Coch-major two Scruples, of Castor powder'd two Grains, of Peruvian Balsam four drops, make four Pills; let her take them at five in the Morning, and sleep after; repeat them twice or thrice, every Morn∣ing, or every other Morning, according to the Womans strength, and as they work.

Take of the Waters of Black-Cherries, Rhue, and Compound Briony, each three Ounces; of Castor ty'd up in a rag, and hanged in the Viol half a Dram; of Fine Sugar a Sufficient quan∣tity, make a Julep, whereof let her take four or five Spoonfulls when she is faint, dropping into the first dose, if the fit is violent, twenty drops of the Spirit of Harts-horn.

After the Purging Pills just described are taken, let her use the following.

Take of the filings of Steel eight Grains, with a sufficient quantity of extract of Worm∣wood, make two Pills, let her take them early in the Morning, and at five in the Afternoon, for Thirty days, drinking upon them a

draught of Wormwood Wine. Or if she like a Bolus better;

Take of the Conserves of Roman Wormwood, and of the yellow peel of Oranges each one Ounce, of Angelica and Nutmegs candied and of Venice Treacle each half an Ounce, of can∣died Ginger two Drachms, make an electuary with a sufficient quantity of Syrup of Oranges.

Take of this electuary one Drachm and an half, of the filings of Steel well rub'd eight Grains, make a Bolus with a sufficient quanti∣ty of Syrup of Oranges, to be taken in the Morning, and at five in the Evening, drink∣ing upon it a Glass of Wormwood-wine.

Take of choice Myrrh and Galbanum each one Drachm and an half, of Castor fifteen Grains, with a sufficient quantity of Balsam Peru, make twelve Pills of every Drachm; let her take three every Night, and drink upon them three or four Spoonfuls of Compound Briony Water through the whole course of this process.

But if these Pills move the Body, which sometimes they do in Bodies that are very easily purged, the following may be used instead of them.

Take of Castor one Drachm, of Volatile Salt of Amber half a Drachm, with a sufficient quan∣tity of extract of Rue, make twenty-four small Pills, let her take three every Night.

But Steel Medicines, which must be noted, occasion sometimes in Women great dis∣orders

both of Body and Mind, and not only on the first days, which is usual almost in every body, but also all the time they are taken: In this case the use of Steel must not presently be interrupted, but Lauda∣num must be given every night for some time in some Hysteric water that they may the better bear it.

But when the Symptoms are mild, and it seems the business may be done with∣out Steel, I think it sufficient to Bleed and to Purge three or four times, and then to give the altering Hysteric Pills above-men∣tioned morning and evening for ten days, which method seldom fails, when the Dis∣ease is not violent, yea the Pills alone Bleeding and Purging being omitted, do of∣ten a great deal of good.

But some Women can't bear Hysteric Medicines, and 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 used according to the method prescribed is not sufficient to cure the Dis∣ease, the Sick must drink Tunbridge-waters or the like, for they cure Diseases more e∣fectually than any preparation of Iron; but if in drinking of them any Sickness happen that belongs to Hysteric Symptoms, the Sick must forbear drinking them a day or

two, till that Symptom that hindred their passage is quite gon. And it is to be noted, that Purging must be avoided all the time the Woman drinks these waters. But if this Disease does not yeild to Steel-waters, the Sick must go to the Bath, and when she has used the waters of it 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 months, for in these and others of what kind soever they are, the Patient must per∣sist in the use of them till she is quite well: Venice-treacle used often and a long time is a great remedy in this Disease. Spanish-wine, with Gentian, Angelica, Worm-wood, Centory, and other strengthening things infus'd in it, does a great deal of good, some spoonfuls of it being taken thrice a day, if the Woman be not thin and of a cholerick habit of Body. And truly a large draught of Spanish-wine taken by it self at bed-time for some nights has been very be∣neficial to some Women. Jesuits-powder also wonderfully comforts and invigorates the Blood and Spirits, a Scruple of it be∣ing taken morning and evening for some weeks.

But if the Remedies above-mentioned don't well agree, which often happens in thin and choleric Constitutions, then a

Milk-dyet may be used, for some Women (which one would wonder at at first) that have been a long while afflicted with Hy∣steric Diseases, and could be relieved no other way, have been recovered by Diet∣ing themselves for some time only with Milk; and especially those that Labour with an Hysteric Cholick, which can't be ap∣peased by any thing but Opiates, to which repeated Women are much accustom'd, the pains returning as soon as the vertue of the Opiate fades. But riding on Horse back or in a Coach every day for a long while is the best remedy.

This is the general way of Curing this Disease, which is apply'd to the original cause, namely, the weak constitution of the Blood, and so is to be used only when the Fit is off, therefore as often as the Fit comes join'd with any one of the fore-said Symptoms, if the Disease be such or so great an one that it will not bear a Truce till it may be cured by Medicines that strengthen the Blood and Spirits, we must presently make use of Hysteric Medicines, which by their strong and offensive smell, recall the disorderly and deserting Spirits to their proper Stations; whether they are taken inwardly or smelt to, or outwardly ap∣ply'd, such are Assa-faetida, Galbanum, Spi∣rit of Sal Armoniac, and lastly whatever

has a very ungrateful and offensive smell.

In the next place you must take notice, that if some intollerable pain accompanied the fit, or violent Vomiting, or a Loos∣ness, then besides the Hysterics above∣mentioned, Laudanum is to be used, which is only able to restrain these Symptomes. But in quieting the pains which Vomiting occasion we must take great care that they are not mitigated either by Laudanum or any other Opiat before due evacuations have been made, unless they exceed almost all humane patience. Therefore in lusty Women and such as abound with Blood a Vein must be opened, and the Body purged, especially if they have been lately seized with the fit. But if weak Women and those of a quite contrary Constitution labour with such a fit and pain, and have been afflicted with it not long ago, it will be sufficient to cleanse their Stomachs with a gallon of Pos∣set drink taken in and ejected by Vomiting, and then to give a large Dose of Venice-Treacle, and a few spoonfuls of some Spi∣rituous Liquor, that is pleasing to the taste, with a few drops of Liquid Laudanum, to be taken presently after. But if the Sick has Vomited a great while, and there is danger lest by a further provocation by Vomits the Spirits should be put into a rage, and the Sick too much weakened, in this

case you must give Laudanum without de∣lay, and such a Dose that is sufficient to vanquish it.

But here two things are to be chiefly no∣ted, first that when you have once begun to use Laudanum after due and necessary evacuations, it must be taken in the same Dose, and must be often repeated till the Symptom is quite conquered: only such a space must be betwixt each Dose, that we may know what the former has done, be∣fore we give another: and then when we treat the Disease with Laudanum, we must do nothing else, and nothing must be eva∣cuated, for the gentlest Glister of milk and sugar is sufficient to spoil whatever has been repaired by the Laudanum, and to oc∣casion a return of the Vomiting and pain. But though the Pains above mentioned are apt to overcome the vertue of the Lauda∣num, yet violent Vomiting indicats the lar∣gest Dose of it, and that it should be very of∣ten repeated, for by reason of the Vomiting, the Laudanum is cast up before it can do any good, unless it be given afresh after every time the Sick Vomits, and chiefly in a solid form, and if it be given in a liquor the quantity must be so small that it must but just wet the Stomach, so that by reason of the small quantity of the matter it can∣not be cast up, for instance, some drops

of Liquid Laudanum in one spoonful of strong Cinnamon-water, or the like; and the Sick must be admonished to keep her self quiet presently after taking the Laudanum, and that she keep her Head as much as is possible immoveable, for the smallest moti∣on of the Head provokes Vomiting more than any thing else; and when the Vomit∣ing ceases, and is as it were tam'd, it is ex∣pedient to give a Dose of Laudanum morn∣ing and evening to prevent a relapse, which also ought to be observed after a Loosness, or Hysteric pains.

And because frequent mention has been made of Liquid Laudanum in this Chapter, and it is much used in other Diseases Wo∣men are subject to, I will here set down the best way of making it.

Take of Spanish-wine one pint, of Opium two ounces, of Saffron one ounce, of the Powders of Cinnamon and Cloves each one Drachm; let them be infused together in a Bath for two or three days, till the liquor comes to the consistence of a thin Syrup; strain it and keep it for use. The Dose is sixteen or twenty Drops, to be taken in a small draught of Beer, or in some distilled-water.

CHAP. II.

Of the Green-Sickness.

THE Green-sickness is an ill habit of the Body proceeding from Obstructions, it is accompanied most commonly with a beating of the Heart, difficulty of breath∣ing, and a longing for absurd things, and an unfitness for motion, and other Sym∣toms; the Face and whole Body are pale, and sometimes of a leaden and green colour, there is an inflation, and as it were a swel∣ling upon the Eye-lids; the Legs also swell, especially about the Ankles; there is a hea∣vy and often a lasting pain of the Head, the Pulse is quick, the Sick are drowsie, and have an aversion for wholsome food; lastly, the Disease increasing and the Obstructions being multiplied, a suppression of the Courses at length follows, which shews the Disease is confirmed.

This Disease most commonly is not dan∣gerous, but if it be neglected too much, it occasions great Diseases, as hard Swellings, a Dropsie, and other grievous Diseases, which at length kill the Patient.

When the Disease is small and chiefly a∣rises from Obstructions of the veins of the Womb, it is easily cured by Marriage in

young Virgins. Those that have had this Disease a long while are either Barren, or bring forth Children that are Sickly and short lived.

The Cure is to be perform'd by the same Method and Medicines proposed in the fore∣going Chapter for the cure of the Hysteric Diseases.

CHAP. III.

Of Women that never had their Courses.

THE flux of the Courses is an undoub∣ted sign that a Woman is mature, yet there are some Women that never had them, tho' they have had conversation with their Husbands, and some of them have had Children, and others not; some of them have enjoyed good health, and others have been sickly: the cause of this defect is in general two-fold, the first is common to the whole Body, namely, because a Wo∣man is fleshy, laborious, and her parts are so disposed that every Member takes up and expels what is convenient for it, so that there is no room for a menstruous pur∣gation, these are of a hot Constitution and such as are termed Virago's, they are of a

brown Colour, of a compact Body, and their Loins and Buttocks are large, so are the Breasts and Shoulders, they have a great voice, are strong and hairy, and this Con∣stitution tho' it be the reason that Women are in health, yet it is contrary to their Sex, and the Course of Nature; and there∣fore to be accounted vitious. But other Women are sickly upon this account.

If this Disease proceed from an hot In∣temperies of the Womb, it may be known by a great pain in the part, and by the heat of the whole Belly: a dry Imtempe∣ries may be known by long Fevers going be∣fore, and a thin habit of Body, but in time they grow Gross and Cachectical by reason of the want of this evacuation. If it pro∣ceed from an ill Formation, there are swel∣lings of the Belly, pain and a weight.

If it arise from a hot Intemperies, as it doth most commonly, it must be Cured by four kinds of Remedies, first by cooling Diet, they must eat Chicken, Veal, or the Broth wherein hath been boiled cooling Herbs, as Endive, Sorrel, Lettice, Spi∣nage, and the like; Oranges are also good, and roasted Apples, and stewed Prunes; their Drink must be small Beer; their Sleep and Exercise must be moderate; for violent Exercise and frequent walking are plainly injurious, and so are disturbances of the

Mind. Secondly they must Bleed twice or thrice a Year in the Foot, and for some days they must take such things as are pro∣per to qualifie the hot and bilious Humours, as the waters and syrups of Purslain, Succory Endive, Violets, and the like, and let them be Purged with the following Medicines.

Take of the best Rhubarb two Scruples, infuse it a whole night in four ounces of Endive water, strain it in the morning, and add to it an ounce of Manna, or of the pulp of Cassia, and an ounce of syrup of Roses solutive.

Thirdly, let them use such things as lei∣surely attemperate the heat of the Hu∣mours and Part; as Conserve of Roses, or of Violets, with Endive-water, or a Ptisan before Meals, or Goats-milk in the morn∣ing with the flowers of Violets and Borrage: But the use of Cooling Apozems is much praised in this Case.

Take of cleansed Barly three pugils, of the Roots of Borrage and Succory, each Ounce, of the leaves of Burrage, Succory, Endive, Fumi∣tory and Sorrel, each one Handfull, of the Cordi∣al Flowers, and of the Cold Seeds, each one Pu∣gil, of Anniseeds one Dram, of Prunes Twelve, of Raisons one Ounce; Boyl them in a sufficient quantity of Water to one Pint and an Half; to the strained Liquor add a sufficient quantity of Sugar, make a clear Apozem, aromatize it with a Drachm of the Species of the three Sanders.

But if you intend to have it Purge a little, add towards the latter end the Leaves of Senna, and of the Pulp of Tamarinds, each one Ounce, and after it is boyled, three Ounces of Syrup of Roses solutive, or of Succory with Rhubarb▪

Fourthly, Topicks must be applied to the lower part of the Belly.

Take of Oyl of sweet Almonds (washed with the Waters of Barly, Gourds, and Roses, each a like quantity) one Drachm of Hens-fat, But∣ter, and Goats-milk, each half an Ounce, of the Juice of Gourds, Endive or Violets, each six Drachms, with Wax make a Liniment, Oynt∣ment or Plaister, as the Woman likes best. But it will do most good, if the Part be Fomented before with a Decoction of Lettice, Violets, Marsh-mallows, Fumitory, Mallows, and the like; and to open the Passages, add the Leaves of Maiden-hair, Mercury and Mugwort▪ a Bath may be also made of these.

Night Glisters also wonderfully Cool the Womb and the whole Body.

Take of Chicken-broath altered with the fore∣said Herbs six Ounces, of the Oyl of Sweet-almonds and Violets, each two Ounces, of Sug∣gar one Ounce, Yolks of Eggs two, mingle them, let it be retained, if she can all the Night; and when the Heat is very much, stuff the Chicken for this Decoction with Conserve of Roses.

If the Disease proceed from Dryness, it must be Cured with moistning Meats of

good Nourishment, and with Drinks; and the Woman must walk often, but not so much as to tire her self, and Frictions must be used above the region of the Womb, that the parts may be dilated so that the menstruous Blood may be allured to the Womb. Baths are also proper, and Oynt∣ments made of mucilages of the Seeds of Psyllium and Quinces and the like; and Glysters also do good.

Take of the Decoction of Marsh-mallows, Mallows, and Violets six Ounces, of fresh Butter three Ounces, mingle them, make a Glyster.

But all Evacuations must be avoided, for they increase the Dryness.

If the Disease proceeds from an ill For∣mation, Medicines are most commonly un∣profitable; and therefore you must endea∣vour to lessen the Blood, if it abound, or to divert it another way; therefore you must Bleed three or four times a Year in the Arm, or in the Foot, if Blood seem to a∣bound in the Womb. But if the strength of the Woman cannot bear Bleeding, then she must use a thin Diet, and frequent Exer∣cise, and Frictions all over the Body, es∣pecially early in the Morning, for so the Blood may be turned from the Inner Parts to the Outward, and part of it discussed. Baths moderately hot are also good, and

these things may be sufficient for Married Women, which by conversation with their Husbands are somewhat discharged; but they will not be sufficient for Maids and Widows; and therefore it will be necessary to provoke the Hemorrhoids or to open Is∣sues. But if the Disease proceed from ob∣stinate Obstructions, it must be treated as is proposed in the Chapter of the Suppres∣sion of the Courses.

CHAP. IV.

Of the Courses breaking out by places not Natural.

THE Menstruous Flux happens to break out by contrary wayes, upon two accounts; for either Nature providing for the safety of the Womans Body, when she knows there is any Impediment in the Womb, and the Veins of it, that hinder the Blood from passing, seeks another pas∣sage, whereby she may be unburthened, and the health of the Woman preserved; or forgetting the Natural passages, she ei∣ther accustoms her self to another, or wan∣dring about, she sometimes uses this pas∣sage, sometimes that; for in some the men∣struous Blood is discharged by the Mouth,

in others through the Nostrils, by the Eyes and Bloody Tears, by the Dugs and Piles, also by the Fingers and Urine, and some∣times by a Redness in one of the Cheeks, and if there be an Impediment in the Womb, that hinders the passage of the Blood that way, it is better it should flow these ways than not at all, for so says Hippocrates, Menstruis deficientibus sanguinem e naribus erumpere bonum est.

The cause of this Disease is most com∣monly some violent Passion of the Mind, or some great disturbance happening when the Courses are near flowing; it comes also from Obstructions of the Womb, or by reason of violent Pains, and great Diseases of the upper Parts, also from the weakness of them, when the VVomb and lower Parts are strong; for the weak Parts always re∣ceive what the stronger put upon them. It also comes from some external Cause, as by drinking cold Water unseasonably, or by washing the Feet and Legs unseasona∣bly, or by the use of Vinegar, when the Courses are near.

The Scope of the Cure is Two-fold, the First is the Evacuation of the Blood abounding, the other is the Recalling of it to the lower Parts, which is chiefly done by Cooling the upper Parts, and by Heat∣ing, Moistning, and Opening, the lower

Parts; but both may be well answered by Bleeding in the Foot three or four days before the Blood flows, and by applying Cupping-glasses to the Thighs Legs and Hips, sometimes Dry, but most com∣monly with Scarification, and also by provoking the Hemorrhoids, by Frictions, by Walking, by hot Baths natural or artificial; by Fomentations made of open∣ing Herbs, by Unctions, Pessaries, and uterine Glisters. But see more of this in the Chapter of Suppression of the Courses. The two following Remedies are peculi∣arly proper for this Disease, viz. Bleed∣ing in the Foot for several Months at the times we have mentioned, and the Bath-waters wherein the Woman must be Bathed early in the Morning, and must continue a while in them; but this must be noted, that the Waters must not reach above the region of the Liver, and in the mean while the upper Parts must be ••anned.

CHAP. V.

Of the Courses coming before their due time, and of staying longer than they should.

IN many Women the Courses flow before their accustomed time, and sometimes they stay longer than they should; and this anticipation and delay are sometimes orderly and sometimes disorderly. The Causes are either the Vice of the Womb, as the ill Figure of it, or a Solution of the Continuum, and sometimes a hurt on some other account; as a Vitious humour that irritates before the time, by reason of plenty of Blood, or the thinness or sharp∣ness of it; the quantity of humours occa∣sioning it may be known by the dulness of the Body, by the sanguine habit of the Woman, by a sedentary and idle Life, by excess in eating and drinking, or by some other Evacuation stopped or lessened. The Acrimony of the Blood may be known by the Heat, Erosion, and Pain in the Excre∣tion, or by the Vitious habit of the Wo∣mans Body, and the course of her Life foregoing, or by the Diet she was wont to use, and the like. But if it come lea∣surely,

and without pain, the retentive faculty is weak; it may also be occasioned by a blow or fall.

If it proceed by reason of the Loosness, and fault of the retentive faculty, it must be strengthened by proper Remedies; if it come from a plenitude, it must be reme∣died by a sparing Diet and moderate Ex∣ercise, and by taking away so much Blood as is agreeable to the strength in the mid∣dle of the Month, or a little before the Courses flow. Frictions also in the Arms, and in all the upper parts of the Body are proper; the Woman must abstain from Wine, and all Strong-waters, and instead of them Chalybeats must be used; and if these things do not do the business, she must be blooded in the Arm; but if it pro∣ceed from the Acrimony of the Humours, she must eat freely Meat of good nourish∣ment, and must exercise a little, and such Medicines must be used as attemperate the humours, and she must be purg'd, and Uterine Glisters must be injected made of two Ounces of Oyl of Violets, and four Oun∣ces of the Decoction of Mallows; but care must be taken that the Courses be not quite stopped, because it is dangerous. Lastly, if a blow, a fall, or difficult labour occa∣sion this disease, the following Cataplasm must be applied to the Womb and Neigh∣bouring parts.

Take of the Powders of Dragons-blood, Fran∣kincense, Mastich, and of the greater Comfry, each two Drams, with a sufficient quantity of Turpentine make a Cataplasm.

If the Woman be of a hot Constitution, apply the following Plaister.

Take of the Powders of Roses, Myrtles, and Balaustins, and Mastich, each one Drahom, of fine Flour one Ounce, with the Whites of Eggs make a Plaister.

The Courses stay beyond their time by reason of age, when they are about to go away, or by a vice of the whole Body or of the womb: If it proceed on the account of age, you must only endeavour to pre∣vent those inconveniences which are wont to follow, especially the Gout, and a pain in the Hip, which may be done by a spare Diet, much exercise, and by bleeding yearly, till Nature has been accustomed to the want of the menstruous Purgation: But if it proceed from a Vice of the whole Body, it must be treated as a suppression of the Courses. If it proceed from a pe∣culiar disorder of the Womb, it requires a peculiar Cure, and is a Symptom of the kind of the vitiated action of Excretion, either because it is hindred by the ill For∣mation, or a gross Humour that Obstructs. The Causes therefore are these three, which are contrary to the anticipation of the

Courses, viz. the weakness of the Faculty, the fault of the Humours, and the dulness of the Sense. The impotence of the Facul∣ty is occasioned by the frigidity, or moi∣sture of the Temperament, or by the de∣praved Figure of the Instrument; the Hu∣mour is faulty upon the account of its thick∣ness, siccity and clamminess: The Sense is rendred dull most commonly by moisture abounding. The weak Faculty by reason of Frigidity, is known by the Womans perceiving a weight and disturbance after the time of the coming of her Courses is past. The fault of the Instrument may be known by what went before, as by hard labour, a tumour, cicatrix, leaping or a fall, whereby the Womb, or a part sub∣servient to it is displaced, or the figure of it deformed. The fault of the Humour may be known by those things that are evacuated by the Blood, as if it be whitish it may be seen, if it be gross and clammy, a sedentary life, and a gross and flegmatic Diet went before; the Woman is of a soft, pale and leaden habit of body, and is fat; and by the Bloods flowing slowly, and by the long continuance of the Courses sometimes, and by their ending in a slime. If when they stay a long time before they come, the Woman does not perceive any disturb∣ance in the Womb and neighbouring Parts,

the Sense is dull. If the Disease arise from a thick and clammy Humour, as it does most commonly, it must be cured accord∣ing to Galen, with three sorts of Remedies; First, by a thin and heating Diet, by mo∣derate exercise, and frictions of the Legs: Secondly, by attenuating and heating Poti∣ons made of opening Roots of Calaminth, Fennel, Saxifrage, Burnet, Hysop, and the like, Saffron and Cinnamon being ad∣ded to them, and the Cure must be begun presently after the Purgation of the Cour∣ses. Let the Woman take every Morning five or six Ounces of the following Apo∣zem.

Take of the Roots of Smallage, Fennel, and Parsley, each two Ounces, of the Leaves of Feverfew, Cat-mint, Penny-royal, Maiden-hair, each one Handful and an Half, of the Seeds of Anise and Fennel, each one Drachm and an Half; boyl them in a sufficient quan∣tity of Water to a Quart; in the strained Li∣quor dissolve of the Syrups of Mugwort and Maiden-hair, each three Ounces; the Syrup of Hysop, or of the Five Opening Roots made with∣out Vinegar is also very good, being mixed with the Waters of Fennel, Cat-mint, Penny-royal, and Parsley, and other things may be used which are mentioned in the Chapter of the Sup∣pression of the Courses. 3dly, She must be Pur∣ged with Agarick Trochiscated, or with the Pill of Mastick, Or,

Take of the Pills of Agarick, and Aloephar∣gin, each two Scruples, with the Syrup of Mug∣wort; make four Pills.

Fourthly, Those things which draw the the Blood downwards must be used, as bleeding in the Foot three or four days be∣fore the accustomed time of the Courses; these things being done, the Legs and low∣er Belly must be fomented with a decocti∣on of Fenugreek, Camomile, Dill, Meli∣lot, Fennel, Parsly, Daucus. And while she is bathing let her take one of the Tab∣lets called Diacalaminth; afterwards let the Parts be fumed with Spices, and use Fricti∣ons and Ligatures to the Legs, and let Cupping-glasses be applyed to the Claves of the Legs without scarification; and if the Courses do not yet flow, let the Woman be purged every third day with four or five of the Pills mentioned before. Let the lower Belly be anointed with the Oyls of Capers, White Lillies, Dill, Cinnamon, and Saffron, and let Uterine Glisters be injected made of four Ounces of the De∣coction of Penny-royal, Horse-mint, Thym, and Cresses, with two Ounces of Oyl of Rue, or of Dill, which wonderfully rouze the dull sense of the Womb.

CHAP. VI.

Of the Courses corrupted, or suppurated.

THE Courses may be corrupted four se∣veral ways; First from drawing a putrid quality from the whole Body: Secondly, from the mixture of some putrid humour in the passages: Thirdly, by a long suppression: Fourthly, from an in∣temperies in the Womb, or from an abun∣dance of putrid humours contained in and about it, and are coloured and disordered according to the nature of the humours; they are White, Pale, Livid, Green, Black, Skinny, Fibrous, Membranous, Windy, Fetid, and they have Sand and Worms in them.

The Cure is in a manner the same which is proposed for the Cure of the Whites; for an exact course of Diet being ordered, the Woman must be purged with Agarick trochiscated, or with the Pill of Mastich, if a Phlegmatic humour abounds; if a bi∣lious humour be the cause, let her be pur∣ged with Rhubarb, as

Take of the best Rhubarb, four Scruples, of yellow Myrobalans one Drachm and an Half, infuse them a Night in three Ounces of Succory

Water; to the strained Liquor add of Syrup of Roses Solutive, and of Manna, each one Ounce.

If Melancholy Humours abound,

Take of Senna one Ounce, of the Seeds of An∣nise one Drachm, infuse them in four Ounces of Fumitory-water; to the strained Liquor add of Pulp of Cassia, and of Syrup of Roses Solutive, each one Ounce.

If the Courses are suppurated, such things must be used now and then, as evacute a dust and Cholerick humours, which may be easily prepared with Agarick, Rhubarb, and Senna; and sometimes Glisters must be used, and moderate exercise, which purge the Body and Womb; and if the Stomach abounding with Flegm be the cause, a Vomit used by Intervals is pro∣per, that what is daily heapt up there may be purged off before it enters the Veins.

Thirdly, Such things must be used as are able to eradicate the Disease, and if the Humours are cold and gross, sudorifics must be used, as a Decoction of Sarsapa∣rilla, Guiac, China, and the like. But if Choler or Melancholy be the cause, ba∣thing is most proper; but gentle Frictions and Pessaries are proper for both, and a∣noint the Belly with the Oyl of Sweet Almonds, or with the Oyl of Violets, which

are also to be put up the Womb. But if these things do no good, an Issue must be made in one or both the Arms, which is of excellent use.

CHAP. VII.

Of the Complication of the Courses with other Diseases.

THere is scarce any thing that does di∣sturb Physicians more, and which makes them err so much, as the complica∣tion of the Courses with Diseases; and this happens chiefly six ways. First, When a Disease happens just when the Courses are about to come. Secondly, If by reason of the invasion of a Disease, the Courses come before their due time. Thirdly, If the time of the Courses and of the Disease are complicated, so that they come toge∣ther. Fourthly, If the Courses being sup∣pressed, delayed or lessened, a Disease comes upon them upon an other account. Fifthly, If by reason of a Disease pre-ex∣isting, a suppression or delay of the Cour∣ses is the cause of the increase of the Di∣sease and its Symptoms. Sixthly, If when there is a Disease, the Courses flow.

If therefore the Courses are just about to flow, when the Disease is beginning, or in the process of it, we must consider whether the Disease be one of those, which is occasioned by the Womb, in which case if the Disease requires bleeding without any delay, we must draw it from the foot, that it may be let out by a convenient way, that the Womb may be evacuated, and the cause expelled. But if the Di∣sease arises from the whole Body, or from some principal member of it; that Vein of the Arm (most affirm) must be opened, which chiefly respects the part affected: but this opinion, if it be generally received, seems to me injurious, and we ought rather to distinguish concerning the number of the days, the acuteness of the Disease, and the plenitude of the Body; for if the Di∣sease be not acute, Blood ought to be drawn from the Foot, and especially, if the Woman be within three or four days of her Courses, and in this case she ought to be blooded in the Foot, although the Di∣sease be acute, and this both reason and experience confirms; for Nature is to be evacuated that way she tends, if it be a convenient place; for if the Woman be blooded in the upper parts, we often see that she becomes delirious, and that watch∣ings, sleepy Diseases, difficulty of Breath∣ing,

and at length Death it self follow. But if there be eight days, or thereabouts, be∣fore the time of the Courses, and there is a great plenitude, and the Woman cannot be so sufficiently evacuated by the Foot, as the Disease requires, then all agree that she must be blooded in the Arm, especi∣ally if the Disease be acute; but purging Medicines, Vomits, and Sudorisicks must be deferred till the Courses are over, or you must use those that are very gentle, lest Nature should be hindred, or divert∣ed; for if so, the Blood may be unseaso∣nably detained, or may rush upon some principal part, or increase the Disease. But if it happen that the Womans Cour∣ses are procrastinated, it is lawful to Purge; for sometimes we see that Purg∣ing brings the Courses. If the Disease be Chronical, it is best to Purge eight days after the Courses are gon off.

But if the Courses come before their due time in Diseases, which is the second way of complication, nothing in curing Womens Diseases is so difficult and dan∣gerous, especially at the beginning of the Disease, before universal Remedies have been given; for at other times if we do nothing, there is the less perplexity; but if at the beginning you Bleed or Purge, you hinder the menstruous Purgation, and if

you do neither, the Disease increases. Those things that are proper for the Di∣sease, stop the Courses; and if they flow, they do not relieve the Disease, because they are then Symptomatical; for such an evacuation, is almost always pernicious at the beginning of the Disease, for Na∣ture at that time seldom promotes any useful evacuation; wherefore we must diligently consider what good or hurt comes from it, and from what cause the anticipation of the Courses in Diseases proceeds; for in the beginning and in the increase, as we said, it is full of danger, but in the state and declination, the crup∣tion of the Courses, if they flow easily, is wont to be advantageous, by reason of the fitness of the Season for evacuation, if it be not complicated with some other eva∣cuations of Nature. The Anticipation of the Courses proceeds from many causes: but from whatever cause it come, if there be a plenitude, the Cure must be begun by bleeding in the Foot. But if the Cour∣ses flow at their accustomed time, and hap∣pen to come at the beginning of the Di∣sease, you must first wait on Nature, and if after twelve hours the Flux is not, or is not like to be sufficient, you must bleed in the Foot, to compleat the natural eva∣cuation of the Woman; and moreover,

you must take away so much Blood, as the Disease requires, for we must respect Custom and the Disease too, and this may be understood of violent Diseases; yet it is chiefly to be used in small ones; and therefore that they should not grow to be violent, you must incourage the Courses by all means, by Ligatures, Frictions, Sup∣positories, Glisters, and other things, which are sufficient to provoke the parts near the Womb; and if the Disease arise from a cold cause, you must give such Medicines as promote the Courses, and also respect the Disease: But if a Purge be necessary, you must defer it till the Courses are over, lest the Blood being moved and disturbed thereby, greater mischief should be occa∣sioned.

But if the Disease be one of the greatest, as a Quinsey, Frensy, Plurisie, or an acute Fever, you must first bleed in the Foot, afterwards the same day, you must bleed in the Arm; but in the mean while you must apply Ligatures to the Legs whilst the Blood flows, and this is good Practice; for the Indication of the most violent Di∣sease is always to be respected before that Indication which is taken from the Cour∣ses, and in the same manner you must pro∣ceed in the other Seasons of the Disease, wherein you ought to defer Purging, Vo∣miting

and Sweat, if the Disease requires them, till the Courses are gone off; for the Indication of the Courses is greater than the Indications of these helps, unless a Sanies flow beyond the appointed time, which is not to be accounted at that time to proceed from fulness, and in this case, an Indication for purging being urgent, you may Purge.

The Fourth Case was, when upon the Courses stopt a Disease came. In this case we must first consider whether the Courses are but now stopt, or whether they have been stopt a long while; and moreover, whether the Disease proceeds from this suppression; for if it arise from hence, you must without doubt bleed in the Foot first, nor must we Purge, Vomit, or Sweat be∣fore; and afterwards in the Arm, if the Disease require it, especially if it be four days past the accustomed time of the Cour∣ses. But if the suppression be new, and the Disease not urgent, before you use other means, you must expect a while the flowing of the Courses, especially if you do not understand rightly the nature of the Disease; for it is more secure, the Courses being stopt to bleed in the Foot than to Purge, Vomit, or Sweat. But if notwithstanding bleeding in the Foot, the Courses flow but slowly, you ought to

give such Medicines as move them; and it will be proper to give them before they begin, if you suspect that Nature will not do the business throughly her self.

But if the Courses delay, and the Disease grows worse thereby, most affirm that the Cure must be begun by those helps, which the Disease and its Cause require, without respect to bleeding in the Foot. But I am not of the same Opinion; for in slight Dis∣eases, and in such as will bear a Truce, ex∣perience has taught me that it is best to bleed in the Foot; for the indication from the Courses stopt is more to be minded than a small Disease, and therefore they ought to be provoked, first by Ligatures, Cup∣ping-glasses, Frictions, and Medicines, and afterwards you must provide for the Dis∣ease: But if the Disease be violent, as a Quinsie, Pleurisie, or the like; then cer∣tainly those Remedies must be given which the Disease requires, without considerati∣on of the Veins of the Foot.

But when the Courses should come at the time of the Disease, and are stopt, by rea∣son of the Disease and its Cause, without doubt we ought to bleed in the Foot, and to take away so much Blood, as the pleni∣tude of the Womb requires, or till the Courses flow, and if there be occasion we may Purge gently, and not divert the

Course of Nature. Lastly, if when the Disease is present, the Courses flow by drops before their time, you must proceed as in the second Case concerning the Anticipati∣on of the Courses in Diseases: Or, if it happen at their due time, you must treat them as in the third Case when the Courses happen with the Seasons of the Disease; only the dropping of the Courses signifies a greater oppression of Nature, and there∣fore requires larger bleeding.

CHAP. VIII.

Of the Courses coming difficulty, and with violent Symptoms.

THis Disease is like a Dysury or adifficul∣ty of Urine, for it is accompanied with Pain and a great disturbance, the Symptoms often come before the Courses, and some∣times with the Courses; the Blood comes by drops and is attended with violent Pain. This Symptom comes upon an Obstruction of the Courses, sometimes upon Solution of the Continuum, an Ulcer, Erosion, and painful disorders in the neighbouring parts, The Courses, as was said before, come some∣times drop by drop, and sometimes plenti∣fully;

sometimes by intervals, and some∣times continually; sometimes orderly, and sometimes disorderly.

It is most commonly occasioned by the same Causes from whence a suppression of the Courses proceeds, but gentler; for there is not a total Suppression, but an unequal Obstruction of the Vessels of the Womb, by reason of thick clotted, and feculent blood, which stretches the Vessels, and Na∣ture violently endeavouing to Evacuate it, a gross wind arises, which distending the Vessels, and the neighbouring parts, occa∣sions the violent pain, which continues un∣till the clods are ejected. Sometimes the Blood flows plentifully, yet the Courses are counted difficult and lessened; because tho a great quantity is evacuated, yet it is not answerable to the plenitude. The second Cause is an Ulcer, or some preternatural Tumour in the Womb or neighbouring parts, which are provoked and hurt by the commotion of the Blood. The third is the acrimony of the Humours. This Disease is known by a pain in the Head, a pain in the Stomach, Restlesness, pains in the Loins, and of the lower Belly, just like the pains of Child-bearing, coming with the Courses, or eight days before. There is often also fainting and convulsions, and a palpitation of the Heart; and by these you may know,

that the Blood is clotted or thick, and a small swelling is sometimes perceived in one or both of the Groins, by reason of clotted Blood contained in it; and just be∣fore the evacuation of the clotted Blood, the pain is most violent, and at the same time if wind be joined with it, it breaks from the Womb or backwards with a noise, and there are wandring pains about the Loins and Hips. If an Ulcer be the cause, Sanies or Pus is mixed with the Blood, and the Courses flow always with a fixed pain. This Disease afflicts Virgins and those that are Barren. The Cure is two-fold, the first respects the Cause, the second the mitigating the Pain. If it proceed from feculent gross and clotted Blood, a thin Diet and mode∣rate Exercise must be ordered, and Medi∣cines that cause Revulsion and Evacuation, must be used. Blood therefore must be drawn from the Arm if there be a great quantity of it, but if the quantity be small, from the Foot; and the clotted Blood that cannot be evacuated, must be drawn out by Cupping-glasses applied to the Thighs and Legs with Scarification, and by Ligatures upon the Legs, and the Humour may be turned by applying Leeches to the Fundament if the pain continue after the Courses are stopp'd, but they must not be used before.

Secondly, Evacuation must be used with this distinction, when feculent and gru∣mous Blood is the cause, you must Bleed; when an Ulcer, Wind, or an Acrid Matter, you must Purge most.

Thirdly, The Passages must be Relaxed and Opened, and the Pain mitigated; wherefore, if the matter be thick, slatulent, feculent, or clammy; a Dram of Venice Treacle, or of Mithridate must be taken at Bed-time in three Ounces of Balm-water; and Baths must be provided, and Lotions for the Legs made of a Decoction of Marsh-mallows, of the Seeds of Flax, Fenugreek, Dill, Rhue, and Mugwort, and the Feet must be bathed in it hot a while, and the vapours must be received, and a Spunge dipt in it must be applyed to the Privities, and the lower Belly must be Fomented after∣wards with Flannel dipt in Wine and Oyl of Roses, or with a Bladder half full of warm Oyl; but it will be better to anoint the Navel, and the region below it with Oyl of Saffron, of White-lillies, the Seeds of Flax, of Capers, of Yolks of Eggs, or of sweet Almonds, among which or with one of them must be dissolved a Drachm of Treacle, a Pessary dipt in the same is also is of great use; or the foresaid Parts may be annointed with Hens-fat and Butter; or with Butter and some of the foresaid Oyls.

The following Oyntment is also very pro∣per.

Take of the juice of Angelica one Drachm, of Oyls of Capers and of White-lilies, each one Ounce and an half, of White-wine half an Ounce, with Wax make an Oyntment.

The following Cataplasm is also very good.

Take of common Oyl, of sweet Wine, and fresh Butter, each two Ounces, of Bran three Ounces; boyl them gently, apply them hot and repeat them frequently.

But if acrid and eroding Matter be the cause you must use gentle Oyntments, and Fomentation of warm Water, or Purslain and Lettice Water with Emulsions of the cold Seeds; and the Parts must be anointed with the Oils of sweet Almonds, of Violets and of Roses.

If the Disease proceeds from an Ulcer, you must endeavour the Cure of it, and you must mitigate the Pain by injecting uterine Glisters made of four Ounces of warm Wa∣ter; and if the heat be very much, the Water must be sweetned with Sugar, and you must add one Drachm of the white Tro∣ches of Rhasis. Or, the Glister may be made with three Ounces of Allum-water, which is of excellent use; or with so much Barly-water with an Ounce of Syrup of Roses; or with Milk-water with Sugar; or

with an Ounce and an half of Milk it self, with the like quantity of a Decoction of the Leaves and Seeds of Plaintain, to which may be added half an Ounce of the emulsion of the cold Seeds; and if the Pain and Heat is very violent, inject two Ounces of the Decoction of Henbane, or white Poppies. But if these things will not do the business, some Opium must be mixed with the De∣coction before mentioned. Lastly, if other remedies will not do the business, an Issue must be opened in the Leg.

CHAP. IX.

Of the Closure of the Womb.

VIrgins labouring under this Disease are said to be Imperforate. This closure is wont to be in three places, viz. in the mouth of the Womb, in the neck of it, and in the Privities. It is occasioned either in the first Formation when a Membrance co∣vers the Orifice of the Womb, or its Neck, or by a Wound, or Ulcer preceding, which growing together stops the Neck of the Womb, or joins the Lips, or it is oc∣casioned by Humours, or a Compression.

If the Closure be in the Privities, it may be easily known, but if it be in the Neck, or Orifice of the Womb, it is not found out till the Courses begin to flow, or till Women are Married; for at the time of the menstruous Purgation, Pains and Gripes are perceived in the region of the Womb at certain times, with a sense of weight, yet no Flux follows. Moreover, you may guess at it, if the Maid be of good habit of Body not Cachetical, and without Obstruction, the Disease continuing the Womb swells, so that Virgins seem to be with Child, and sometimes the whole Body, which looks li∣vid: But if the Neck of the Womb be clo∣sed, it may be known in the first Copualti∣on, because it cannot admit the Virile Mem∣ber. Lastly, if the Orifice of the Womb be shut, it is difficultly known, but it may be found out by the hand of a Skilful Mid∣wife.

As to the prognostick, if the Closure be in the Orifice of the Privities, it is easily Cured by a small Section: But if it be in the inner Parts, the Cure is much more diffi∣cult.

When a Membrane shuts the passage, it is easily Cured, but when the Closure is from fleshy Matter, as it happens after Ulcers, then the Cure is much more difficult.

The Closure of the inner Orifice of the Womb is Incurable, for Chirurgcial In∣struments cannot work upon it.

If the Closure of the Womb be contra∣cted from the Birth, it must be opened by simple Section; but if it takes its rise from an Ulcer, as it often happens in the French-Pox; we must consider, whether it be an Excrescence of Flesh that does not wholly stop the passage; and whether it quite stops For if it be only an Excrescence, we must endeavour (convenient Evacuations going before) first to hinder the increase of the Flesh by drying and discussing Medicines, and afterwards we must lessen the Flesh by Medicines made of Frankincense, Birth∣wort, the Bark of Frankincense, Roses, Ba∣laustins, Mastick, Myrrh, Aloes, and the like; and if these things are not sufficient, we must use burnt Allom, Unguentum, Aegyptiacum, and the like; or the Flesh may be cut off by that Instrument that is used for extirpating a Polipus. But if the Neck of the Womb be wholly shut, we must endeavour to renew the Ulcer, and to take off the superfluous Flesh by the foresaid Medicines, or it must be cut.

If a Tumour shut the passage of the Womb, it must be removed by proper Re∣medies.

If it be occasioned by a Compression of

the Neck of the Womb, that which causes the Compression must be removed, namely, a Stone in the Bladder, a Tumour of the right Gut, or the like.

When the passage is too narrow, it most commonly proceeds from hardness and dry∣ness; and therefore you must use moistning, emollient, and relaxing things; as half Baths, Fomentations, Liniments, and Pes∣saries; and so the part being relaxed, you must put a leaden Pipe, or white Wax fit∣ted for the purpose, moistened with Butter, or some emollient Oyl, and she must always wear it, or at least a-nights; and a-days; let a Pessary made of Cotten be used anointed with Oyntment Marsh-mallows, or the like.

CHAP. X.

Of Suppression of the Courses

THere is said to be a Suppression of the Courses, when in Women of a ma∣ture Age, that neither give suck nor are with Child, the Evacuation of Blood by the Womb, which is Naturally wont to be Monthly, flows seldom, or sparingly, or is wholly stopt.

Because this Suppression proceeds from Natural and Preternatural Causes, the signs of both shall be distinctly proposed, lest the Practitioner should be deceived by Wo∣men being with Child by Illegitimate Coiti∣on, and so rashly prescribe Medicines to provoke the Courses.

First therefore, Women with Child most commonly retain their Natural Co∣lour, and others do not.

Secondly, the Symptoms which do happen to Women with Child at the beginning, abate Daily, but on the contrary in Sup∣pression of the Courses, the longer they are stop'd, so much the more the Symptoms are increased.

Thirdly, In Women with Child after the third Month, the motion and situation of the Child may be sensibly perceived by lay∣ing the hand on the Belly. But in others the Swelling is not at all hard, nor is it always contained within the Limits of the Womb.

Fourthly, If the inward Mouth of the Womb be touched by a Skilful Midwife, she will find it not exactly closed, as it is in Women with Child; but rather hard, con∣tracted, and somewhat painful.

Fifthly, Women with Child are most commonly cheerful; but on the contrary in a Suppression, they are most commonly sorrowful and sad.

A Suppression of the Courses is very dan∣gerous, and many desperate Diseases arise from it.

The Cure of this Disease must be varied according to the variety of the Causes, and first, if it proceed from too great a quanti∣ty of Blood, bleeding must be ordered in the Arm, and a large quantity of Blood must be taken away; afterwards it must be drawn downwards by opening the low∣er Veins about the time the Woman used to have her Courses before she was ill.

If by reason of want of Blood the Courses stop, as after long Fevers, after great E∣vacuations, and when the Body is much wasted, you must not endeavour to provoke the Courses till the Body is replenish'd, and a sufficient quantity of Blood is bred, which being done they generally flow of their own accord; but if it happens that Nature for∣forgets her Office, she must be rous'd up by opening the lower Veins, and by Me∣dicines proposed in the Chapter of Hyste∣rick Diseases: But the quantity of Blood must be moderate, lest the strength should be dejected, and the Sick should fall into a Consumption. yet it must be carefully no∣ted, that every wasting of the Body does not shew a want of Blood, but only that which succeeds great Evacuations, and the like. For sometimes it happens that the

Courses being suppressed and detained in the Veins, occasion an ill quality, whereby the Blood is rendred unfit to nourish the Parts, upon which account the Body wasts, tho the Veins are full of Blood, in which Case large bleeding is required.

As to the suppression of the Courses which happens by a preposterous motion of the Blood, when it is evacuated by bleeding at Nose, by Vomiting, Spitting, or Hemorrhoids, and other parts, the Cure of it is perform'd by repelling the Blood from the parts through which it flows contrary to Nature, and by draw∣ing it back to the passage of the Womb. The first is performed when the Blood rushes out of the upper parts, by washing the Arms, Head, and Face, with cold Wa∣ter, and by forbearing the exercise of those parts, especially singing and speaking aloud. The second is perform'd by open∣ing the lower Veins, three or Four days before the Blood breaks out, and by Cup∣ing-Glasses applied to the Thighs and Legs sometimes with, sometimes without Scarification, by provoking the Hemorr∣hoids, by Running, by Walking, Fomen∣tations, and Baths made of opening Herbs; but the Bath water is especially commend∣ed, and the Sick must bath in them often a good while after Meals, but the water

must not rise above the Navel, and at the same time the upper parts be cool'd by fan∣ning them.

If the Blood flow by the Hemorrhoids, the Cure is very difficult; for if you use things to draw downwards, they bring them also to the Fundament, and if you use astringent things to it, they by near∣ness of the parts, repell what should be brought to the Womb; so that the only way of Cure is to apply such things to the Womb as may allure the Blood thither, after you have used such things as draw the Blood downwards.

CHAP. XI.

Of an Immoderate Flux of the Courses.

AN immoderate Flux of the Courses comes either in Child-bed, or at o∣ther times, as to the first that afflicts Wo∣men most on the first day after a difficult Labour, and is accompanied with a long train of Hysteric Symptoms; and as it hap∣pens only on the first days so usually does not last long, for if a thickning diet be or∣der'd, it soon abates: The following Drink may be also used.

Take of Plantain water and Red wine, each one Pint, boil them till a third part be consumed, sweeten it with a sufficient quantity of white Sugar, and let her take half a pint twice or thrice a day, and in the mean while the follow∣ing Medicine tyed up in a rag, may be often held to her Nose.

Take of Galbanum and Assa foetida each two Drams, of Castor one Dram and half, of Volatile Salt of Amber half a Dram, mingle them: Or instead of it, Spirit of Sal armoniac may be used.

But as to the Flux which happens out of Child-bed, you must bleed in the Arm, and eight Ounces of Blood must be taken away, the next Morning the following Purge must be given.

Take of Tamarinds half an Ounce, of Sena two Drams, of Rubarb one Dram and an half, infuse them in a sufficient quantity of Fountain water, in three Ounces of the strain'd Liquor, disolve of Manna, and Syrup of Roses solutive each, an Ounce, make a Purging Potion, which is to be repeated every third day for twice. Every Night at bedtime through the whole course of the Disease give an Ounce of Dia∣codium mixt with two Ounces of Black Cher∣ry water.

Take of the Conserve of dried Roses two Ounces, of the Troches of Lemnian Earth a Dram and an half, of Pomgranate peel and of

red Coral prepared each two Scruples, of Blood Stone, Dragons Blood, and Bole-armenic each two Scruples, with a sufficient quantity of Sim∣ple Syrup of Coral, make an Electuary, where∣of let her take the quantity of a large Nutmeg in the Morning, and at five in the Afternoon, drinking upon it six Spoonfuls of the following Julip.

Take of the waters of Oakbuds and of Plan∣tain each three Ounces, of Cinnamon water hordeated and of Syrup of dried Roses each one Ounce, of Spirit of Vitriol a sufficient quan∣tity to make it pleasantly acid.

Take of the Leaves of Plantain and Nettles each a sufficient quantity, beat them together in a Marble Mortar, and press out the juice, clarifie it, and give six Spoonfuls of it cold three or four times in a day; after the first Purge apply the following Plaister to the region of the Loins.

Take of the Plasters of Diapalma and ad herniam each equal parts, mix them and spread them on Leather.

A cooling and thickening Diet must be order'd, only it may be proper to allow once or twice a day a small glass of Claret to recover the strength.

CHAP. XII.

Of the Whites.

THis obstinate and lasting Disease may be cured by bleeding once, and by Purging with two Scruples of Pill Coch-Major four times, and by the following strengthening Medicines.

Take of Venice Treacle one Ounce and an half, of the Conserve of the Yellow Peel of Oranges one Ounce, of Diascordium half an Ounce, of Ginger candied, and Nutmegs can∣died each three Drams, of compound Powder of Crabs eyes one Dram and an half, of the out∣ward Peel of Pomgranats, of the roots of Spa∣nish Angelica, and of the troches of Lemnian Earth each one Dram, of Bole-Armenic two Scruples, of Gun-arabic half a Dram, with a sufficient quantity of Syrup of dried Roses make an Electuary, whereof let her take the quantity of a large Nutmeg in the Morning, and at five in the Afternoon, and at Night, drinking upon it six Spoonfuls of the following infusion.

Take of the roots of Elecampane, Master∣wort, Angelica, and Gentian, each half an Ounce, of the Leaves of Roman Wormwood, white Horehound, the lesser Centory and Ca∣laminth

each one handful, of Juniper-berries one Ounce, cut them small, and infuse them in five pints of Canary Wine, let them stand in infusion, and strain them only as you use them.

CHAP. XIII.

Of Barrenness.

BArrenness proceeds from many causes, but they may be reduced to four Heads, according to the four Natural Operations which are required to perfect Conception. The first is that the Woman in Copulati∣on receive the Mans seed: Secondly, that it's retain'd a due time: Thirdly, that it is nourished in the Womb: Fourthly, that the Woman afford due Matter for the forming and necessary increase of the Em∣broy; and hence four impediments of Con∣ception arise.

First, The Reception of the Seed is hin∣dered by many causes, as immature Age, when by reason of the narrowness of the Genital passages the Woman cannot admit the Mans Yard, or at least not without great pain, which makes her dislike Co∣pulation; and Old Age has the same effect;

for in elderly Virgins the Genital parts for want of use, are rendr'd so strait, that they can't easily receive the virile Member, and such as are lame, or have their Limbs distorted, or their Hips depressed, can scarce lye in such a posture as is necessary for a fit Reception of the Seed; too much fat also stops the passages, and makes the Copulation incommodious: And lastly, a cold intemperies of the Womb makes the Woman dull, so that she scarce injoys any pleasure in Copula∣tion, or is so flowly moved, that the in∣ward Orifice of the Womb does not open seasonably to receive the Mans Seed. The Passions of the Mind also are a great hin∣derance, especially hatred between Man and Wife, whereby the Woman having an aversion for such pleasure does not supply Spirits sufficient to make the Genital parts turgent at the time of Co∣pulation; nor does the Womb kindly meet the Seed, and draw it into its Cavity, from whence and from mixture of both the Seeds, Conception arises.

The Reception of the Seed may be also hinder'd by Swellings, Ulcers, Obstructi∣ons, Narrowness or Distorsions of the Ge∣nital parts, or of the Neighbouring parts, or by a stone in the Bladder or the like.

Conception may be also hindred by rea∣son

the Seed is not retained upon the ac∣count of too great moisture of the Womb, namely when its fill'd with many excremen∣titious humours, whereby being render'd too laxe it cannot be contracted, as it ought to retain the Seed received, but this chiefly happens by reason of miscarriage or hard labour, whereby the Fibres of the Womb and its inner Orifice are torn, but the Whites are the most common cause of Barrenness.

Conception is also hindred when the Seed is not sufficiently nourished in the Womb, as when the Intemperies of the Womb is so very cold, that it extingui∣shes the Seed, or so hot as that it dis∣sipates it, or over-moist or dry.

The Age fit for Conception is from fourteen to fifty, and therefore those Wo∣men that are younger or older do not con∣ceive, by reason of a defect of Seed and menstruous Blood, yet it must be confessed, that some Women have conceived who never had their Courses.

A disproportion betwixt the Mans and Womans Seed is also the occasion of Bar∣renness, tho there is no sensible defect in either, and it happens sometimes that the same Man has Children by another Wo∣man, and the same Woman Children by another Man, when together they were

Childless. It comes to pass sometimes that after a Woman has conversed ten or more Years with her Husband, and has not conceived, afterwards she has had Chil∣dren, the cause whereof is the change of her Constitution by time.

Having made frequent mention of Wo∣mens Seed, I must here acquaint you that ma∣ny Learned Physicians and Anatomists deny that Women have any Seed, for some Wo∣men send forth no humour as is called Seed, and yet they are Fruitful enough, yea some after they have begun to emit such an hu∣mour, tho indeed they took great pleasure in Copulation, yet grew less fruitful than be∣fore. 'Tis also said by some that a semi∣nal Air or Vapour arising from the Mans Seed, and not the Seed it self causes Con∣ception; but passing by Controversies and nice Speculations, I according to my way of Writing, set down such Methods and Medicines as are approved of for the Cure of this Disease.

And First, the narrowness of the geni∣tal parts by reason of youth, in progress of time will grow large enough, and there∣fore there is no need of any other Cure, but in the mean while Copulation must be forbid, for by the too early use of it, the natural constitution of the parts is disor∣dered, but if it proceed from small stature or age, it is incurable.

Over-fatness may be corrected by a spare and proper Diet, and by convenient evacuations.

If Barrenness proceeds from a disorder∣ly Diet, as from excessive eating or drink∣ing, the Woman must be reduced to a re∣gular course of Life.

Such as are robust and of a manly Con∣stitution must by all means be reduced to a womanly state; that they may become fit for generation, they must forbear strong Meats and Labour, and the Courses must be forced, and by Bleeding and Purging and the like, the habit of the Body must be rendred cold and moist.

But the most frequent cause of Barren∣ness is a cold and moist disposition of the whole Body and of the Womb, which the Whites often accompany, and for the cure in this case, the Whites must be cured by the method prescribed in the Chapter of the Whites, and the following things must be ordered, which are peculiarly pro∣per.

And First the flegmatick humours must be evacuated by Medicines that purge Sweat and force Urine, and revulsion must be made by Issues in the Arms, Neck and Legs, and the principal parts must be strengthened by Treacle, Mithridate, Con∣fection of Alkermes and the like.

Afterwards such things must be used as are proper by a specific quality to strength∣en the Womb and to help Conception.

Take of the roots of Eringo and Satyrion candied each one Ounce, of green Ginger can∣died half an Ounce, of Hazel Nuts, Pine Nuts, and Pistachies each six Drams, one Nutmeg candied, of the Seed of Rocket and Cresses each two Drams, of the ashes of a Bulls Pisle, of the Reins of Scinks and of the raspings of Ivory each one Dram, of confecti∣on of Alkermes three Drams, of Diambra and sweet Diamoch each one Ounce and an half, of Ambergriese half a Dram, with the Syrup of candied Citrons, make an Electuary, let her take the quantity of a Nutmeg at bedtime, drinking upon it a glass of good Wine.

Some count the Secundine of a Woman dried and powderd very effectual, one Drachm of it being taken.

The Seeds of Bishops weed are also much commended.

Many good Authors affirm, that if a Woman drink six Ounces of the juice of Garden Sage with a little Salt, the fourth day of her Menstruous Purgation, and a quarter of an hour after has Conversation with her Husband, she will infallibly con∣ceive. And by the use of this remedy Aetius says, the Egyptian Women became fruitful after a great Plague.

It's said many have conceived when their having Children has bin despair'd of, by thrusting up far in the Privities Garlic heated with Oyl of Spike, and wrapt in a fine rag, for it powerfully forces the Cour∣ses, and cleanses and delights the Womb.

CHAP. XIV.

Of the Parts of Women that serve for Generation.

THE Parts serving for Generation in Women may be divided into the Pri∣vities, the Womb, the Testicles, and the Vessels that prepare and carry. That part is called the Privities which appears at first sight without dissection, it reaches from the lower part of the Os Pubis, within an Inch of the Fundament; it is less and closer in Maids, than in those that have born Children. It hath two Lips, which toward the Pubes grows thicker, and meeting upon the mid∣dle of the Os Pubis makes that rising that is called the Hill of Venus; its outward sub∣stance is Skin covered with Hair, as the Lips are, which begin to grow in this place about the age of Fourteen; the inner sub∣stance of the Hill of Venus chiefly consists

of Fat, which makes it bunch up, which in Copulation hinders the bones of the Pubes of the Man and Woman to hit one against another, which would by causing pain abate the Venereal pleasure. A Muscle springing from the sphincter of the Fundament lies under this Fat. Its Office is to straighten the Orifice of the Sheath. The Nymphs and the Clitoris appear when the Lips are drawn a little aside: The Nymphs stand next the Urine, as it spouts out from the Blad∣der, and keeps the Lips from being wet; they are placed on each side, just within the Lips, they are two fleshy and soft Producti∣ons beginning at the upper part of the Pri∣vities, where they make that wrinkled membranous Production, which cloaths the Clitoris like a Fore-skin: They are in shape and colour like the Thrils that hang under a Cocks Throat, they have a red substance partly Fleshy, partly Membranous; with∣in Soft and Spongy, composed loosly of small Membranes and Vessels, so that they are very easily distended by the influx of the Animal Spirits and Arterial Blood. They are larger in grown Maids than in Young, and grow larger upon the use of Venery, and after the Bearing of Children; their use is to defend the inner Parts, and to cover the passage of the Urine, and a good part of the Orifice of the Sheath in the upper

part of the Privity. Betwixt the Nymphs is placed the Clitoris; it answers to a Man's Yard, in shape, situation, substance, erecti∣on, and differs from it only in length and bigness. Those that are called Hermo∣phrodites have it so long and big, as to be able to Converse with Women in the man∣ner of Men. They are not of two Sexs as is commonly reported, only their Stones are placed in the Lips of the Privities, and their Clitoris is preternaturally extended: But in most it does not appear unless the Lips are drawn aside: It is a little, long and round Body, it lies under the fat of the hill of Venus, and puffs up in Venery, and straightening the Orifice of the Sheath makes it embrace the Virile Member the more closely: Its outward end is like the Glans of a Men's Yard, and as the Glans in Men is the seat of the greatest pleasure in Copulation; so is this in Women: There is as it were a hole in it, tho indeed there is really no such thing, most of it is covered with a thin Membrane from the Conjunction of the Nymphs: It has two pair of Muscles, the upper are round and spring from the bones of the Hip; these by straitening the roots of the Nervous Bodies, that arise on each side from the bunching of the Os Ischium detain the Blood and Spirits in them, and so erect the Clitoris, even as

those in Men do the Virile Member; the other rise from the Sphincter of the Funda∣ment, and these serve to straiten and nar∣row the Orifice of the Sheath: It has Veins, and Arteries, and Nerves, which are some∣what large. In some Eastern Countries the Clitoris is wont to be so large, that for its deformity, and the hindrance it causes in Copulation, they used to cut it quite out, or to sear it, to hinder its growth.

The Sheath is so call'd because it receives the Virile Member like a sheath, it is soft and loose, uneven and wrinkly, of a ner∣vous but somewhat spongy Substance, which is puft up in Copulation to embrace the Yard the better: Its about seven fin∣gers breadth long, and as wide as the strait Gut; but the length and width differ in respect of Age, and as the Woman is more or less provoked to Copulation: The wrinkles are much more numerous and close in Virgins, than in those that have Born many Children, and in Whores that use frequent Copulation, and in Women that have had the Whites a long while.

It has very many Arteries and Veins, some whereof inosculate one with another, and others not. By the Arteries that open into it, the Courses sometimes flow in Women with Child, that are full of Blood. These Vessels bring plenty of Blood to it

in Copulation, which by heating and puf∣fing up the Sheath increases the pleasure, and hinders the Man's Seed from cooling, before it is conveyed to the Womb. All along the Sheath there are abundance of Pores, from whence a thin Humour always flows, especially in Copulation, and in∣creases the pleasure of the Woman, and is that which is supposed to be her Seed. Near its outer end, under the Nymphs, in its upper part, it receives the Neck of the Bladder. In Virgins its passage is so narrow, that at their first Conversation with a Man, they have commonly more pain than plea∣sure, by reason of the extension of it by the Virile Member, which breaks some small Vessels, from whence Blood issues.

The Hymen is a thin nervous Mem∣brane, interwoven with fleshy Fibres, and endowed with many little Arteries, and Veins, behind the insertion of the Neck of the Bladder, with a hole in the midst, that will admit the top of ones little finger, whereby the Courses flow, it is also called the Girdle of Chastity. But it is broken and bleeds at the first Copulation, and ne∣ver closes again. But tho' a Man when he finds these signs of Virginity, may cer∣tainly conclude he has Married a Maid; yet if they are wanting, it does not neces∣sarily follow that Virginity is wanting;

for the Hymen may be corroded by sharp Humours flowing through it with the Cour∣ses, and from other Causes; or, if a Maid be so indiscreet as to become a Bride while her Courses flow, or within a Day after, then the Hymen and the wrinkled Mem∣brane of the Sheath are so relaxed, that the Virile Member may enter without any ob∣struction, and so give suspition of Uncha∣stity, when there is really no occasion for it. Sometimes in old Maids the Hymen is so strong that it cannot be penetrated with∣out difficulty; and in some it is naturally quite closed up, and so their Courses are stopt, which much endangers their Life; if it be not opened with a Chirurgical Instru∣ment.

The Myrtle-berry Caruncles lie close to the Hymen, the largest of 'em is uppermost, standing just at the Mouth of the passage of the Urine, which it shuts after making water; opposite to this at the bottom of the Sheath there is another, and in each side one. But of these, there is only the first in Maids, the other three being made by the broken Hymen. These three when the Sheath is extended disappear in Labour, and cannot be seen till the Sheath is contracted to its natural straitness.

The Sheath near its outer Orifice, has a Sphincter Muscle about three fingers broad

that contracts it as the case requires; and therefore Men and Women need not doubt but that their Genitals will be proportion∣able, for the Sheath is so artificially made, that it can suit with every Penis.

The Womb is seated in the lowest part of the Belly, betwixt the Bladder and straight Gut, its hindmost part is loose, that it may be extended as the Child increases, but its sides are tied fast by two pair of Liga∣ments. Its substance is whitish, nervous, and compact in Virgins, but a little spon∣gy and soft in Women with Child. It has two Membranes, the outer is strong and double arising from the Peritoneum, the inner being proper is Fibrous and more Porous. Betwixt these Membranes, there is a certain fleshy and fibrous contexture, which in Women with Child, together with the said Membranes, imbibes so much of the nutritious Humours, that then flow thither, that the more the Child increases, the more fleshy, fibrous, and thick does the Womb grow, so that in the last months it is an inch thick, and some times two fin∣gers breadth, tho' it be extended to so much greater compass, than it has when a Wo∣man is not with Child, and yet within three weeks after Delivery it is as thin as before, and contracts so wonderfully, that it may be held in ones hand. In Virgins it is a∣bout

two fingers breadth broad, and three long; in those that have Copulated, it is a little bigger, it is like a Pear, only a lit∣tle flattish above and below, but in Women with Child it becomes more round. In Maids its cavity is so small, that it will hard∣ly contain a large Hazel-nut; it is divided be a Line that goes length-ways, much like that in a Man's Cod. Its Arteries spring partly from the Spermatick and Hypoga∣strick; they run along the Womb, bending and winding, that they may be extended without danger of breaking, when the Womb is stretched with the Child. The monthly Courses flow by these Arteries in greatest quantity into the Womb it self: But in less quantity by the Branches that open into the Neck of the Womb, and a small quantity of the Courses come out of the Sheath. It is much disputed what is the reason of the Courses, whether they flow by reason of too great quantity of Blood, or whether at set times; there is also a fermentation of the Blood, which opens the orifices of the Arteries: But it is most probable that it proceeds from a fermenta∣tion at appointed times, for if a Woman feeds high and so breeds much Blood, the Courses flow never the sooner, tho' per∣haps they may be in a greater quantity; and if she use the greatest abstinence and spare∣ness

of Diet, they will not be the longer before they come, so that when through such effervency the Blood flows plentifully into the Vessels of the Womb, and the Veins of the Womb are not able to carry it all back again by Circulation, it flows out of the extremities of the Arteries so long, till the too great quantity of the Blood is les∣sened, and the fermentation ceases, which it does usually after three or four days. The Courses seldom flow in Women with Child, and the wanting of them is their first item of having Conceived.

The Veins spring from the Preparantes, and from the Epigastrick, the Nerves from the greatest plexus of the mesentery of the Intercostal Pair, and from the lowest plex∣us of the same, and also from the Nerves of the Os Sacrum, and the same run also to the Testes or Ovaria. These plexus of Nerves are chiefly affected in Hysterick Fits, and are Convulsive, and often happen when the Womb is not at all in fault; and the Ball that seems to rise from the bottom of the Belly in these Fits, and to beat strongly about the Navel, which is usually supposed to be the rising of the Womb, is nothing but a Convulsion of these Nerves; for some Men are troubled with the same Symp∣tom.

The use of the Womb is to receive into its capacity the principals of the formation of the Fetus, to afford it nourishment, and to preserve it from injuries, and at length to expel it.

The neck of the Womb seems to be a part of the Fundus, only it is much more narrower, for its cavity is no wider in Vir∣gins than a small Quill, and in Women with Child its inner orifice does either quite close its sides together, or is daubed up with a slimy yellowish Humour, so that nothing then can enter into the Womb. It has the same Membranes, and the same Vessels with the Womb.

Womens Testicles differ much from Mens, their situation is within the Body, on each side two fingers breadth from the bot∣tom of the Womb, to the sides whereof they are knit by a strong Ligament; they are flat on the sides, in their lower part oval; their Superficies is more rugged and unequal, than in those of Men, they differ in bigness, according to Age; in those newly come to Maturity, they are about half as big as those of Men, but in such as are in Years, they are less and harder, tho' they sometimes grow preternaturally to a vast bigness, for seve∣ral Quarts of Liquor has been found con∣tained in them, in a Dropsie of the Womb;

they have but one Membrane that encom∣passes them round; but on their upper side where the preparing Vessels enter them, they are about half way involved in ano∣ther Membrane that accompanies those Vessels, and springs from the Peritoneum; when this cover is removed, their substance appears whitish, but is wholly different from Mens Testicles; for Mens are composed of Seminary Vessels, which being continued to one another are twenty or thirty Ells long, if they could be drawn out at length without breaking; but Womens do principally consist of a great many Membranes and small Fibres, loosly united to one another; among which there are several little Bladders full of clear water; the liquor contained in those Blad∣ders has been always supposed by the fol∣lowers of Hippocrates and Galen, to be Seed stored up in them; but Dr. Harvey and many Learned Physicians and Anatomists suppose these little Bladders to contain no∣thing of Seed, but that they are truly Eggs, analogous to those of Fowl and o∣ther Creatures, and that the Testicles so called are not truly so, nor have any such Office as those of Men, but are indeed an Ovarium, wherein those Eggs are nourished by the sanguinary Vessels dispersed through them, and from whence one or more, as they are fecundated by the Man's Seed, se∣parate,

and are conveyed into the Womb by the Tubae Falopianae: If you boyl these Eggs their Liquor will have the same colour, tast, and consistency with the white of Birds Eggs, and they do not want shells, because they are sufficiently defended by the Womb. These Eggs in Women are commonly a∣bout the number of twenty in each Testi∣cle, whereof some are far less than o∣thers.

The Spermatick Vessels are of two sorts; Arteries and Veins; the Arteries are two as in Men. They spring from the great Artery a little below the Emulgents (ve∣ry rarely either of them from the Emul∣gent it self) and pass down towards the Testes, not by such a direct course as in Men, but with much twirling and winding among the Veins, with which they have no inosculation, as has been generally said. But for all their Winding, when they are stretched out to their full length, they are not so long as those of Men. The Veins are two, arising as in Men, the right from the Trunk of the Cava, a little below the Emulgent, and the left from the Emul∣gent it self, but they are much shorter than in Men; both the Arteries and Veins as they pass down are covered with one common Coat from the Peritoneum, and near the Testes they are divided into two

Branches, the upper whereof is implanted into the Testicle by a Triple-root, and the other is subdivided below the Testes into three twigs, one of which goes to the bottom of the Womb, another to the Tuba and round ligament, the third creep∣ing by the side of the Womb, under its common Membrane ends in its Neck, where it is Woven with the Hypogastrick Vessels like a net. By this way it is that the Courses sometimes flow in Women with Child, for the first Months, and not out of the inner Cavity of the Womb.

The use of these Spermatick Vessels is not to Minister to the Generation of Seed, according to the Ancient Doctrine, but to the Nutrition of the Eggs in the Ovaria or Testes, according to the new, and to the nourishment of the Fetus, and of the solid parts, and the expurgation of the Courses.

The carrying Vessels that go straight from the Testes to the bottom of the Womb, and were supposed to emit the Seed from the Stones into the bottom of the Womb, are accounted by de Graef only Ligaments of the Testicles to keep them in their place; for they come not to the Inner Cavity of the VVomb. The Fallo∣pian Tubes are very slender and narrow Ducts, nervous and white, arising from

the horns or sides of the VVomb, and at a little distance from it they become lar∣ger, and twist like the tendrel of a Vine, till nearer their end, where ceasing their winding they turn very large, and seem membranous and fleshy, which end is very much torn and jagged like rent Cloths, and has a large Foramen, which lies closed, because those jaggs fall together, but it being opened, they are like the ut∣most Orifice of a Brass Trumpet. These Tubes, according to Dr. Harvey, are the same in VVomen, that the horns of the VVomb are in other creatures, for they answer to those both in situation, connexi∣on, amplitude, perforation, likeness, and also Office. The capacity of these Ducts varies very much; for in the beginning, as it goes out of the VVomb, it only admits a Bristle, but in its progress, where it is largest, it will receive ones little finger; but in the outmost extremity, where it is divided into jaggs, it is but about a quar∣ter so wide. They are very uncertain al∣so in their length, for from four or five they sometimes increase to eight or nine fingers breadth long. Their use is in a fruitful Copulation to grant a passage to a more subtile part of the Masculine Seed, or to a Seminal Air towards the Testes to bedew the Eggs contained in

them, which Eggs, one or more being by that means fecundated, and dropping off from the Testes, are received by the ex∣tremity of the Tubes, and carried along the inner Cavity to the Womb. But it may be objected that the narrowness of the Tubes are not fit for such a use; yet ••e that considers the straitness of the in∣ner Orifice of the Womb, both in Maids and in Women with Child, and yet ob∣serves it to dilate so much upon occasion, as to make way for the Birth of a Child, cannot wonder that to serve a necessary end of Nature, the small duct of the Tubes, should be so far widened, as to allow pas∣sage to an Egg, seeing its proportion to their duct is many times less, than of the Child to the usual largness of the said Orifice.

CHAP. XV.

Of Conception.

COnception is nothing else but an action of the Womb, whereby the prolifie Seeds of the Man and Woman are there received and retained, that an Infant may be engendered, and formed out of it.

There are two sorts of Conception, the one true, according to Nature, to which succeeds the Generation of the Infant in the Womb; the other false, as a false Conception, Mole, or any other strange Matter.

It is not absolutely necessary, that the Mans Seed should be received, and retain∣ed entire; for a small quantity of it may be sufficient, nay a meer steam of it, to impregnat.

Conception may be known by the more than ordinary delight in the act, and some few Months after, the Woman per∣ceives a small pain about her Navel, and some little Commotions in the bottom of her belly. The inward Orifice of the Womb is exactly closed, she longs for strange things, she is often troubled with Nauseating and Vomiting, her Courses are stopt, the Navel starts, her Nipples are very obscure or dark coloured, with a yellowish circle round about, her eyes are dejected and hollow, the Whites of them dull and troubled, her Blood, when she has Conceived some time, is always bad; the Belly is flat: Yet it must be ac∣knowledged that some of these signs are also to be found upon an Obstruction of the Courses in Virgins; wherefore judg∣ment upon Conception must not be too

positive, especially, when the Woman is upon tryal for her life, for some upon having their Courses have been judged not with Child, and yet after Execution have been found to be so.

The Infant moves it self manifestly a∣bout the forth Month, sooner or later as the Woman is strong or weak. Some Wo∣men feel it from the second, others about the third Month, and some before that time. At the beginning, the first motions are very small, but grow greater propor∣tionably, as the Infant grows bigger and stronger.

CHAP. XVI.

Of a Mole.

A Mole is deformed and useless Flesh contained in the Womb, and is oc∣casioned by the corrupted Seed of the Man and Woman, for it is never generated without the use of Copulation; it is co∣vered with a Membrane and sticks to the Womb, the longer it is retained in the Womb the harder it grows, and is more difficultly expelled: Most commonly there is but one, yet sometimes more; when it

is ejected in the second Month it's called a false Conception.

It's difficult to distinguish a Mole, from being with Child, for the Courses are stopt, the Belly grows big by degrees, and the Breasts are increased. But the first sign of it is a leaden colour in the Face, the Belly is harder and sorer than when a Woman is with Child, and it is very troublesome and painful to go with, and it falls on whatsoever side she turns; there is a great weariness in her Legs and Thighs, she finds a great heaviness at the bottom of her Belly, and her Urin is obstructed; but it may be certainly known, if no motion be felt after four or five Months, or when her Reckoning is out. Some have a Mole two or three Years, and sometimes much longer.

As to the Cure, I shall speak only of that part of it which may be performed by Me∣dicines, for if it stick much to the bottom of the Womb, or is very large, it will scarce be expelled unless a Chyrurgeon extract it.

Give the Woman a Spoonful of Syrup of Mugwort Morning and Evening for three days following, either by it self or mixt with an Ounce of Penny-royal-water; after∣wards Purge her every other day, or every third day with the fetid Pill, two Scruples

or a Dram may be taken at a time early in the Morning, and let her sleep if she can till they begin to work; let her be purged in this manner five times.

Things that loosen must be also applied frequently to the Womb to open the pas∣sages likewise to the Belly, Groins, Loins, and Hips, with Spunges and Flannels; the following Fomentation is of excellent use.

Take of the leaves of Marsh-mallows and Mallows each one handful, of the roots of round and long Birthwort each one handful, of the leaves of Mugwort, Mercury, Feverfew, Sage, Hysop and Calaminth each half an handful, of the Seeds of Flax, Marshmallows, Fenugreek, Anise, Lovage, each half an Ounce, of the Flowers of Camomile, Melilote, Rose∣mary, Broom, Mugwort, each one Pugil, of Bran one Pugil; hoyl them in a sufficient quantity of Water to five quarts; add of Oyl of Olives half a pint, of the Oyls of Camomile and sweet Almonds each four Ounces, of the Oyl of Lillies two Ounces; foment the parts as a∣bove directed, and afterwards anoint them with Ointment of Marshmallows.

CHAP. XVII.

Of Superfoetation.

THere is a great dispute whether a Wo∣man, who hath two or more Chil∣dren at once, conceived of them at one or several coitions: Some will have this to be superfoetation; but there are signs whereby we may know the difference, whe∣ther both Children were begotten at once, or successively one after another. Supefoe∣tation, according to Hippocrates, is a rei∣terated Conception, when a Woman be∣ing already with Child conceives again the second time. That which makes many be∣lieve, that there can be no Superfoetation is, because as soon as a Woman has Con∣ceived, her Womb closes, and is exactly firm, so that the Seed of the Man, absolute∣ly necessary to Conception, finding no place nor entry, cannot, as they say, be recei∣ved, nor contained in it: But it may be answered, that tho' the Womb be usually exactly shut and close, when a Woman has Conceived, yet it may be sometimes opened to let pass some ferous slimy Excre∣ments, or especially when a Woman is much delighted in the act of Copulation.

But this second Conception is very rare; for we must not imagine, that when a Wo∣man brings forth two or more Children at once, there is a Superfoetation; because they are almost always begot in the same act, by the reception of abundance of Seed into the Womb.

When a Woman brings forth one or more Children at a Birth, begotten at once, which are usually called Twins, it is known by their being both almost of an equal bigness and thickness, and by having but one common after-birth, not separated one from the other, but by their Mem∣branes: But if there are several Children, and a Superfoetation, they will not have a common burthen, nor will they be of an equal bigness.

To conclude, Of a hundred Women that have Twins, ninety of them have but one burthen common to them both, which is a certain sign they had no Superfoetation.

CHAP. XVIII.

Of the Womb-Cake, of the Membranes involving the Child, and of the Hu∣mours contain'd in them, of the um∣bilical Vessels, of the parts of a Child that differ from those of the adult.

THE Womb-Cake, otherwise called the Womb-Liver, for the likeness of substance, is soft, and has innumerable Fibres and small Vessels; it is two Fingers breadth, thick in its middle, but thinner near the edges, and a quarter of a Yard over from one side to the other, when the Infant is near the Birth; on that side next the Foe∣tus, it is smooth and something hollowish, like Navelwort, and is knit to the Chori∣on; but on that next the Womb, it is ve∣ry unequal, having a great many bunchings, whereby it sticks fast to the Womb. VVhen there is but one Child in the Womb, it is but one; but if there be Twins there are two Womb-Cakes, and a particular rope of Umbilical Vessels is inserted into each from each Child; it grows not out of the Womb originally, but its first rudi∣ments appear like a woolly substance on the outside of the outer Membrane that

invests the Embrio called Chorion, about the eighth or ninth Week, upon which in a short while a red fleshly and soft substance grows, but unequally and a little in knobs, and then it presently thereby sticks to the Womb, and is very conspicuous a∣bout the twelfth or thirteenth Week, till now the Infant is increased and nourished wholly by the apposition of the Cristalline or albugineous liquor, wherein it swims loose in the inner Membrane, called Am∣nios, having no Umbilical Vessels, where∣by to receive any thing from the Womb-Cake. But when it grows bigger, and begins to want nourishment, the extremi∣ties of the Umbilical Vessels begin to grow out of the Navel by little and little, and are extended towards the Womb-cake, that they may draw out of it a more nourishing juice, and carry it to the Infant, as Plants do from the Earth by their roots. It has Vessels from the Womb and from the Chorion; the former are of four kinds, Arteries, Veins, Nerves, and Lymphe∣ducts; all which tho' they be very large, and visible in the Womb, and also where the Womb-Cake is joyned to it, yet they send the smallest Capilaries to the Womb it self. Those that come from the Cho∣rion are Arteries and Veins. The Arteries and Veins that come from the Womb,

spring from the Hypogastricks, and also that branch of the Supermaticks that is in∣certed into the bottom of the Womb; those that come from the Chorion are the Umbilical Vessels of the Infant. The Womb-Cake after it is joyned to the Womb, sticks most firmly to it for the first Months, as unripe Fruit does to the Tree, but as the Infant becomes bigger and ri∣per, and nearer to the Birth, by so much the more easily will it part from the Womb, and at length it falls out of the Womb, and makes part of the After∣birth.

Next to the Womb-Cake follow the two Membranes, viz. Chorion the outer, and Amnios the inner, wherein the Child is wrapt: Betwixt these two after the Child is perfectly formed, there is a third, viz. Allantois. The Chorion is pretty thick, smooth on the inside, but without somewhat unequal and rough, and in that part of it which sticks to the Womb-cake, and by it to the Womb, it has very many Vessels which spring from the Womb it self and the Umbilical Vessels. Twins are both inclosed in one Chorion, but have each a particular Amnios; it invests the Egg or∣riginally, which Egg being brought to the Womb, and becoming a Conception, this Membrane imbibes the moisture that be∣dews

the Womb plentifully at that time. This Liquor that it imbibes, is thought to be the Nutritious Juice that ouzes out of the Capilary Orifices of the Hypogastrick and Spermatick Arteries, and is of the same nature with that which afterward is separated in the Womb-cake, and carried to the Infant by the Umbilical Vein; and with that also which abounds in the Amnios even till the Birth.

The Amnios is the inmost Membrane that immediately contains the Child; it is not knit to the Chorion in any place save where the Umbilical Vessels pass through them both into the Womb-cake; it is ve∣ry thin, soft, smooth, and pellucid, and encompasses the Infant very loosly, it has Vessels from the same Origins as the Chori∣on. From a limpid Liquor contained in this Membrane, the first lineaments of the Embrio are drawn. But because this Li∣quor is so very little, there sweats through this Membrane presently part of that Nu∣tritious Albugineous Humour that is con∣tained in the Chorion, which it had imbi∣bed out of the Womb, and by the addition of this Humour to the undiscernible Ru∣diments of the Embrio, it receives its in∣crease. But tho' the Amnios have its ad∣ditional Nutricious Liquor at first only by Transudation, yet when the Umbilical

Vessels, and the Womb-cakes are formed, it receives it after another manner, for then being separated from the Mothers Arteries by the Placenta, and imbibed by the Um∣bilical Veins of the Infant passes directly to its Heart, from whence being driven a great part of it down the Aorta, it is sent forth again by the Umbilical Arteries, out of whose Capillaries dispersed plentifully through the Amnios, it issues into its cavi∣ty. A third Membrane which invests the whole Infant is the Allantoides; it has the same Figure as the Chorion and Amnios, betwixt which it is placed in their whole circumference. Now, tho' it must be sup∣posed that this as well as the other two is originally in the Egg, yet there is no ap∣pearance of it, till after the Umbilical Vessels and the Womb-cake are formed, and the albugineous Liquor ceases to be im∣bibed by the Chorion out of the Uterus; but as soon as the Infant begins to be nourished by the Umbilical Vessels, and the Urachus is permeable, then presently this Membrane begins to shew it self, containing a very thin Liquor, which is the Urine of the In∣fant brought into it by the Urachus, and wherewith it is filled daily more and more till the Birth: It may be known from the Chorion and Amnios by this, that they have numerous Vessels dispersed through them;

but this has not the least visible Vein or Ar∣tery; it is very hard to separate the Cho∣rion from it, but towards the Birth it be∣comes so turgid with Urine, that the Amni∣os which immediately contains the Infant, swims 〈◊◊〉〈◊◊〉 Liquor that it contains is the Urine 〈◊◊〉〈◊◊〉 brought hither by the 〈◊◊〉〈◊◊〉 soon as the In∣fant is perfect 〈…〉〈…〉, its Kidneys must needs perform 〈…〉〈…〉 Office of separating the Serum from the Blood, for otherwise it would be affected with an Ansarca; I say, the Serum is separated in the Kidneys, and glides down from thence into the Blad∣der, wherein there is a pretty large quan∣tity when the Infant is five or six months old: Now it flows not out of the Bladder by its orifice, because at that time the Sphincter is too contracted and narrow, and if it should pass that way, it would mix with the nourishing juice wherein the Infant swims in the Amnios, and wherewith by taking it in by its mouth, it is partly nou∣rished, and so would defile and corrupt it. Nature therefore has provided it another passage by the Urachus inserted into the bottom of the Bladder, which tho it grows solid like a Ligament after the Child is Born, as the umbilical Vein does, yet while the Infant is in the Womb, it is open and conveighs the Urine into the Allantoi∣des,

that is placed betwixt the Chorion and Amnios, where it is collected and pre∣served till the Birth.

The Naval-string is membraneous, wrea∣thed, and unequal, and arises from the Na∣vel; it reaches to the Womb-cake; it is a∣bout half an Ell long, and a finger thick, The Vessels contained in this string, and covered with the common coat called Funi∣culus are four, one Vein, two Arteries, and the Urachus; the Vein is larger than the Aretries, and arises from the Liver of the Infant at the trunk of the Vena porta, and from thence passing out of the Navel it runs along the Funiculus to the Womb-cake, into which it is implanted by innu∣merable Roots; but before it reaches it, it sends some little twigs into the Amnios. The umbilical Vein serves for conveying to the Infant the nutricious juice separated in the Womb-cake from the Mothers Arte∣ries; but together with this juice returns so much of the Arterial blood, that comes from the Infant, as is not spent upon the nourishment of the Womb-cake, or of the Chorion and Amnios.

In the Funiculus are included also two Arteries, which are not both of them to∣gether so big as the Vein; they spring out of the inner Iliacal branches of the great Ar∣tery, and passing by the sides of the Blad∣der,

they rise up to the Navel, out of which they are conducted to the Womb-cake, in the same common cover with the Vein and Urachus wherewith they are twi∣ned and wreathed like a Rope. Spirituous blood is driven from the Infant by the bea∣ting of its Heart to the Womb-cake, and the Membranes, for nourishment, from which, what Blood remains circulates back again to the umbilical Vein together with nutricious juice, imbibed afresh by its Ca∣pillaries dispersed in the Womb-cake. But besides Arterial Blood, there flows out of the Navel by them part of the Nutricious juice, that was imported by the umbilical Vein, I say flows out by these Arteries, which by their branches, that are dispersed through the Amnios, discharge it by their little mouths into it. The fourth Umbili∣cal Vessel is the Urachus, or Urinary Vessel, it is a small, membranous, round Pipe indu∣ed with a straight cavity arising from the bottom of the Bladder up to the Navel; out of which it passes along within the com∣mon cover and opens into the Allantoides. These four Vessels, as has been said above, have one common cover, which also keeps each of them from touching the other; it is called Funiculus; it is membranous, round and hollow, indifferent thick, consisting of a double coat, the inner from the Perito∣neum,

and the outer from the Paniculus carnosus. It has several knots, which Dr. Wharton thinks are little Glands, through which the nutricious juice distills out of the capacity of the Funiculus into the cavity of the Amnios.

Midwives guess by their number how many more Children the Mother shall have, but without reason. When the Infant is Born, its Navel-rope is wont to be tyed a∣bout one or two fingers breadth from the Navel, with a strong Thread cast about it several times, and then about two or three fingers breadth beyond the Ligature to be cut off; what is not cut off is suffered to remain till it drop off of its own ac∣cord.

As to the way how the Infant is nouri∣shed there has been great Disputes, some affirm by Blood only, and that received by the Umbilical Vein, others by Chile only received in by the Mouth; but indeed ac∣cording to the different degrees of Perfecti∣on, that an Egg passes from Conception to an Infant ready for the Birth, it is nouri∣shed variously. For, First, As soon as an Egg Impregnated descends into the Womb, it presently imbibes through its outer Membrane some of that albugineous Liquor, that at this time plentifully bedews the in∣ternal Superfices of the Womb, so that as

soon as the first Lineaments of an Embryo begin to be drawn, out of that Humour contained in the Amnios, they presently re∣ceive increase by the apposition of the said Liquor filtrated out of the Chorion through the Amnios into its cavity; and this same Liquor, that thus increases the first rudiments of the Embryo, Dr. Harvey calls Coliquamentum. But when the parts of the Embryo begin to be a little more perfect, and the Chorion becomes so dense, that not any more of the said Liquor is im∣bibed by it, the Umbilical Vessels begin to be formed, and to extend to the side of the Amnios which they penetrate, and both the Vein and Arteries pass also through the Allantois and Chorion, and are implanted into the Womb-Cake, that at this time, first gathering upon the Chorion joins it to the Womb; and now the Hypogastrick and Spermatick Arteries, that before cast the nutricious Juice into the cavity of the Womb, open by the orifices into the Womb-cake, where they deposite the said juice, which is absorded by the Umbilical Vein, and by it conveyed, first to the Li∣ver, then to the Heart of the Infant, where the thinner and the more spirituous part of it is turn'd into Blood; but the more gross and earthy part of it descending by the Aorta enters the Umbilical Arteries, and

by those branches of them, that run through the Amnios, is discharged into its cavity.

The grosser nutricious Juice being depo∣sited by the Umbilical Arteries in the Amni∣os, as soon as the Mouth, Gullet, and Sto∣mach, and the like are formed so perfectly, that the Foetus can swallow, it sucks in some of the said Juice, which descending into the Stomach and Intestines, is received by the Lacteal Veins, as in grown Persons. The Infant therefore is nourished three se∣veral ways, but only by one Humour: First, by apposition of it, while it is yet an im∣perfect Embrio, and has not the Umbilical Vessels formed: But after these are per∣fected, it then receives the same nutricious Juice by the Umbilical Vein, the more Spi∣rituous and thin part whereof it changes into Blood, and sends forth the grosser part by the Umbilical Artery into the Amnios, which the Infant sucks in at its Mouth, and undergoing a new Concoction in its stomach, is received out of the Intestines by the Lacteal Veins, as is done after the birth.

A Child in the Womb differs from an adult Person in many parts, the parts are less, the colour of the whole reddish, the Bones soft, and many of them gristly and flexible in the Head: There are several

differences: First, the Head, in respect to the proportion of the rest of the Body, is bigger, the Crown is not covered with Bone, but only with a Membrane; the Bone of the Forehead is divided, as also of the under Jaw, and the Os Cuneiforme is divided into four. The Bone of the hinder part of the Head is distinguished into three, four or five Bones. The Brain is softer, and more fluid, and the Nerves very soft. The Bones that serve the Sense of Hearing are wonderfully hard and big; the Teeth lie hid in the little holes of the Jaw-bone; the Dugs swell, and out of them in Infants new born, whether Male or Female, a serous Milk issues forth sometimes of its own accord, and some∣times with a gentle pressure: The Ver∣tebrae of the Back want their spinous pro∣cesses, and each of them made of three distinct Bones: The Heart is remarkably big, and its Auriculae large: There are two Unions of the greater Vessels, that are not conspicuous in grown Persons: First, the Foramen ovale, by which there is a pas∣sage open, out of the Cava into the Vein of the Lungs, just as each of them are o∣pening, the first into the right Ventricle, and the latter into the left Ventricle of the Heart, and this Foramen, just as it opens into the Vein of the Lungs has a Valve

that hinders any thing from returning out of the said Vein into the Foramen: Se∣condly, the Arterial Channel, which two fingers breadth from the Basis of the Heart joyns the Artery of the Lungs to the Aorta; it has a pretty lage Cavity, and ascends a little obliquely from the said Artery to the Aorta, into which it conveys the Blood, that was driven into the Artery of the Lungs, out of the right Ventricle of the Heart, so that it never comes into the left Ventricle, as the Blood that is sent out of the left Venticle into the Aorta ne∣ver came in the right, except a little that is returned from the nutrition of the Lungs, but past immediately into it out of the Vena Cava by the Foramen ovale, so that the Blood passes not through both the Ven∣tricles, as it does after the Child is born. You may know whether Infants killed by Whores, and which they commonly affirm were still-born, were really so or no, by putting the Lungs of the Infant in Water; for if they were still-born the Lungs will sink, if alive, so as to breath never so lit∣tle while, they will swim. The Gland Thymus is very large, and consists as it were of three Glands; the Umbilical Ves∣sels go out of the Abdomen; the Stomach is narrower, but pretty full of a whitish liquor: The Caul is scarce visible, the

Guts are seventimes longer than the Body; the Excrements in the small Guts are fleg∣matick and yellow, but in the thick some∣what hard and blackish, sometimes green∣ish; the Caecum is larger than usual, and often fill'd with Faeces: the Liver is very large, and extends it self into the left side, and covers all the upper part of the Sto∣mach, it has a passage, which is not in grown Persons, called the Veiny Channel, which arising out of the Sinus of the Porta, carries the greatest part of what is brought by the Umbilical Vein directly, and in a full stream into the Cava above the Liver: But this passage presently closes, as soon as the Infant is born, and turns to a liga∣ment, as doth the Urachus and the two Umbilical Arteries. The Spleen is small; the Gall-bladder is full of yellow or green Choler; the Sweet-bread is very large and white; the Kidneys are bigger and unequal in their Superficies; the Renes Succentu∣riati are exceeding large; the Ureters are wide, and the Bladder stretched with Urine; in Females the VVomb is depressed, the Tubes long, and the Testes very large; the little Bones of the VVrists and Instep are gristly, and not firmly joyned toge∣ther.

Its Knees are drawn up to the Belly, its Legs bending backwards, its Feet across,

and its Hands lifted up to its head, one of which it holds to the Temple or Ear, the other to the Cheek, where there are white spots on the Skin, as if it had been rub∣bed upon; the Back-bone turns round, the Head hanging down towards its Knees, its Face commonly towards the Mothers Back; but near the birth, sometimes a VVeek or two before, it alters its situati∣on, and tumbles down with its Head to the Neck of the VVomb, and its Feet up∣wards; then the VVomb also settles down∣wards, and its Orifice relaxes, and opens; and the Infant moving up and down tears the Membrans wherein it is included, and the waters flowing into the Sheath; but some∣times the Membranes come forth whole; at the same time the neighbouring parts are loosened and become fit for distension, and the Bones near are so much relaxed in their Joynts, that they make way for the Infant, and the motion of it so much disturbs the VVomb, that the Fibres of it and the Mus∣cles of the Belly contract altogether to ex∣pel it.

CHAP. XIX.

Of the Management of a Woman with Child.

THE Woman ought to be kept in a good moderate and clear Air, and she must Eat what she likes best, and be sure not to Fast too long; only she must observe not to eat too much at a time; and to com∣fort the Stomach, which is always weak in this condition, she may Drink a little Wine, or for want of it strong Beer at Meals. As to Sleep, a Woman with Child requires more sleep than she does at other times. As to Exercise and Rest, she must order her self according to the different times; for at the beginning she ought to keep her self quiet, and not to use Copula∣tion: Riding on Horse-back, or in a Wag∣gon, or indeed in a Coach is not safe at a∣ny time of her being with Child, especial∣ly when she is near her time, for such Exer∣cises often cause Miscarriage. But she may Walk gently, or be carried in a Chair. She must not carry or lift heavy Burdens, or lift up her Arms too high, and there∣fore ought not to dress her own Head. Let her Exercise be gentle walking in low-heel'd

Shoes; but she had better Rest too much than Exercise too much, for more hard La∣bours are occasioned by violent Exercise than by any other thing. Moreover, it is convenient that the Woman should abstain from Copulation the last two months, for the Body is very much moved, and the Bel∣ly compressed in the action, which causes the Child to take a wrong posture.

If the Belly be bound, as it is often at this time, Prunes stewed, or Veal Broath may be often used, or the following Glister may be used.

Boyl an Handful of Mallow Leaves, in three quarters of a Pint of Milk, let the Milk just boyl up, add to it two Ounces of brown Sugar, and a little fresh Butter, strain it for use.

She must moderate her Passions, and great care must be taken that she be not Frighted, and that Melancholy News be not sudden∣ly told her, but you must endeavour to keep her as chearful as possibly you can, the sudden surprizes of joy must be also avoid∣ed, for excesses on either hand are preju∣dicial. The Cloaths of a Woman with Child should sit easie, for any immoderate pressure is apt to make the Child deform∣ed, and hurts the Breasts, and very often causes miscarriage. Unnecessary Bleeding must be avoided, so must all strong Purges

but if Purging is requisite, only such things as Purge gently must be used, as Cassia, Rubarb, and Manna. The Cassia is best sucked out of the Canes, the Rubarb may be chewed, and an Ounce and a half or two Ounces of Manna may be dissolved in Posset-drink, and used upon occasion in the Morning.

Vomiting often afflicts Women with Child, but if it be moderate and at the beginning and without great straining it is beneficial; if it continues longer than the third or fourth Month it ought to be reme∣died; in order to which let the Woman use good food, and a little at a time, and let her use with her meat the juice of Oran∣ges, she may eat now and then Broth mix∣ed with the yolk of an Egg, for it's very nourishing and of easie digestion, and after meals let her eat a little Marmalade of Quinces, and she may drink a Glass of Cla∣ret; she must forbear fat meat and Sauces, and sweet and sugar'd Sauces. But if the Vomiting continues notwithstanding this regular Diet till the Woman is above half gon, she must take the following Purge.

Take of Tamarinds half an Ounce, of Sena one Dram, of Rubarb one Dram and an half, boyl them in a sufficient quantity of water, in three Ounces of the strained Liquor dissolve an Ounce of Manna, and an Ounce of Syrup of

Succory with Rubarb; make a purging potion to be taken in the Morning. It may be repeated once or oftener upon occasion.

And it may be proper for the Woman in the Winter time to were a Lambskin or the like upon her Stomach and Belly.

If pains of the Back, Reins and Hips are violent, the Woman must be blooded, and take at bed-time sixteen drops of the Liquid Laudanum mentioned at the latter end of the Chapter of Hysteric Diseases in a glass of Canary Wine, or in any thing else she likes, and she must keep her Bed till the pain abates; if the pain is continual, the Belly must be supported with a Swaith fit∣ted for the purpose.

If after the third or fourth Month the Breasts are very painful, 'tis convenient the Woman shou'd bleed in the Arm, if she be full of blood, and use a Diet that is moderately cooling and nourishing; but if the pain comes at the beginning, we ought to leave the whole business to nature, only the Woman must have a care that she re∣ceives no blows on those parts, nor must she be strait laced, for fear the Breasts shou'd impostumate.

If incontinence or difficulty of Urin be occasion'd by the weight and bigness of the Belly, the Woman may remedy it, and ease her self, if when she wou'd make wa∣ter,

she lift up with both her hands the bottom of her Belly, or she may wear a large Swaith fitted for this use, to bear up the Belly, but the best way is to keep her in Bed.

If a sharpness of Urin causes an Inflam∣mation on the Neck of the Bladder, it may be appeased by a regular cooling Diet, and emulsions of the cold Seeds used Morning and Evening.

Take of blanched Almonds number twelve, of the four greater cold Seeds each one Dram and an half, of the Seeds of Lettice and white Poppies each half a Dram, beat them in a Marble Mortar, and pour on them gently three quarters of a pint of Poppy Water, make an emulsion for two doses, add one Ounce of Sy∣rup of Violets and half a Dram of Sal Prunella.

If the Inflammation and Sharpness of Urine be not removed by the things above-mention'd, a little Blood may be taken from the Arm, and the neck of the Blad∣der may be bathed with the following De∣coction, with Flannels dipt in it and pressed out.

Take of the roots of Marsh-mallows one Ounce, of the Leaves of Mallows, Marsh-mal∣lows, Pellitory, and Violets, each one handful, of the Flowers of Melilote one handful, of the Seeds of Flax and Fenugreek each two Drams, boyl them in a sufficient quantity of Water to a pint and half.

But if the Woman notwithstanding she observes these directions cannot make wa∣ter, it must be drawn out with a Catheter by an Artist.

If the Woman be troubled with a vio∣lent Cough she must be blooded in the Arm at any time of her being with Child, for this is apt to occasion miscarriage, and all salted and spiced meat and sharp things must be forborn. She may now and then use juice of Liquorish, Sugar Candy, and Syrup of Violets, and if the Body be bound a Glister of Milk and Sugar may be inject∣ed. The following Syrup is very proper in this case.

Take half a pint of Claret Wine, one Dram of Cinnamon, half a Dozen Cloves, and four Ounces of Sugar, burn the Wine, and boyl it to the consistence of a Syrup, whereof let the Woman take three spoonfuls at Bedtime.

The Woman must go loose in her Clothes, and if the Rheum be very thin, and the Cough tickles much, Sixteen drops of the Liquid Laudanum mentioned in the Chapter of Hysteric Diseases must be now and then taken at bedtime in some liquor she uses to drink.

If the Legs and Thighs swell and are painful, they must be swaithed with a Swaith three or four Fingers broad, begin∣ning to swaith from the bottom; but in

this case 'tis best for the Woman to be kept in Bed; if there be signs of fulness of blood, she must be blooded in the Arm.

If the big bellied Woman be troubled with the Piles, and abound with Blood, she must be blooded in the Arm, and if her Body is Costive, the emollient Glyster men∣tioned above must be used, and afterwards to ease the Pain they must be anointed oft∣en with Populean Ointment mixt with a few Grains of Opium: For instance,

Take of Populean Ointment one Dram, of Opium five Grains, beat them well together in a Mortar, and anoint the Piles with it twice or thrice a day.

But if the Inflammation and the swel∣ling are much, you must apply Leeches to the part affected, and let her keep her Bed.

If the Piles bleed of themselves immo∣derately (for if the Flux be moderate at this time the Woman being full of Blood she may be relieved thereby) a cooling and thickening course of Diet must be order'd, as three parts of Fountain water, and one of Milk boyl'd together and drank cold, roasted Apples, Barly-broths, and the like, also thickning and cooling Juleps and Emul∣sions.

Take of the Waters of Plantain and Cinna∣mon hordeated each four Ounces, of distilled

Vinegar half an Ounce, of True-bole and Dra∣gons-blood each half a Dram, of the Liquid Laudanum mentioned in the Chapter of Hysteric Fits thirty drops, of Syrup of Myrtles one Ounce and an half, mix them and make a Ju∣lep, let her take four or five Spoonfuls every night at Bed-time.

Take of the four greater cold Seeds, each one Dram and an half, of sweet Almonds num∣ber four, of the Seeds of white Poppies two Drams, Plantain Water eight Ounces, of red Poppy Water four Ounces, of Cinnamon Water hordeated one Ounce and an half, make an Emulsion, to which add three Drams of pearled Sugar, and half an Ounce of the Juice of Cevil Orange, mingle them, let her take four Ounces thrice a day.

Bleeding in the Arm is also proper in this case to turn the Flux.

If a loosness comes upon a Woman with Child, and continues above five days, she must use Food of easie digestion and little at a time, and let her Drink be Claret Wine mixt with Water, wherein Iron has been quenched, and now and then Milk boyl'd with thrice the quantity of Water, or the white Decoction made in the follow∣ing manner.

Take of Calcined Harts-horn powder'd two Ounces, of Fountain water two quarts, boyl it till half is consumed, strain it gently through

a linnen rag, and add to it three Ounces of Syrup of Quinces.

And before Meals she may eat a little Marmalade of Quinces. But note, that before she uses these astringents, it will be convenient to purge off the ill humours with the following Potion.

Take of Rubarb one Dram and a half, of Sena two Drams, boyl them in a sufficient quantity of Water, to three Ounces of strain'd Liquor, add one Ounce of Syrup of Succory with Rubarb, and two Drams of Cinnamon-water. Let it be taken in the Morning.

But if the Loosness turn to the Bloody-flux, the case is very dangerous, and there∣fore after the use of the purging Potion above mention'd, if the Woman has strength enough to bear it, you must im∣mediately give sixteen drops of the Liquid Laudanum so often mentioned in this Trea∣tise, in two or three Spoonfuls of Cinna∣mon-water hordeated or the like, which must be repeated every night at bedtime, and in the Morning too, if the Flux con∣tinue violent, and to keep up the strength four or five Spoonfuls of the following Ju∣lep may be taken often.

Take of the Waters of Black-cherries and Strawberries each four Ounces, of Epidemic water and Compound Scordium-water, and of Cinnamon-water hordeated each one Ounce, of

Pearls prepared one Dram and an half, of Chrystaline Sugar a Sufficient quantity, make a Julep.

The VVomans Drink in this case must be the Milk water, or the white Decoction above described, and when she is very weak, she may take for her ordinary Drink, a quart of Fountain water boyl'd with half a pint of Sack; and she may eat sometimes Panada, and sometimes Broth made of lean Mutton, and she must be kept in Bed: Moreover a Glister made of half a pint of Cows Milk, and an Ounce and an half of Venice-treacle must be injected daily.

If the VVoman has her Courses after the fourth or fifth Month of her being with Child (for some VVomen have them till the Fifth Month, without any manner of pre∣judice to themselves or their Children) you must endeavour to stop them then, and before too if you suppose they slow by reason of the heat and acrimony of the Blood, or the weakness of the Vessels, and not from an abundance of Blood, which may be known by her having her Courses much when she was not with Child.

To stop this Flux, the VVoman must be kept in bed, and forbear all things that may heat the Blood, especially anger; she must use a strengthening and cooling Diet, feeding on Meat that breeds good blood

and thickens it, as Broths made of Poul∣try, Necks of Mutton, Knuckles of Veal, wherein may be boyl'd cooling Herbs; she may eat new lay'd Eggs, Gellies, Rice-milk, Barly-broth, and the like, and Iron must be quenched in her Beer, and she must forbear Copulation, and the Belly must be bathed about the region of the VVomb with Tent, wherein Pomegranate-peel, Pro∣vence Roses and Cinnamon has been boyl'd.

But if the VVoman be taken with Flood∣ing, the case is extreamly hazardous, and if it continues violent, she must be deli∣ver'd without delay, for otherwise death will necessarily follow: Yet it is to be no∣ted, that it must not be done presently as soon as the Flux is perceived, because some small Floodings have been sometimes sup∣pressed by keeping quiet in bed, by bleed∣ing in the Arm, and the use of Remedies above mention'd: If therefore the Blood flows, but in a small quantity, and conti∣nues but a little while, she must not be de∣livered; but if it flows in so great abun∣dance that she falls into Convulsions and Faintings, the Operation must not be de∣ferred, whether she has pains and throws or not.

And because in Floodings, weakness and faintings ever follow, we must endeavour to preserve that little strength the VVo∣man

has left, and to increase it if possible, that so she may be able to bear the Opera∣tion; to which purpose there ought to be given her from time to time good strength∣ening Broths, Gellies, and a little good VVine, she must always smell to Vinegar, and have a warm toast dipt in VVine and Cinnamon appli'd to the region of her heart, which do her more good than solid Food, and to prevent the Blood from flooding in great abundance before she can be deliver∣ed, a Vein in her Arm may be open'd to turn the course of it, and Napkins dipt in VVater and Vinegar may be apply'd all along her Reins.

If the Woman be troubled with a bear∣ing down of the Womb, her best way is to keep in Bed; but if she cannot conve∣niently do so, she must wear a broad Swaith to keep up her Belly; but if the bearing down proceeds from humours that relax the Ligaments of the VVomb, she must be kept to a drying Diet, her Food being rather roasted than boyl'd, and must refrain from Copulation and must not be strait Laced.

If the lips of the Privities are much swelled, by reason of watery humours fal∣ling upon them, you must scarifie with a Lancet all along the Lips, that the hu∣mours may distil out, and you must fo∣ment

the Parts with the following De∣coction.

Take of the leaves of Bays, Sage, Rosemary, and of the Flowers of Camomile each one hand∣ful, boyl them in a Sufficient quantity of Foun∣tain water; to a pint and half of the strain'd Liquor, add a quarter of a pint of Brandy, and bath the parts affected often with a Spunge dipt in the hot Liquor.

CHAP. XX.

Of Miscarriage.

TO prevent Miscarriage, all indisposi∣tions of the Body which are wont to occasion it must be removed, as fulness of Blood, ill humours, and peculiar Di∣seases of the VVomb, as Swellings, Ulcers and the like.

Fulness of Blood opens the Veins of the VVomb, or Strangles the Infant, and there∣fore the VVoman must be Blooded, and so much Blood must be taken away, as will sufficiently discharge nature.

If an ill habit of body and ill humours are the cause of Miscarriage, the VVoman must be frequently purged, and a small

quantity of Blood may be taken away, and betwixt the Purges, such things must be used as correct the indisposition of the Bowels, and the sharpness of the humours, and the humours must be thickened if they are too thin. And if Flegmatick humours abound, they must be carried off by Sweats and such things as force Urin: Issues in the Arms and Thighs are also very proper to prevent Miscarriage, whatever ill hu∣mours abound in the body.

The peculiar Diseases of the VVomb, as over great Moisture, Swellings, Ulcers, and such like, must be cured by their pro∣per Remedies: And first, if Moisture a∣bound, let the Woman be purged with two Scruples of the Pill Coch-major twice a week, and when she does not Purge, let her drink Morning and Evening of the fol∣lowing Decoction.

Take of the roots of Sarsaparilla four Oun∣ces, of China two Ounces, of white and red Sanders each half an Ounce, of the rasping of Harts-horn and Ivory each three Drams, in∣fuse them, and boyl them in eight pints of Fountain water till half is consumed; add a quarter of pound of Raisins of the Sun, and if the Woman be of a Flegmatick constitution, instead of China, add two Ounces of Guia∣cum rasped. Let her drink half a pint Morn∣ing and Evening.

Take of Franckincense, Myrrh, Mastich, Storax, Calamite, Gum of Juniper, Lada∣num, each one Ounce, with a sufficient quanti∣ty of Turpentine make Troches, and let one or more of them be cast on live Coals, and let the fume be received into the Privities through a Funnel.

If a Swelling be the cause, you must make application according to the nature of the humour, and the time and other Circumstances of the swelling; if it be hot and made by fluxion, which may be known by the pain and suddenness of the swelling, as also by the Tension and Pul∣sation, and by being accompanied with a Fever, Bleeding must be used in the first place, and the Woman must be frequent∣ly purged with the purging Potion men∣tion'd in the foregoing Chapter, made of Tamarinds, Sena, Manna, and the like, and after Evacuations you must apply cooling and repelling things to the Reins and the lower part of the Belly, as Oyl of Roses washed in Vinegar and the like, and the following Decoction may be in∣jected into the Womb.

Take of the leaves of Plantain, Water Lil∣lies, Night-shade, and Endive each one hand∣ful, of red Roses two Pugils, boyl them in three pints of Fountain water till a pint is consumed, add to it of Oyl of Myrtles one Ounce, of Vinegar half an Ounce.

But note you must not use cooling and repelling things too long, lest the Tumour be hardened thereby and turn to a Scirr∣hus, and therefore soon after the begin∣ning of the Swelling, emollient and resolv∣ing things must be mixt with Repellents, Mallows, Marshmallows, Mugwort, Fe∣nugreek, Camomile and Melilote; and if the pain be violent, you must inject into the Womb Goat or Sheeps milk, with Opium and Saffron each three or four Grains, to which may be added a little Rose Water.

But if the swelling cannot be resolved and tends to Suppuration, it must be fur∣thered by the application of the following Pultis.

Take of the roots of Marshmallows, of the Flowers of Camomile and Melilote, of the Seeds of Flax and Fenugreek each one Ounce, of fat Figs number eight, boyl them to the consistence of a Pultis, then add the yolks of four Eggs, of Saffron half a Scruple, of Oyl of Lillies and fresh butter each one Ounce, make a Cataplasm.

If the Swelling be made by congestion, it is slow and without pain, and generally cold, and the matter of it is either thin and serous, or thick and flegmatick and apt to grow hard. In this case Steel Medi∣cines used as directed in the Chapter of

Hysteric Diseases do good, but purging must go before: Issues in the Legs are also proper, and emollient and resolving Medi∣cines must be apply'd outwardly in the fol∣lowing manner.

Take of the Roots of Marshmallows and Lillies each two Ounces, of the leaves of Mal∣lows, Violets, Marshmallows, and Bears∣breech each one handful, of the Seeds of Flax and Fenugreek each one Ounce, of the leaves of Mugwort and Calamint half a handful, of the Flowers of Camomile and Melilote each one Pugil, boyl them in three pints of Foun∣tain water till a third be consumed, and fo∣ment the region of the Pubes and Groin with a Spunge dipt in it and pressed out: Of the same Decoction the dose of the Simples being increas∣ed, a bath may be made, which is very ef∣fectual in this case, and more powerful than the Fomentation▪ Glisters also and Injections may be made of the same Decoction, and fre∣quently used, whereunto may be added the Oyls of Lillies, Camomile, and sweet Almonds.

But these Medicines must be used with great caution, lest the swelling shou'd de∣generate into a Cancer, and indeed 'tis to no purpose to use Medicines when the Swelling is without pain and of a stony na∣ture.

But if an Ulcer be the cause, the cure of it must be performed by stopping the Fluxion of the humours, and by cleansing and con∣glutinating the Ulcer; and first if the Bo∣dy abound with Blood, or if the Ulcer be accompanied with an Inflammation, a Vein must be opened in the Arm, and Bleeding must be repeated as often as there is dan∣ger of a new Fluxion, especially at the times of the Courses, to lessen them, for they are wont to increase the matter of the Ulcer, and to promote the Flux of other humours to the Womb. Purging is al∣so very necessary to cleanse the Body from ill humours, but it ought to consist of gen∣tle Catharticks, as of Sena, Rhubarb, Ta∣marinds, Myrobolans and the like, or the Purging Potion of Tamarinds may be used but if the Woman Vomits easily she may take the following Vomit or the like.

Take of Vinum benedictum six Drams, of the Water of Carduus Benedictus one Ounce, of Oxymel of squills half an Ounce, mingle them, make a Vomit, let it be taken about four in the afternoon, and she must drink a large draught of Posset Drink after every time she Vomits.

The days the Sick does not Purge, a Vulnerary Decoction must be used a long while in the following manner.

Take of the leaves of Agrimony, Knot-grass, Burnet, and Plantine, each one handful, of the roots of China three Drams, of Coriander one Dram, of Raisins half an Ounce, of red Sanders one Scruple, boyl them in Chicken broth, strain it, let the Sick drink it Morn∣ing and Evening.

If there be a Fever, and if a great quantity of matter be evacuated, Whey is very proper, half a pint or more being taken in a Morning with a little Honey of Roses, and if there is an Hectick Fever and the Body begins to wast, Asses milk must be taken with Sugar of Roses for a whole Month.

Turpentine washed in some proper wa∣ter for the Womb, as in Mugwort or Fe∣verfew water, or in some water proper for the Ulcer, as Plantain or Rose wa∣ter, and taken with Sugar of Roses clean∣ses and heals the Ulcer.

To cleanse dry and heal the Ulcer va∣rious injections are proposed, but they must not be used till the Inflammation is taken off, and till the pain is quieted, and therefore upon account of the Inflammation an Emulsion of the cold Seeds, or the Whey of Goats Milk, or Milk it self may be injected first, and if necessity requires, a Decoction of Poppy heads and tops of Mallows may be injected. Some Practitio∣ners

say, the Sick may be much relieved by injecting frequently warm water, and when the heat and pain is quieted, we may use such things as cleanse, beginning with the gentle, and proceeding gradually to the stronger. The gentle are Whey with Sugar, a Decoction of Barly with Sugar, or Honey of Roses, but Simple Hydromel cleanses most. But if the Ul∣cer be very sordid, the following Decocti∣on may be used.

Take of the roots of Gentian, Rhaponticum, Zedoary, and round Birthwort each one Ounce, of White-wine three pints, boyl them to the con∣sumption of a third part; in the strain'd Liquor dissolve half a pound of Sugar, and keep it for use; a little Ʋnguentum Aegyptiacum may be added to it if there be occasion to cleanse more.

If the Ulcer be deep, the fume menti∣on'd above may be used; when the Ulcer is very obstinate, Cinnabar must be added, which is of excellent use.

If these Diseases happen when a Wo∣man is with Child, the difficulty is great∣er, because bigbellied Women cannot so easily bear all kind of remedies, yet lest being destitute of all help they shou'd re∣main in extream danger of Miscarriage and Death, some kind of Remedies are to be used; therefore if she be too full of

Blood, she must have a Vein opened, tho she be with Child, especially in the first Month, and so twice or thrice if need be, but much Blood must not be taken away at a time. And when there is abundanee of ill humours, gentle purging must be used and repeated, especially in the mid∣dle Months, and in the mean while those astringent and strengthening▪ Medicines must be used all the time the Woman is with Child, that are proper to hinder Miscarriage.

Take of Kermes Berries and Tormentil roots each three Ounces, of Mastich one Dram and an half, make a Powder, whereof give now and then half a Dram, or as much as will lie on the point of a knife, or let her take every Morning some grains of Mastich: Or

Take of conserve of Roses two Ounces, of Citron Peel Candied six Drams, of Myrobo∣lans candied, of the Pulp of Dates each half an Ounce, of Coral prepared, Pearl prepared, and shavings of Harts-horn each one Dram, with Syrup of Quinces make an Electuary, of which let the Woman take often the quantity of a Nutmeg.

The following Lozenges are very good for they strengthen, and by little and lit∣tle free the Body from Excrements, tho they do not sensibly purge sometimes.

Take of Mace, of the three Sorts of San∣ders, Rubarb, Sena, Coral, Pearl, each one Scruple, of Sugar dissolved in Rose-water four Ounces, make all into Lozenges weighing three Drams apeece; let her take one twice a Week by it self, or dissolved in a little Broth.

The following Plaster may be apply'd to the Reins.

Take of the Plaster ad Herniam and de Minio each equal parts, spread it on Leather, and apply it to the small of the Back.

But Plasters must not be worn long to∣gether, lest they should cause an heat of Urin, and the Stone in the Kidnies.

In the use of these things, the Woman must keep her self as quiet as possibly she can, both in Body and Mind, and must abstain from Copulation.

But if notwithstanding the Medicines a∣foresaid, by reason of the Vehemence of the cause, whether it be outward or in∣ward, the Sick be ready to miscarry, we must do the best we can with the follow∣ing remedies, and in the first place so soon as Pains and Throws shall be perceived in the lower part of the Belly, and in the Loins, we must endeavour to allay them both by Medicines taken inwardly and outwardly apply'd according to the varie∣ty of the Causes, and if Crudities and

Wind are the cause, as they are most usu∣ally when the cause is within, a Powder must be given made of Aromaticum Rosa∣tum and Coriander Seeds, and we may give of the Imperial Water if Flegm and Wind abound.

At the same time let Carminative Medi∣cines be apply'd below the Navel of the Patient, such are Bags of Anise Seeds, Fen∣nel Seeds, Fenugreek Seeds, Flowers of Camomile, Elder, Rosemary and Stechas, mixt together, or a Rose Cake fryed in a Pan with rich Canary, and sprinkled with Powder of Nutmegs and Coriander Seeds, or the Gaul of a Wether new kill'd or his Lungs lay'd on warm. If by these means the pains cease not, let a Glister be injected made of Wine and Oyl, wherein two Drams of Philonium Romanum may be dissolved, or Narcoticks may be given inwardly in a small quantity to allay the Violence of the humours and wind, as we are wont to do in pains of the Colick. But if Blood begins to come away, Frictions and painful Ligatures of the upper parts must be used to turn the course of the Blood, and if the Woman be full of Blood, it will not be amiss to take some Blood from her, especially before it begins to low, but it must be taken away at several times a little at once.

And if the Flux of Blood continues we must proceed to an astringent and thick∣ening Diet and Medicines, as mentioned above. Astringent Fomentations may be also used outwardly made of Pomgranate-peels, Cypress Nuts, Acorn Cups, Balau∣stines, and the like, boyl'd in Smiths wa∣ter and Red wine: Or a little bag full of Red Roses and Balaustines may be boyl'd in Red Wine and apply'd hot to the Womans Belly: And the Plaister above mentioned may be used. It is be∣lieved, that the two following Medicines will certainly retain the Child in the Womb if they be used before it is torn from the Vessels of the Womb.

Take of leaves of Gold, Number twelve, of Spodium one Dram, the Cocks treading of three Eggs not addle, mix all very well till the Gold be broken into small peeces, after∣wards dissolve them in a draught of White Wine, and give it three Mornings follow∣ing.

At the same time let the following Ca∣taplasm be applied.

Take of Male Frankincense powdred two Ounces, the whites of five Eggs, let them be stirred together over hot Coals, add Turpen∣tine to make them stick, then spread them upon Tow, and lay them upon her Navel as hot as she can possibly endure them twice a

day Morning and Evening on the three days afore-said.

CHAP. XXI.

The Signs that precede a Natural and Ʋnnatural Delivery.

THE signs preceding a natural La∣bour a few days before, are sinking down of the Belly, which hinders a Woman at that time in walking as easie as she used to do, and thence flows from the Womb slimy humours, appoint∣ed by nature to moisten and smoothen the passage, that its inward Orifice may the more easily be dilated, when it is ne∣cessary, which beginning to open a little at that time suffers that slime to flow a∣way.

The signs accompanying present Labour are, great pains about the Region of the Reins and Loins, which coming and re∣doubling by intervals, answer in the bot∣tom of the Belly with reiterated Throws, the Face is red and inflamed, because the Blood is much heated by the continual en∣deavours of the Woman to bring forth

the Child, as also because that during these strong Throws, her respiration is ever intercepted, for which reason much Blood hath recourse to the Face, her Privy Parts are swelled, because the Infants head often thrusts, and causes the Neigh∣bouring Parts to distend outwards; upon which account they appear swell'd in this manner; she is often subject to vomiting, which makes many believe, who know not the cause of it, that the Women are for this reason in danger: But it is ge∣nerally the sign of a speedy delivery, be∣cause the good pains are then excited and redoubled every moment, until the busi∣ness is finished.

When the Birth is very near, Women are troubled with an universal trembling, and chiefly of the Legs and Thighs, with the heat of the whole Body and Humours, which then flow from the Womb, and they are often discoloured with Blood, which with the signs above mentioned is an in∣fallible sign of the nearness of the Birth. This the Women usually call shows, and if one then puts up their Finger into the Neck of the Womb, they will find the inner Orifice dilated, at the opening whereof, the Membranes of the Infant containing the Waters present themselves, and are strongly forc'd downwards with

every pain the Woman has, at which time one may perceive them to resist the Finger, more or less as the pains are stronger or weaker. These Membranes with the Waters in them, when gathered (that is, when they are advanced before the head of the Child, which makes the Midwives call it the gathering of the Wa∣ters) presenting themselves at this inward Orifice, do then resemble very well to the touch of the Finger, abortive Eggs which have yet no shell, but are only covered with a simple Membrane. After this the pains redoubling continually, the Mem∣branes are broken by the strong impulse of the Waters, which incontinently flow away, and then the head of the Child is easily felt naked, and presented at the opening of the inward Orifice of the Womb: now all these or the greatest part of them meeting together, at what time soever of a VVomans going with Child it be, whether at the full time or no, one may be assured she will soon be deliver∣ed: But great care must be taken not to hasten her Labour before the necessity of it be known by these signs; for that would but torment the VVoman and Child in vain, and put them both in danger of their lives:

Labour contrary to nature is when the Child comes in an ill Figure and Situation, as when it presents any otherwise than the Head first; as also when the Waters flow away a long time before it is born; also when the After-burthen comes first. The Labour is also grievous when accom∣panied with a Fever, or any other conside∣rable Disease which may destroy the Child in the Womb; also when pains are small and come slow with long intervals and lit∣tle profit, upon which account the Wo∣man is extreamly tired; but the wrong posture of the Infant is most commonly the cause of difficult Labour. As soon as it is known that the Woman is certainly in labour by the signs above mentioned, then must all things necessary to comfort the Woman in her Labour be got ready, and the better to help her, care must be taken that she be not strait laced; a pret∣ty strong Glister may be given her, or more than one, if there be occasion, which must be done at the beginning, before the Child be too forwards, for afterwards it is very difficult for her to receive them▪ in the mean while all things necessary for her Labour should be put in order, as well for the Woman as the Child; her Mid∣wifes Stool, or rather a Pallet-bed girted

placed close by the Fire, if the Season re∣quire it; the Pallet ought to be so placed, as to be turned round about when there is occasion, the better to help the Woman. If the Woman be full of Blood, it may be convenient to Bleed her a little, for by this means her Breasts being disingaged, and her Respiration free, she will have more strength to bear down her pains, which may be done without danger, be∣cause the Child being about that time rea∣dy to be born, hath no more need of the Mothers Blood for its nourishment, which has been often practised with good success. Besides, this Evacuation often hin∣ders her having a Fever after delivery, and to preserve her strength, it will be convenient to give her some good Gelly Broaths, new laid Eggs, or some Spoon∣fuls of burnt Wine from time to time, or a Toast dipt in Wine, avoiding solid Food. Above all she must be perswaded to hold out her pains, bearing them down as much as she can, at the instant when they take her. The Midwife must 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; she must also a∣noint all the bearing place with emollient

Oyls, Hogs grease or fresh Butter, if she perceive it can hardly be dilated; and all the while she must be near her Wo∣man to observe her gestures diligently, her complaints and pains; for so she may guess pretty well how the Labour ad∣vances, without being obliged to touch her Body so often. The Woman may by intervals rest her self on the Bed to refresh her self, but not too long, especially if she be a little short thick Woman, for they have always worst Labours, if they lie much on their Beds in their Travail, es∣pecially of their first Children, than when they are prevailed with to walk about the Chamber; (but they must be suppor∣ted under the Arms, if it be necessary) for by this means the weight of the Child causes the inward Orifice to dilate sooner than in Bed. When the Waters of the Child are ready and gather'd, the Mid∣wife ought to let them break of them∣selves, for the breaking of them before the Infant be wholly in the passage pro∣longs the Labour; for by the too hasty breaking of these Waters, which ought to help the Child to slide forth with grea∣ter ease, he remains dry, which hinders afterwards the Pains and Throws, so that they cannot be so effectual in excluding

the Child, as otherwise they would have been: It is therefore better to let them break of themselves, and then the Mid∣wife may easily find the Child bare by the part which first presents, and so judge certainly whether it comes right, that is with the Head, which she will find hard, big, round, and equal; but if it be any other part, she will perceive something unequal and rugged, and hard or soft, more or less according to the parts; im∣mediately let her dispatch to deliver her Woman, if she be not already, and assist the Birth, which ordinarily happens soon after, if natural, in the following man∣ner.

After the Waters be broke of them∣selves, as above-said, let the Woman be presently placed on the Pallate provided for her to this purpose, near the Fire, or she may, if she like it better, be de∣livered in her ordinary Bed; for all Wo∣men are not accustomed to be delivered in the same posture, some will be deliver∣ed on their Knees, others standing, lean∣ing with their elbows on a Pillow, upon a Table, or the side of a Bed, and others lying upon a Quilt in the midst of the Chamber. But the best and surest way of Delivery is in Bed, to avoid the in∣convenience

and trouble of being carried thither afterwards, in which case it ought to be Furnished rather with a Quilt than a Feather-bed, having upon it Linnen and Cloaths in many folds, with other necessaries to be changed upon occasion, that the Woman may not be incommo∣ded afterwards with the Blood, Waters, and other filth, which is voided in La∣bour. The Bed must be so made, that the Woman being ready to be delivered, should lie on her back upon it, with her Head and Breast a little raised, so as that she be neither lying nor setting; for in this manner she breaths best, and will have more strength to help her pains, than if she sunk down into her Bed; be∣ing in this posture she must spread her Thighs abroad, folding her Legs a little towards her Buttocks, somewhat raised by a small Pillow underneath, and her Feet must be staid against some firm thing; moreover let her hold some By-standers with her Hands, that she may the bet∣ter stay her self during her pains. Being thus placed near the side of her Bed, with her Midwife by to help upon occa∣sion, she must take courage, and further her pains the best she can, bearing them down, when they take her, which she may

do by holding her Breath, and forcing her self all she can, just as when she goes to stool. In the mean while the Midwife must comfort her, and persuade her to endure her Labour bravely, and put her in hopes of a speedy delivery. The Mid∣wife, with her Hand anointed with Oyl or fresh Butter, may gently dilate the in∣ward Orifice of the Womb, putting her Fingers ends into its entry, and stretch∣ing them one from another, and thrust∣ing by little and little the sides of the Orifice towards the hinder part of the Childs Head, anointing these parts also with fresh Butter. When the Infants Head begins to advance to the inward Orifice, it is commonly said it is crown'd, and when it is come so far, that the ex∣tremity begins to appear manifestly with∣out the privy Parts, it is then said that the Child is in the passage, and the Wo∣man in Travail imagins, tho it is no such thing, that her Midwife hurts her with her Fingers, finding her self as it were scratched, and pricked with Pins in those parts, by reason of the violent dis∣tension, which the bigness of the Childs Head causes there.

When things are in this posture, the Midwife must seat her self conveniently

to receive the Child, which will soon come, and with her Fingers ends, her Nails being close paired, endeavour to thrust, as above-said, this crowning of the Womb, back off over the Head of the Child; and as soon as it is advanced as far as the Ears, or thereabouts, she may take hold of the two Sides with her two Hands, that when a good pain comes, she may quickly draw forth the Child, taking care that the Navel-string be not then intangled about the Neck, or any other part, lest thereby the After-burthen be pulled with violence, and possibly the Womb also, whereunto it is fastened, and so cause Flooding, or else break the string, whereby the Woman may come to be more difficultly delivered. It must also be observed, that the Head be not drawn forth straight, but shaking it a little from one side to the other, that the Shoulders may sooner and easier take place, im∣mediately after it is past, which must be done without losing any time, lest the Head being past, the Child be stopt there by the largeness of the Shoulders, and be in danger of being suffocated in the pas∣sage: But as soon as the head is born, if there be need, the Midwife may slide in her Finger under the Arm-pits, and

the rest of the Body will follow without any difficulty. As soon as the Midwife has in this manner drawn forth the Child, she must put it on one side, lest the Blood and Waters, which follow immediately after should choak it; afterwards let her be very careful to examin that there be no more Children in the Womb, which she may know, if putting her hand up the entry, she finds there another Water gather∣ing. If it be so, she must have a care not to go about to fetch the After-burthen, till the Woman be delivered of all her Children; wherefore the first string must be cut, being first tied with a Thred three or four double, and the other end must be fastened with a string to the Wo∣mans Thigh.

As soon as the Child is born, before the Navel-string is tied or cut, the Woman must be freed of the After-burthen. To perform this, the Midwife having taken the string must wind it once or twice a∣bout one or two of her Fingers of her left hand joined together, the better to hold it, wherewith she may then draw it moderately, and with the right Hand, she may only take a single hold of it a∣bove the left near the Privities, draw∣ing likewise with that very gently, rest∣ing

the Fore-finger of the same Hand ex∣tended, and stretched forth along the string towards the entry of the Sheath, always observing to draw it from the side, where the burthen cleaves least. Above all things care must be taken, that it be not drawn forth with too much vio∣lence, lest by breaking the string, you are obliged to put the whole Hand into the Womb to deliver the Woman, or the Womb be drawn down forth with it; also by drawing it out with too much violence, a great flooding may thereby happen. To facilitate the expulsion, the Woman may blow strongly into her Hands shut, or she may put her Finger into her Throat, as if she would provoke Vomiting, or she may strive as if she were going to stool, bearing always down, and holding her breath. When all these circumstances have been observed, if you meet with difficulty, you may, if need be, after that you know on which side the After-birth is situated, command an experienced Nurse-keeper to press the Belly lightly with the flat of her Hand, directing it gently downwards by way of Friction; above all being careful not to do it too violently; but if all this be in vain, then must the Hand be directed

into the VVomb to loosen and separate it.

As soon as the VVoman is delivered of both Child and Burthen, it must then be considered whether there be all, and care had, that not the least part of it remain behind, not so much as the skirts or clods of Blood, which ought all to be brought away with the first; for otherwise, being retained, they cause great pains. When the Woman has two Children, you must not fetch the Burthen, as was said be∣fore, till both the Children are born, and then it may be done without danger, sha∣king and drawing it always gently some∣times by one string, sometimes by the other, and sometimes by both together, and so by turns till all is come. When the Infant comes right and naturally, the Woman is brought to Bed, and deliver∣ed with little help, for which the mean∣est Midwifes are capable, and oft-times for want of them, a simple Nursekeeper may supply the place. But when it is a wrong Labour there is a great Mystery belongs to it; for then the skill and pru∣dence of a Surgeon is for the most part requisite.

Immediately after the Woman is de∣livered, and the Burthen come away, care

must be taken that the loosening of it be not followed with a Flooding; if it be not, a soft closure must be immediately applied to the Womb, five or six times double, to prevent the cold Air entring in and stopping the Vessels, whereby the Womb should cleanse by degrees when the VVomb is so closed: If the VVoman was not delivered upon her ordinary Bed, let her presently be carried into it by some strong Body or more if there be need, rather than to let her walk thither; which Bed must be ready warmed and prepared, as is requisite for the cleansings. But if she were delivered on it, which is best and safest to prevent the danger and trouble of carrying her to it, then all the soul Linnen and other things put there for receiving the Bloud, VVaters, and other filth, which comes away in Labour, must be removed, and she must be placed con∣veniently in it for her ease and rest, which she much wants to recover her of the Pains and Labour she endured in Tra∣vail, she must be placed with her Head and Body a little raised for to breath the freer, and to cleanse the better, especial∣ly of that Blood which then comes away, that so it may not clod, which being re∣tained causes very great pains. All this

will happen if they have not liberty to come freely by this convenient Situation, in which she must put down her Legs and Thighs close together having a small Pil∣low for her greater ease, if she desire it under her Hams, upon which they may rest a little. Being so put to Bed, let her lie neither on one side nor the other, but just on the middle of her Back, that so the VVomb may repossess its natural and proper place.

It is an ordinary custom to give the VVoman, as soon as she is delivered, two Ounces of Oyl of Sweet Almonds, and as much Syrup of Maiden-hair, which is good to sweeten and temper the inside of the Throat, which was heated, and hoarse by her continual cryes, and holding her breath, to bear down her Throws during her Labour; it is also good to prevent the Grips; but this Potion goes so much against the Stomachs of some VVomen, that being forced to take it with an aver∣sion, it may do them more hurt than good; therefore let none have it, but those that desire it and have no aversion for it: But good Broath taken after she is a little setled may be more beneficial.

Having thus accommodated her, and pro∣vided for her Belly, Breasts, and lower

parts, leave her to rest and sleep if she can, making no noise, the Bed-Cur∣tains being close drawn, and the Doors and VVindows of her Chamber shut, that so seeing no light, she may the sooner fall asleep.

As soon as the Bed is cleansed from the foul Linnen and other impurities of the Labour, and the Woman therein pla∣ced, let there be outwardly applied all over the bottom of her Belly and Pri∣vities, the following anodyne Pultiss made of two Ounces of sweet Almonds with two or three new laid Eggs yolks and whites, stirring them together in an earth∣en Pipkin over hot Embers till it comes to the consistence of a Pultiss, which be∣ing spread upon Cloath, must be applyed to those parts indifferently warm, having first taken away the Closures which were put to her, presently after her Delivery, and likewise such clods of Blood as were there left. This is a very fit Remedy to appease the Pains which Women common∣ly suffer in those Parts, by reason of the violence then endured by the Infants Birth; it must lie on five or six hours, and then be renewed a second time, if there be occasion. Afterwards make a Decoction of Barly, Linseed, and Chervil, or with Marsh-mal∣lows

and Violet Leaves, adding to a Pint of it an Ounce of Honey of Roses, where∣with, being luke-warm, Foment three or four times a-day, for the first five or six days of Child-bed, the bearing place, cleansing it very well from the Clods of Blood and other Excrements which are there emptied. Some Persons only use for this purpose luke-warm Milk, and ma∣ny Women only Barly-water. Great care must be taken at the beginning that no stop∣ping thing be given to hinder the cleans∣ings, but when ten or twelve Days are past, and she has cleansed sufficiently, Remedies may then be used to fortifie the Parts, for which purpose a Decoction is very proper made of Province Roses, Leaves and Roots of Plantain and Smiths water, and when she has sufficiently and fully done Cleansing, which is usually af∣ter the eighteenth or twentieth Day, there may be made for those that desire it, a very strong astringent Lotion to fortifie and settle those parts which have been much relaxed, as well by the great exten∣sion they received, as by the Humours, wherewith they have been so long time soak'd; this Remedy may be composed with an Ounce and an half of Pomgranat Peel, an Ounce of Cypress Nuts, half an

Ounce of Accorns, an Ounce of seal'd Earth, an Handful of Provence Roses, and two Drachms of Roch-allom, all which being infused in a Quart and half a Pint of strong Red-wine, or that it may not be too sharp, some Smiths water may be mixed with the Wine, afterwards boil it to a Quart, then strain it, squeez∣ing it strongly; and with this Decoction Foment the inferior parts Night and Morning to strengthen and confirm them. But they will never be reduced to the same state they were in, before the Woman had Children. A small Plaister of Galba∣num, with a little Civit in the middle may be also applyed to the Womans Navel. As for Swaiths they need not be used the first Day, or at least very loosly, especial∣ly if there has been hard Labour, because the least compression of the Womans Bel∣ly, which is then very sore, as the Womb also is, proves a great inconvenience to her; wherefore let her not be swaithed until the second Day, and that very gent∣ly at the beginning. The use of Swaiths and of a good large square Bolster over the whole Belly may be continued the first seven or eight Days to keep it a little stea∣dy; but they must be taken off and re∣moved often to anoint the Womans Belly

all over, if it be sore, and if she has After-Pains, with Oils of sweet Almonds and St. Johns-wort mixed together, which may be done every Day. But after that time they may be degrees begin to swaith her straiter, to contract and gather to∣gether the parts which are greatly extend∣ed, during her going with Child, which may be then safely done, because the Womb by these former cleansings is so diminished, that it cannot be too much compressed by the Swaiths.

Proper Remedies may be applied to the Breasts to drive back the Milk, if the Woman will not be a Nurse; but if she intends to be a Nurse, it will be sufficient to keep her Breasts very close, and well covered with gentle and soft Cloaths to keep them warm, and to prevent the curd∣ling of the Milk; and if there be danger of too much Milk being carried thither, anoint the Breasts with Oyl of Roses and a little Vinegar beat together, and put upon them some fine Linnen dipt in it, ob∣serving that if the Woman do Suckle the Child, she give not the Breast the same day she is brought to Bed, because then all her Humours are extreamly moved with the pains and agitation of the Labour; there∣fore let her defer it at least till the next

day; and it would be yet better to stay four or five days or longer, to the end the fu∣ry of the Milk, and the abundance of the Humours, which flow to the Breast at the beginning, may be spent, in which time another Woman may give it Suck.

Although a Woman be naturally Deli∣vered, yet notwithstanding she must ob∣serve a good Diet, to prevent many ill acci∣dents which may happen to her during her Child-bed, at the beginning whereof she must be directed in her Meat and Drink almost in the same manner as if she had a Fever, that so it may be prevented, in as much as she is then very subject to it; for this reason she must be regular in her Diet, especially the three or four first Days, in which time she must be nourished only with good Broaths, new-laid Eggs, and Gellies, without using at the beginning more solid Meats: but when the great a∣bundance of her Milk is a little past, she may with more safety eat a little Broath at Din∣ner, or a small piece of boyl'd Chicken, or Mutton; afterwards, if no accident happens, she may be degrees be nourished more plentifully, provided that it be a third part less than she was accustomed to take in her perfect health, and that her Food be of good and easie Digestion; as

for her Drink, let it be a Ptisan made of Liquorish, Figs, and Anniseeds, boyled in Water: She may also, if she be not Feve∣rish, drink a little white Wine well mixed with Water, but not till after the fifth or sixth Day. But it is to be noted that la∣borious Women of a strong Constitution require a more plentiful feeding; yet not∣withstanding, if they do not change the quality, they must at least retrench the quantity of their ordinary Food.

The Child-bed Woman must likewise keep her self very quiet in her Bed lying on her Back, with her Head raised, and not turn∣ing often from side to side; that so the Womb may be the better settled in its first Situation: She must free her self at that time from all care of Business, let her talk as little as may be, and that with a low Voice, and let no ill News be brought to her, which may affect her, because all these things do cause so great a commotion of the Humours, that Nature not being able to overcome them, cannot make the necessary Evacuation of them, which has been the Death of many. The Woman ought always to keep her Body open with Glisters, taking one once in two Days, which not only evacuate the gross Excre∣ments, but also by drawing downwards

cause her to Cleanse the better. When she has observed this Rule a Fortnight or three Weeks, which is very near the time of ha∣ving Cleansed sufficiently, that those Parts may be throughly cleansed before she goes abroad, and begin upon a new Score, let her take a gentle Purge of Sen∣na, Cassia, and Syrup of Cichory, with Ru∣barb, which is good to Purge the Stomach and Bowels of those ill Humours Nature could not evacuate by the Womb: This Purge may be repeated upon occasion.

Women in their first Labours have ma∣ny times bruises and rents of the outward parts of the Womb, and they must never be neglected, lest they degenerate into malig∣nant Ulcers; for the heat and moisture of these Parts, besides the filth which conti∣nually flows thence, easily contributes to it, if convenient Remedies be not timely applied; wherefore as soon as the Woman is laid, if there be only simple contusions and excoriations, apply a Pultiss made of yolks and whites of new-laid Eggs and Oil of Roses seethed a little over warm Em∣bers, continually stirring till it be mixed, and then spread it upon a fine Cloath, and apply it very warm for five or six Hours, when being taken away, lay some fine Rags dipt in Oil of St. Johns-wort on each side

the bearing place, and renew them twice or thrice a Day. Foment these parts with Barly-water and Honey of Roses to cleanse them from the Excrements which pass, and when the VVoman makes water, let them be defended with fine Rags to hinder the Urine from causing pain and smarting. Sometimes the bruises are so great, that the Bearing-place is inflamed, and a very considerable abscess follows, in which Case it must be opened just below the Swelling in the most convenient place; and after the Matter is evacuated, a detersive Decoction must be injected into the Cavi∣ty, made of Barly-water and Oyl of Roses, to which Spirit of Wine may be added, if there be any danger of Corruption, and afterwards the Ulcer must be Dressed ac∣cording to Art.

Sometimes it happens that the Perine∣um is so rent, that the Privities and the Fundament is all in one; in this case, ha∣ving cleansed the Womb from such Excre∣ments as may be there with Red-wine, let the Rent be strongly stitched together with three or four stiches, or more, according to the length of the separation, taking at each stich good hold of the Flesh, that so it may not break out, and then dress it with Linimentum Arcaei, or the like; clap∣ing

a Plaister on, and some Linnen above to prevent, as much as may be, the falling of the Urine, and other Excrements upon it, because the acrimony of them would make it smart, and cause Pain; and that these parts may close together with more ease, let the Woman keep her Thighs close to∣gether, without the least spreading until the Cure be perfected: but if afterwards she happens to be with Child, she will be obliged to prevent the like mischief to a∣noint those parts with Emollient Oyls, and Oyntments, and when she is in Labour, she must forbear helping her. Throws too strongly at once, but leave Nature to perform it by degrees, together with the help of a Midwife well Instructed in her Art; for usually when these parts have been once rent, it is very difficult to pre∣vent the like in the following Travail, be∣cause the Scar there made does straighten the parts yet more; wherefore it were to be wished for greater security against the like accidents, that the Woman should have no more Children.

CHAP. XXII.

Of hard Labour.

MAny Causes may be assigned that oc∣casion hard Labour, as the natural weakness of the Mothers Body, or her Age, she being too Young or too Old; or it may be occasioned by Diseases that she had with her big Belly, leanness or too much dryness of the Body, or Fat compressing the passages of the Womb, the ill confor∣mation of the Bones encompassing the Womb, as in those that are Lame, may also occasion it; Wind swelling the Bow∣els, a Stone or Preternatural Tumour in the Bladder that presses the Womb may be the occasion; so may the ill constituti∣on of the Lungs, or of the parts serving respiration, for the holding of the Breath conduceth much to the Exclusion of the Child. Various Diseases of the VVomb may also render the Delivery difficult, as swellings, Ulcers, Obstructions, and the like. The hard Labour is occasioned by the Child, when by reason it is Dead, or Putrified, or any way Diseased it cannot confer any thing to its own exclusion; al∣so

when the Body or Head is too large, or when there are more than one; so Twins most commonly cause hard Labour, or the ill situation of the Child is the cause, or when the Hands or the Feet offer first, or when one Hand or one Foot comes out first, or when it is doubled, or when the Membranes break too soon, so that the VVater flows out and leaves the Orifice of the VVomb dry at the time of Exclusion, or when the Membranes are too thick, so that they can∣not be easily broken by the Child.

Cold and dry Air and a North-wind are very injurious to VVomen in Labour, be∣cause they bind the Body and drive the Blood and Spirits to the inner parts, and they are very injurious to the Child com∣ing from so warm a place. And hot Weather dissipates the Spirits, and weak∣ens the Child. Crude Nourishment and such as is difficultly concocted and binds taken in a great quantity before Labours renders it difficult, the Stomach being weak∣ned, and the common passages contracted, which ought to be open in this Case. Drowsiness hinders the action of the Mo∣ther. The unseasonable motion of the VVoman much retards the Delivery, as when she refuses upon occasion to stand, walk, lie, or sit, or slings her self about

unadvisedly so that the Child cannot be Born the right way, being turned prepo∣sterously by the restlesness of the Mother. Urine in the Bladder, or Excrements in the right Gut, or the Piles when they are much swell'd hinder Natures endeavours, by narrowing the Neck of the VVomb. Fear, Sorrow, Anger make the Labour difficult. A Blow, a Fall, or a Wound, may also much obstruct the Labour. Want of good assistance to lift the Woman up just at the time of Delivery, and an Igno∣rant Midwife who orders the Woman to endeavour an expulsion, and to stop her breath when the ligaments of the Fetus stick firmly to the Womb, so that the Woman is tired before the time of her De∣livery.

In hard Labour Women commonly give a Spoonful or two of Cinamon-water, or Cinnamon powder'd with a little Saffron, or half a Dram of Confection of Alker∣mes in Broth, or half a Scruple of Saffron alone in some Broth, or every hour a lit-VVine.

If these things are not sufficient the fol∣lowing may be used which have been fre∣quently found very effectual.

Take of Dittany of Creet, and both the Birthworts, and of Troaches of Mirrh each half a Scruple, of Saffron and Cinnamon each Twelve Grains, of confection of Alkermes half a Dram, of Cinnamon-water half an Ounce, of Orange-flower-water, and of Mugwort-wa∣ter each one Ounce, make a Potion. Oyl of Amber and of Cinnamon, and extract of Saffron are very effectual in a small quanti∣ty, namely five Grains of extract of Saffron, four or five drops of Oyl of Cinnamon, twelve or fifteen drops of Oyl of Amber in Wine, Broth or some other Liquor; and let the Wo∣man take Sneesing Powder for it hastens deli∣very.

The Midwife must frequently anoint the Womb with the Oyls of Lilies or of Sweet Almonds, and the Belly must be fomented with a Decoction of the Roots of Marshmallows and Lilies, of the Leaves of Mallows, Violets, Mugwort, of the Seeds of Fenugreek and Flax, of the Flowers of Camomile and Melilote. Sharp Glisters must be also injected to stimulate the Womb, and to carry off the Excre∣ments. Anoint the Navel with Oyl of Amber.

If the Child begins to come forth pre∣posterously, as with one Arm or Foot, the Midwife must thrust them back, and turn the Child right, which may be done by placing the Woman on her Back upon a Bed with her Head low and Feet high.

CHAP. XXIII.

Of a dead Child.

WHEN the Child is dead the mo∣tion of it ceases, which either the Woman felt before in the Womb, or the Midwife with her Hand; a sense of weight with pain afflicts the Belly, and the Child falls like a Stone from side to side; the Belly feels cold, the Eyes are Hollow, the Face and Lips pale, the extream parts cold and livid, the Breasts flaccid, and at length the Child putrifying, stinking matter Flows from the Womb, and an ill and strong smell exhales from the Womans Body, and her Breath stinks. If the Secundine be excluded first, it is a cer∣tain sign that the Child is dead.

The whole cure consists in the exclusion or extraction of the Child.

Take of the Leaves of Savine dryed, of the roots of round Birthwort, of the Troches of Myrrh and of Castor each one Dram, of Cinnamon half a Dram, of Saffron one Scru∣ple, mingle them make a Powder, whereof let her take one Dram in Savine Water.

Foment the Pubes, Privities, and Pe∣rineum, with an Emollient Decoction made of the Leaves of Mallows, and Marsh∣mallows, and the like and let a Pessary be put up the Privities.

Take of the Roots of round Birthwort, Or∣ris, Black Hellebore, of Coloquintida and Myrrh each one Dram, of Galbanum and Opopanax each half a Dram, with Ox Gall, make a Pessary.

If after having tried Medicines a long while, the Child cannot be ejected, it must be extracted by a Surgeon, either with In∣struments, or with the Hand alone.

CHAP. XXIV.

Of the Caesarian Delivery.

THE Caesarian Delivery is a dextrous extraction of a Living or Dead Child from the Mothers Womb, which cannot be other ways excluded, and that with∣out endangering the Life of both, or of either, and without spoiling the Faculty of conceiving; and by this Art the first Scipio Africanus of the Romans was cut out of his Mothers Womb, and therefore was called Caesar. This Caesarian Section is thought to be necessary, when the Mother and the Child are so weak, that they can∣not be preserved any other way. The use of it is twofold, one, that a living Child may be extracted; the other, that the Mother may be preserved alive; and tho' it is very hazardous, yet in a des∣perate case it is better to do something than nothing; especially when a confe∣deracy is like to be broken by the death of a Wife; or when a Family is like to be extinguished; or some Kingdom or Principality is like to be lost. In this manner we find in the Annals of Spain,

the King of Navar was preserved; for his Mother being wounded in the Belly by the Saracens, as she was Hunting, a No∣ble Man coming to her help, saw the Child put its hand out of the Wound, and drew it forth, and educated it privately; and afterwards, when the Nobility was contending about the Election of a Prince, he brought out the young King, and so the Controversie ended.

The causes which require this operati∣on are, a too great Child, or Twins, or more that endeavour to be born to∣gether; or if a fleshy Mole join to the Child, the ill posture of it, and if it can∣not be reduced to a better, either by its own help, or the help of others; or be∣cause it is dead, or so much swell'd by a Disease, that the Naturall passage is too narrow: But in this case, it is best to take it away peece-meal. The causes on the Mothers part are the narrowness of the passages, either naturally, by reason she is too young, or too old; or because the VVomb is shut, either by a Cicatrix or a Callous. Moreover many tumours in the Womb, or the Mouth of it may be the cause: In these cases, tho it be very dangerous, yet it is very necessary to use Section, and the operation may be hap∣pily

performed, as may appear by se∣veral Experiments to him that reads Rousel.

But before you enter upon this Ope∣ration, you must consider, whether the Child can be Extracted any other way that is safer and easier. You must more∣over consider whether there are Signs of Death, and if so, you must not enter up∣on the Operation, lest the Womans Death be laid upon the Section, and your rash∣ness: But when you have througly weigh∣ed all things, if the Woman be of a strong Nature, tho by reason of the La∣bour she is weak, you may venture upon the Operation.

Most Authors would have it made on the left side of the Belly, because it is more free from the Liver; but I, says Mauri∣ceau, think it will be better and more skilfully made just in the middle of the Belly between the two right Muscles: be∣cause in this place there is only the cover∣ings, and the white line to cut. To dis∣patch then with more ease and speed, the Chyrugeon having placed the Woman so, that the Belly may be a little raised; let him take a good sharp incision Knife, very sharp on one side, with which he must quickly make an Incision, just in the

middle of the Belly between the two right Muscles unto the Peritoneum, of the length and extent of the Womb, or thereabouts; after that he must only peirce the Peritoneum with the point of his Knife, to make an Orifice for one or two of the Fingers of his left hand, in∣to which he must immediately thrust them to cut it, lifting it up with them, and conducting the Instrument for fear of pricking the Guts, in proportion to the first incision of the coverings, which hav∣ing done, the Womb will soon appear, into which he must make an Incision in the same manner, as he did in the Peri∣toneum, being careful not to thrust his Instrument at once too far in; having then so opened the VVomb, he must like∣wise make an incision in the Infants Mem∣branes; taking care not to wound it with the Instrument, and then he will soon see it, and must immediatly take it out of the burthen, which he must nimbly se∣parate from the bottom of the VVomb, and finding it to be yet living, let him praise God for having so blessed and pros∣pered his Operation. But the Children so delivered are usually so weak, if not quite dead, as it often happens, that it is hard to know, whether it is alive or dead;

yet one may be confident the Child is living, if by touching the Navel-string, the Umbilical Arteries are perceived to move, as also the Heart, by laying the Hand on the Breast, and if it prove so, means must be used to fetch it to it self, by spouting some VVine into the Nose and Mouth, and by warming it, until it begins to stir of it self.

But it is to be noted, that Mauriceau much disapproves this cruel Operation, and says it ought not to be performed until the VVoman is dead, for that the VVo∣man always dies in the operation, or pre∣sently after.

CHAP. XXV.

Of the Secundine retained.

IN a natural Birth the Secundine is usu∣ally excluded presently after the Child; and when it is not, the Life of the Wo∣man is much indangered. It is retained by the too great thickness of the Coats, the swelling of them, and by an afflux of Humours occasion'd by hard Labour; also by the strutting of the Mouth of the Womb after the exclusion of the Child. The External Causes are, Coldness of the Air, whereby the Secundine is repelled, and the Orifice of the Womb shut. Cer∣tain perfumes, whereby the Womb is allured upwards, violent passions of the Mind, as Fear, and sudden Frights, the perverseness of the Woman, who will not abide in such a posture, or use such en∣deavours as are requisite, the weight of the Child, whereby the Navel is broken, the After-birth remaining within, the un∣skilfulness of the Midwife who cuts the Vessels of the Navel too soon, or does not hold them in her Left Hand as she ought, for if she let them go, they are drawn

back into the Womb, and are hid there with the Secundine.

It is easie to know when the Secundine is retained in the VVomb, but sometimes a piece of it is separated and remains in the Womb, which is not so easily perceiv∣ed, yet it may be known, because the Womb after Delivery endeavours to eject something; but tho its endeavours are but small, a sense of heat and pain is per∣ceived in the Womb, and after a few days a cadaverous smell exhales from the Womb. The retention of the Secundine is very dangerous, and if it continues some days, an acute Fever, Nauseousness, Faintings, difficulty of Breathing, Cold∣ness of the extream Parts, Convulsive Fits, and at length Death follows.

The Secundine retained, is expelled by the same remedies, which are proposed for a dead Child, to which may be added some Specificks deliver'd by Authors. Ru∣landus says, he has given with success thirty drops of Oyl of Juniper. Some or∣der the Woman to bite an Onion three or four times and to swallow the Juice, and presently after to drink a small draught of Wine. The Juice of green Lovage drank in Rhenish-wine is also commended. Sneesing is also good; but the best way is

to have it drawn out by a skilful Chy∣rurgeon, before the Inflammation is in∣creased. If the Secundine cannot be e∣jected by any means, but sticks firmly to the Womb, and putrifies there, Suppura∣ratives must be injected; to this purpose Basilicon may be dissolved in the following Decoction.

Take of the Leaves of Mallows with the roots three handfuls, of the roots of both the Birthworts each six Drams, of Flax Seeds and Fenugreek Seeds each half an Ounce, of Violets one handful, of the Flowers of Camo∣mile, and the lesser Centory each half an hand∣ful, make a Decoction in Water mingled with Oyl, if you would have it suppurate much, but to cleanse add a little Ʋngentum Aegyp∣tiacum.

CHAP. XXVI.

Of the Flooding of a Woman new laid.

FLooding is a more dangerous accident than any other which may happen to a Woman newly laid, and which dispatch∣es her so soon, if it be in a great quan∣tity, that there is not often time to pre∣vent it; wherefore in this case conve∣nient Remedies must be speedily ap∣plied to stop it; to which purpose it is fit to consider what causes the Flooding, and if it be a false Conception, a piece of the burthen or clodded Blood remain∣ing behind, all diligence must be used to fetch them away, or to cause a speedy expulsion of them. But if when nothing remains behind in the Womb, the Blood notwithstanding continues to flow, you must Blood in the Arm to make diversion, and let her Body be laid flat, and not raised, that so the Blood may not be sent down to the lower Parts. Let her keep

her self very quiet, and not turn from side to side; the upper part of her Belly must not be Swathed or Bolstered, and her Chamber must be kept a little cool, and the Coverings of the Bed must not be many, that so the Flooding may not be promoted by the heat.

But if notwithstanding all this the Blood flows continually, the last remedies must be tryed, which is to lay the Wo∣man upon fresh Straw, with a single Cloath on it, and no Quilt, that so her Reins may not be heated, applying along her Loins Cloaths wet in cold Vinegar and Water, unless it be Winter, and then it must be a little warmed; and to the end her strength may be preserved, which is extreamly wasted, let her take every half Hour a little good strong Broath with a few Spoonfuls of Gelly, and between whiles the Yolk of a new laid Egg; but too much Food must not be given at a time, because her Stomach cannot digest it. Her Drink must be Red Wine with a little Water wherein Iron has been quenched; and if there is the least appearance of Excrements contained in the Guts, make no Scruple to give a Glister to evacuate them. But if not∣withstanding

the Blood continues Flood∣ing, then the Woman will often have Fainting Fits, and be in great danger of losing her Life, because we cannot apply in those places the Remedies fit to stop the opening of the Vessels as we can in another.

CHAP. XXVII.

Of a Suppression of the Child-bed Pur∣gations, and After-pains.

THE Suppression of the Lochia is one of the worst Symptoms that can be∣fall a Woman in Child-bed, especially if they happen to be totally and suddenly stopt the first three or four days, which is the time they should come down plen∣tifully.

To bring the Lochia well down, let the Woman avoid Passion, and all di∣sturbances of the Mind, which may stop them; let her lie in Bed with her Head and Breast a little raised, keeping her self quiet, that so the Humours may be carried downwards by their natural ten∣dency. Let her observe a good Diet, somewhat hot and moist, and apply an Hysteric Plaster to her Navel.

Take of the Conserves of Roman Worm∣wood and Rue each one Ounce, of the Tro∣ches of Myrrh two Drams, of Castor, Eng∣lish

Saffron, Volatile Salt of Armoniac, and of Assa fetida, each half a Dram, with a sufficient quantity of the Syrup of the five opening Roots, make an Electuary. Let her take the quantity of a Large Nutmeg every third Hour, drinking upon it three or four Spoonfuls of the following mixture.

Take of the Water of Penny royal and Balm each three Ounces, of Compound Briony water two Ounces, of Syrup of Mugwort three Ounces and an half, of Saffron two Drams, of Castor tied up in a rag and hang∣ed in a Glass one Scruple, mingle them.

If these things are used presently upon the Suppression, they generally take it off▪ but if they have been used so long that all the quantity is taken, and the Lochia are still stopt, in this case we may use Laudanum for once, but it is best to mix it with Hesterick things: For instance, take sixteen drops of Liquid Laudanum in a Spoonful of Compound Briony, or Water. But it must be carfully noted, that if after having once taken it, the business is not done, Opium must not be repeated again, but having waited a while, to see what it will do, we must return again to Emme∣nagoges mixt with Hystericks, and after∣wards we must inject a Glister; but what

was said before of Opium, is to be taken notice of in respect of Glisters, for un∣less the first bring down the Lochia, no∣thing is to be hoped for from more.

These things therefore being done, it is safest and the duty of a prudent Phy∣sician to wait and see what time will do, for if the Woman live over the twenti∣eth day, she will be in a manner out of danger, and then she will be able to bear such a method as is proper and effectual enough to force the Lochia.

If the After-pains are more than usual, you must Swath the Womans Belly gent∣ly, that it may subside, and not move hi∣ther and thither, as it often happens af∣ter delivery, upon so sudden an evacua∣tion, and then give three Ounces of Oyl of Almonds fresh drawn, mixt with one Ounce and an half of Syrup of Vio∣lets.

And Glisters may be injected made of Milk and Sugar, and yolks of Eggs, and the Belly must be anointed with the Oyl of Dill, or of Rue, or of Jasmine. A Fo∣mentation may be also made of a De∣coction of Mugwort, Feverfew, Baulm, of the Leaves of Bays, and Calaminth, of the Seeds of Daucus, Cummin, and Carraways, of the Flowers of Camomile

and Wall-flower, made in Water and White-wine, or in Milk. It is also pro∣per to cover the Belly with a Sheeps-skin, fresh flead off, and appli'd hot. The fol∣lowing Powder taken presently after de∣livery preserves the Woman from Pain in a wonderful manner; and some think if the Woman takes it in her first lying in, she will never be troubled with these Pains.

Take of Comfry dryed one Dram, of the Kirnels of Peach stones, and of Nutmegs, each two Scruples, of Amber half a Dram, of Ambergrise half a Scruple, make a Pow∣der, whereof let her take a Dram with White∣wine, and if there be a Fever with Broth.

If the Woman after delivery be trou∣bled with a pain in the Groin, it may be taken off by applying a Plaster of Galba∣num and Assafetida to the Navel, in the middle whereof some Grains of Musk must be placed.

CHAP. XXVIII.

Of acute Diseases of Women in Child-Bed.

A Putrid Fever seises Child-bed Wo∣men at various Seasons, and upon several occasions, sometimes presently af∣ter delivery, especially if it has been dif∣ficult and hard, sometimes on the first, sometimes on the second, third, or fourth day, but the later it begins, the better it goes off.

It begins and proceeds most commonly in the following manner, after a previ∣ous indisposition, the Fever begins most commonly with a shaking and shivering, which Heat presently follows, and after that Sweat, the first or second day fits of Heat and Cold succeed one another, and then all the Blood being inflamed, the Lochia if they were not suppressed before, flow but little, or quite stop; if the Di∣sease be acute, and of quick motion, it comes to its height the third or fourth day; the Heat is violent, and the Thirst

very much, the Pulse vehement and quick, watchings obstinate, there is a great rest∣lessness, that the sick tumble from one side of the Bed to the other continually; the Urin is thick and red, and there are many other grievous Symptoms; when the Fever is in its state, no Crisis is to be expected, for I never saw this Disease go off by a critical Sweat.

The acute Diseases of Women in Child-bed are sometimes accompanied with a Quinsie, Plurisie, Peripneumonia, Bloody-flux, Small-pox, and the like; of these a Quinsie, Plurisie, and Peripneumonia, by reason of the great Smilitude of the Cause, and Analogy of the Cure, may be considered together; presently at their first beginning we must endeavour that the Blood fixed any where, and beginning to be extravasated be restor'd to Circula∣tion, lest an Imposthume should be occa∣sioned; wherefore internal remedies which free the Blood from Coagulation must be used, of which sort are Diaphoreticks a∣bounding with Volatile Salt, as Spirit of Harts-horn, of Soot, and Urine, also Testaceous and Bezoartick Powders, La∣pis Prunella, Decoctions and a Julep made of Vegetables that force Urine and the Courses, with all which must be mixt

such things as have been found by expe∣rience to be proper for Uterine Diseases. Moreover discutient Medicines, which dis∣perse the matter impacted, such are Lini∣ments, Fomentations, and Cataplasms, must be carefully applyed to the parts affected; in the mean while the violent Motion and immoderate effervescence must be driven far from thence, and the filth must be driven as much as is possi∣ble downwards; to this end Frictions, Ligatures, Epispasticks, and if there be occasion, Cupping Glasses, must be applied about the Legs and Feet. If the Disease be very violent Bleeding is indicated, and unless there be a Plethora in the whole Body, and the Inflammation be very acute in the part affected, it were be best to open a Vein in the Foot, or to apply Leeches to the Hemorrhoidal Veins; but if ne∣cessity urge, we may bleed in the Arm, and afterwards, if it can be admitted, in the Foot; but you must take notice, that Bleeding must be cautiously used in these Cases, for unless it does good, which I have seldom found, the Sick is in a worse condition, being render'd weaker there∣by.

The Bloody-flux is very often deadly, and so much the rather, because such

things as qualifie the Blood, and that moderately bind, are indicated; but the Flux of the Lochia forbids them, where∣fore in this case till she has been well Purged by a long Flux of the Lochia, the fierceness of the Symptoms must at pre∣sent be only appeased.

The Indications in the Small-pox are not only contrary to those above describ∣ed, but also to one another; for the Flux of the Lochia must be moderately re∣strain'd; but in the mean while the efflore∣scence of the Blood, and gentle Sweating must be continued, wherefore such things as are of an Alexipharmic and Astrin∣gent Nature must be boyl'd in their Broths, as the Roots of Tormentil and Bistort; and in this case the Woman must not eat Flesh, or the Broths of it, nor must she rise, but be kept as quiet as is possible, and the whole business must be left in a manner to God and Na∣ture▪

All Women in Child-bed have an in∣bred Venom, and they ought to be care∣ful of it, and to avoid it as much as the greatest Malignity; wherefore they ought to use an exact course of Diet, whereby the impurities of the Blood and Humours may be purged in Child-bed without the

danger of a Fever, and that the disorders of the Womb may be healed, and their strength weakned by delivery may be re∣stored, to which end three things are to be minded, first an exact course of Diet must be ordered, viz. That they be fed for a Week at least with Water-gruel, sometimes made with Beer, sometimes made with Water mixt with White-wine, or with Panada, and other things of easie Digestion: Secondly, They must take great care that they do not catch cold, whereby the Pores and the Lochia may be stopt; wherefore let them conti∣nue in Bed at least till the tenth day: Thirdly, The Lochia must be gently pro∣voked; to this end Midwives when af∣ter hard Labour, there is danger of the stoppage of the Lochia, give Sperma Ceti, Irish Slates powdered, or White-wine Tinctured with Saffron, and they make the Gruel with Water and White-wine, wherein as also in Posset-Drink they boyl Marygold Flowers, the Leaves of Penny-royal, or Mugwort.

CHAP. XXIX.

Of the Melancholy, Madness, Deliri∣um, and Epilepsie of Women in Child-bed.

THese Diseases happen in Child-bed, for want of a sufficient evacuation, by rea∣son of the fault of the Blood, the Suppressi∣on of it, or too great an Evacuation; or by Fevers, an ill Vapour rushing upon the Brain, whereof Lusitanus mentions an observation of a very Beautiful Lady, that presently after delivery fell Melan∣choly, and was mad for a Month, but by the use of a few Medicines recovered her Senses; and I, says Rodericus a Castro, have often cured a Dutch Merchants Wife who was frequently distracted after deli∣very. These Diseases are thus distinguish∣ed, Melancholy is a Delirium without a Fever, occasioned by a Melancholy humour possessing the Seat of the Mind. Madness is more outragious, and a hot Intemperies is the occasion of it; whereas Melancholy proceeds from a cold In∣temperies:

An Epilepsie is a Convulsion of all the parts of the Body, not perpe∣tual, but by intervals, with a depravati∣on of Sense and Jugdment. Lastly, a De∣lirium is an alienation of the Mind, and proceeds most commonly from a bilious Fever, and therefore is not a Disease, but a Symptom.

These are the general Indications; if these Diseases proceed from an immode∣rat Flux, it must be stopt, the strength must be kept up, and the cold and dry Intemperies must be corrected. If they proceed from a Suppression of the Child-bed Purgations, they must be forced; if they are occasioned by a fault in the Blood, they must be treated as the Me∣lancholy of Virgins and Widows.

The most Grievous Symptom of these Diseases are obstinate Watching; in this case apply often to the Temples the fol∣lowing Oxyrrhodine.

Take of the Waters of Roses and Plantain, each four Ounces, of Oyl of Roses, three Ounces, of Vinegar of Roses one Ounce, the Powder of Red Sanders, one Drachm, mingle them, apply it in a Rag, or Populeon Oynt∣ment mixed with Oyntment of Roses, three Grains of Opium, and one Scruple of Saffron;

or a live Pigeon cut in two may be applied hot to the Head. And if these things do not do, one Dram of Philonium may be given in Lettice Water and a little Wine at Bed-time. Note that in an Epilepsie the Oxyrrhodine a∣bove mentioned is not so proper, because it cools the Head too much, and in Melancholy such things must be added to it as moisten more.

CHAP. XXX.

Of driving away the Milk, of Tumors from Milk, of want of Milk, and of Chaps of the Nipples.

IF the Milk flow too freely into the Breasts, a Thin and Spare Diet must be ordered, and the Breasts must be often sucked to prevent the Inflammation of them, and the immoderate effervescence of the Blood; and if it be not thought conveni∣ent that the Woman should give suck▪ it is customary on the first or third day of Lying in, to apply over the Breasts moderately astringent Cerecloths, or the Populean Oyntment, and Galens cooling Cerate equally mixt, and spread on Lin∣nen; some use Linnen dipt in Luke-warm Verjuice, wherein a little Allom has bin dissolved, that so it may be more astrin∣gent; but great care must be taken in the application and change of these things, that the Woman catch not the least cold, as also that no Inflammation or Impostume be caused, instead of driving back the

Milk: Wherefore things are to be applyed according to the variety of the case.

But the best way to drive away the Milk is the causing an ample Evacuation of the Lochia, which is much further'd by keeping the Belly open with Glist∣ers.

Milk is the occasion of many tumours of divers kinds: The differences may be thus enumerated; if the Ferment of the Breast be over active, it separates the Milk with too great violence, causing thereby an over Fermentation in the part, which usually produces a Tumor called a Phlegmon, if the Serum be hot, or partakes much of Blood; otherwise it raises a Tumor called an Oedema; or if the matter be disposed to Coagulate, the Kings Evil: And these are the most fre∣quent Species of Tumors generally repu∣ted to arise from Milk, and either of them may degenerate into a Scirrhus, and that Scirrhus into a Cancer. The Signs are Visible; if the first happen, there are all the Symptoms of a Phlegmon, Heat, Redness, Tension, Pulsation, and the like; if the Second, large distension with pain, but no heat; if the Kings Evil, then hard Kernels are easily felt.

Swellings made by the over eagerness of the milky Ferment go easily off, if no other Symptom attend them. Sucking and drawing the Breast for the most part discharges the Milk, as fast as it can be generated, and then all goes off well. But if the Fermentation produce any dis∣order in the Blood, there is more or less danger according to the quality of the Tumor produced, viz. A Phlegmon is apt to occasion a Fever, Oedematous Tu∣mors are apt to grow Ulcers, and some∣times Scrophulous, and Scirrhous, and require a long time for their Cure. Be∣cause it frequently happens to Women in Child-bed, that their Breasts do swell extraordinarly by reason of abundance of Milk, which flows into them, and occasions Inflammations, Impostumations, and the like; therefore their Diet ought to be slender, and of such a quality as may less dispose the Humours to ferment, as Wa∣ter-gruel, Panado, and the like. But if the Inflammation be not violent, or the Patient weak, Chicken Broath may be al∣lowed with Wood-sorrel, Purslain, Let∣tice boiled in it, or a boiled Chicken, a Potched Egg, and such sort of Meats of easie digestion. The Medicines proper to diminish the Milk, are Lettice, Purslain,

Endive, Succory, Smallage, and the like, the Seeds of wild Rue, Cummin, Basil powdered and given to the quantity of one Dram daily in Broath, will dry up the Milk, as Authors write.

The Milk is usually drawn out of the Breasts by the Infants sucking them: But if the Child be so weak, it cannot suck, or does not discharge them enough, some body else must do it, or young Whelps may suck them, or the Mother may draw her own Breasts her self by an Instrument sold for that purpose.

The swelling made by the Milk is re∣strained by the application of Night-shade, Lettice, Plantain, Vine-tops, Bramble-buds, Horse-tail, and the like, or with the Oyl of Myrtles and Vinegar.

It may be discussed by the application of Mints, Catmints, Rue, the Seeds of Fenugreek, Cummin, Fennel, and the like, or dried up by applying Cloaths dipt in Lime water, or a Solution of Sacharum Saturni in the Water of Frogs Spawn; du∣ring which time fine Tow may be sprink∣led with Ceruss, and applied to the Arm∣pits: But these things must be only used at the beginning of the Fluxion.

But if the Inflammation be gon too far towards Suppuration, then it must be pro∣moted

with Suppuratives, and opened by Incision or a Caustick.

Where the swelling has been hard, and not inflamed, use the following Cerat.

Take of the tops of Wormwood powdered two Drams, of the Seeds of Fenugreek and Fennel, each one Ounce and an half, of the Juice of Henbane and Hemlock, each three Ounces, of Oyntment of Marsh-mallows two Ounces, of Ducks Fat, and Goose Grease, each one Ounce, of Deers Suet two Ounces, of Liquid Storax half an Ounce, with a suf∣ficient quantity of Wax, make a Cerat.

Hemlock boyled in Wine, and beaten up with Hogs Lard resolves the hardness of the Breasts. Green Mints, or Chick∣weed are common applications, and of good use, either alone or mixed with other Medicines, in all the hard Swellings of the Breast occasioned by Milk. All Plasters applied to the Breasts must have a hole sniped in them for the Nipples, lest they be fretted by them, especially that the Milk may be drawn forth whilst the Medicines lye on.

But it is best to prevent such Swellings at the beginning by procuring an ample and large Evacuation of the Lochia. For

the Chaps and Excoriations of the Niples, Rags dipt in Plantain-water may be ap∣plied, or the Oyntment called Diapom∣pholigos may be used: But great care must be taken that nothing be applied to disgust the Child; wherefore some only use Honey of Roses: But if the Excoria∣tion and Pain be much, the Woman must forbear giving the Child suck.

If the Child has wholly sucked off the Nipples, the Milk then must be quite dri∣ed away, that so the Ulcers which re∣main may be the sooner healed.

CHAP. XXXI.

Of want of Milk.

THE cause of want of Milk is a Vice of the Blood, the weakness of the Body, or of the Child, the smallness of the Breasts, the narrowness of the Ves∣sels, any immoderate Evacuation by ano∣ther part, as by the Mouth, by the Cour∣ses, by the Nostrils, or by the Hemor∣rhoids, by immoderate Cold, ill Diet, Fasting, great Labour, or Sorrow.

The whole Cure in a manner consists in Diet. If therefore it be occasioned for want of Blood, or by a dry Intemperies, from whence it chiefly proceeds, it must be cured by a hot and moist Diet, and the Air must be moist and moderately warm. Sleep is better than immoderate Watching. The Bread must be Wheaten and well fermented. Goats or Sheeps Milk boil'd with Yolks of Eggs, and sweetned is good; so is Rice boild with Milk and Honey, Potched Eggs, Chicken Broath, Mutton or Veal Broath, or Broath

of Phesants, or the Flesh of them with a Sauce made of Rocket and Honey; the Udders of Animals are also good. Of Fishes, a Trout, Mullet, a Salmon, Soles, Place, Pikes, and the like are good; and for the second Course, Sweet Almonds, Raisins of the Sun, Pistaches, Pine Nuts, Rocket, Parsnips roasted under the Em∣bers, or prepared with Honey. Dia∣scorides and Avicenna commend Fennel and Smalage; Lettice is also good, so are Cabbage, Wild Thime, Leeks, Rocket, Fennel. Let her drink be sweet Wine, or White-wine, or Barley water with the Seeds of Fennel, or Ale; wherein if you boyl Butter, Sugar, and Bread, you'll Scarce find a better Diet for this pur∣pose. The German Women use this for their Meat and Drink almost all the time they give suck. All things that are acid, acrid, bitter and very hot must be avoid∣ed. But if this defect proceed from heat or choler, you must use cooling things, and the Body must be purged according to the Nature of the Humour: But if the Blood be Flegmatick, and the Vessels ob∣structed, you must open the Obstructions and attenuate the Blood; therefore you must give hot things, as Smallage, Dill, Penny-royal with Wine: But you must be

careful not to give things that are too hot; for they dry up the Milk. And as those things which Moderately provoke the Courses breed Milk, so those that vio∣lently force them lessen it.

Blood is never to be drawn, nor are strong Purges to be used: But if it be ne∣cessary to use Purging by reason of the fault of the Humours, the Nurse must take four days before such things as in∣crease the Milk, and such Medicines must be given as increase the Milk. As

Take of thee Seeds of Fennel, of Leeks, and Rocket, each two Drams, of Mace one Dram, of the Leaves of Mallows half a handful, boyl them in Chicken Broath, and let her take six Ounces of the Broath, and wash▪ the Breasts with the Broath.

But if the want of Milk proceeds from the smallness of the Breasts, foment them with a Decoction of Fenugreek, and Ca∣momile made in Wine, or with hot Beer and Butter. But if these things do not good, you must chuse another Nurse; but you must try all things first, for change of Milk is very injurious to the Child.

CHAP. XXXII.

Of a Woman suckling her own Children, and of chusing a Nurse.

THE Mothers Milk is fittest for the Child, because it is most agreeable to it Nature: Besides the Mother will be more vigilant and careful than a hired Nurse; for none can love, the Child so well as the own Mother, who upon the account of her affection is unwearied in the attending of the Child, and thinks she never does enough for it, and is pre∣sently awaked by its crying; whereas mercenary Nurses often overlay Children and suffocate them. Moreover the Body, and the disposition of the Mind are more framed by the Milk and Nourishment, than by the nature of the Seed; and as you often observe that the Child is purg∣ed when the Nurse is Purged; so the Bo∣dy and Humours are in a manner the same with hers, as Trees partake of the nature of the Soil they are planted in. Be∣sides, it is the duty of a Mother to nurse

her own Child; for those that do not are but half Mothers, and to be sure cannot love them so well as those that do. Up∣on this account a Roman Youth of the Fa∣mily of the Gracchi, returning Rich and Victorious from the Wars, being met by his Mother and his Nurse, gave his Mo∣ther a Silver Ring, and his Nurse a Gold Chain; whereat his Mother being offended; You, said he, nourished me on∣ly Nine Months in the Womb, and then rejected me, this Woman received me into her Arms, and suckled me two Years, and taught me to be orderly. The Water nourishes what is bred in the Water, and the Earth nourishes what is bred in the Earth: Nor is there any Beast so cruel, as not to nourish its young ones. Tygers, Lions, and Vipers take care of their young ones, and only Man makes Found∣lings of his: Oh! incredible and execra∣ble Villany, what can be more cruel, than to expose a tender Infant that im∣plores his Mothers help, as soon as pos∣sibly she can get rid of it? But God in his Providence often punishes their Inhu∣manity; for their Milk often curdles in their Breast, and occasions dreadful pains, so that those Breasts, which were denied their Children are forced to be suckt by

Puppies; nor is this all, for their Breasts are often Inflamed and Suppurated, and must be cut with Knives, or burnt with red hot Irons, or becoming Cancerous, the rotten Flesh drops from them piece∣meal. But some will object in their ex∣cuse, that they are either too young or too weak, yet without doubt if they are able to Conceive, they may Suckle too; for God never gave them Breasts full of Milk to no purpose. But if they have not Milk enough, which is the only real ex∣cuse, a Nurse must be chosen, who ought to be of an age betwixt twenty and thir∣ty; she ought to be of a strong Constitu∣tion, well Coloured, not too Fat, nor too Lean; she must not have rotten Teeth, nor a stinking Breath, nor be affected with Scabs, Ulcers, the French-Pox, Gout, Consumption, or any other Di∣sease. Thirdly, Her Manners are to be considered; for the Child sucks them in with the Milk; whereof the Nurse ought to be good tempered; she must not be subject to violent Passions, nor wholly without Passion, nor of a weak Judgment; she must not be squint eyed, lest the Child should be so; she must be Chast, and not have Conversation with her Hus∣band, lest her Courses should flow, or the

Blood be disturbed, and consequently the Milk; or be with Child, whereby the Milk would be lessened, and become vi∣tious: but some think that the Courses flowing moderately does not vitiate the Milk, but rather cleanses the rest of the Blood. Fourthly, we must consider the time from Delivery; for she must not give suck too near Delivery, nor too long from the time of it. She must not give suck until she be free of the Child-bed Purgations; the time most approved of, is from the Second Month to the Sixth, and she should have Nursed a Child be∣fore. Fifthly, The Breasts are to be con∣sidered, which ought to be moderately full, not loose and hanging down; but solid and firm, of a moderate bigness and hardness, and the Veins of them should look blew, and dispersed into ma∣ny streams, moderately elevated, that they may contain the more Milk; for if they are dense, and the Milk is bound up in them, and as it were suffocated, the Child can scarce draw it, and so either takes a distaste, or if it suck on, the Nose is flattened by the pressure. Sixthly, The Paps must not be so short as that the Child cannot take hold of them with his Lips, nor so long and

thick, as to fill the Infants Mouth, so that it cannot readily use its Tongue to suck or swallow. Seventhly, The nature of the Milk must be considered, which, be∣sides the clearness and sweetness of it, which are the first requisits, must be also sweet-sented, not too thick nor too thin, which may be tried by dipping a hair in the Milk, hanging it up, if the Milk slide off, it is naught, but if it compass the whole hair it is good. Eightly, chuse a Nurse which was last delivered of a Male child. Ninethly, Such an one as is not wont to miscarry. Tenthly, She must not be with Child. The Nurse so described on the first days she begins to suckle must use a simple Diet, lest too much Milk should overwhelm the tender Infant. Af∣terwards let her have good Meats: She must not Drink excessively, she must ab∣stain from Wine, and from salt, sharp, and a stringent Meats, and Leeks, Onions, Garlick, Rocket and Spices. She must avoid all perturbations of Mind, and Co∣pulation; let her moderately exercise her Arms and upper Parts. Lastly, Her Diet must be such, as the Nature and Constitution of the Infant requires; if the Child be of a hot Constitution, she must use a cooling Diet; but if the In∣fant

be of a cold Constitution, a little Wine and Spices must be allowed, and stronger exercise, and if the Nurse be not well, she must be purged, and Diet must be ordered according to the faults of the Milk, and the disorders of the Child. The Nurse must be always chearful, and laugh∣ing, and singing with the Child. She must keep it clean. She must speak distinctly. She must assist the Child in sucking by pressing gently her Breasts; but she must not let the Child suck too much at once.

CHAP. XXXIII.

Of Wrinkles in the Belly and Breasts after Delivery.

WHen the Child in the Womb grows big, it stretches the Belly, or maks it chap, so that after Delivery Wrinkles remain in the Belly, and her Breasts grow small after the Milk goes a∣way for the same reason. The Chaps may be prevented, if after the fourth Month of being with Child, a Linnen cloath dipt in the Oyl of sweet Almonds be applied to the Belly. The Wrinkles left after Delivery may be taken off by two sorts of Remedies.

First therefore, If the Womans Month be not out, apply to the Belly the follow∣ing Oyntment.

Take of Sperma Ceti two Drams, of Oyl of Sweet Almonds, and St. Johns Wort, each one Ounce and an half, of Goats Suet one Ounce, of new Wax a sufficient quantity, make an Oyntment.

Secondly, After the Womans lying in, such things may be used as gently bind, and render the Belly solid and firm.

Take of the distilled Water of Mallows, and Marsh-mallow, each one Quart, of Rose-Water a Pint and half, two Lemons▪ peeled and sliced, of unripe Sloes one Pound; infuse them together two days, and then distil them in a Glass Alembick with a gentle fire, and bath the Womans Belly with it. But the fol∣lowing makes the Belly more solid.

Take of Figs one Pound, of the Meal of Barley and Beans, each half an Ounce, of the Meal of Rice two Ounces, of Galls, and Cypress Nuts, each one Dram, of Mastich, and Myrrh, each one Dram and half, of the Seeds of Fennel one Dram; boyl them all in Smiths Water till they are a little thick, then apply them to the Belly; or after bathing with a Decoction of the foresaid things: apply the following Pultiss to the Belly.

Take of the Meal of Beans, Rice, Acorns and Almonds, each two Ounces, of Bricks powdered one Ounce, of Bole-armenick two Drams, of Dragons Blood one Dram, of Cypress Nuts half an Ounce, of Kermes three Drams, of Galls half an Ounce, of Oyl of Myrtles six Ounces, of the Waters of Med∣lars,

and Sloes, each one Pint, of Rose-water one Pint and an half; boyl them to the consist∣ence of a Pultiss, apply it to the Belly.

It also makes the Breasts solid. But lest the Breast and Bowels should be of∣fended by its frigidity and binding qua∣lity, add of Mastick two Drams, of Nut∣megs three Drams, of Florentine Orris half an Ounce. Myrrh mixed with these, the Decoction of it, or used any other way renders the Belly smooth and firm, and the Breasts hard compact and small, and narrows the Privities, and is accounted a great secret in this case.

CHAP. XXXIV.

Of straitning the Privities after De∣livery.

AFter Delivery the Privities are lax; and hence Barreness, and a falling of the Womb are sometimes occasioned. The Cure is performed by two sorts of Remedies.

First, if the Privities are too moist, such things must be used as dry; the following Uterine Glister is very pro∣per.

Take of Galls number four, of Spodium two Spoonfuls, powder them very fine, and add Six Ounces of Stiptic-wine; afterwards put up the following Pessary.

Take of the Bark of the Pine two Drams, Allom one Dram, of Cyprus one Pugil, boyl them in Wine to the consistence of a Pultiss, apply them often with a rag: Or infuse Galls in Rain-water eight days, and with soft Wool sprinkled with Sulphur, and dipt in

this Water and dried without pressing, make a Pessary.

But Secondly, And chiefly you must use Astringents, Foment the Genitals with the Water or Decoction of Acorns, unripe Sloes, and of Horse-tail; or Foment the Parts with Allom-water, or with Stiptic-Wine, that is, red and rough Wine boyl'd with Galls, Leaves of Myrtles, Red Ro∣ses, Pomgranet-peel Balaustines, and Cy∣press Nuts: Or,

Take of Cypress Nuts and Galls, each one Pound, of Roch-allom, and the filings of Iron prepared in Vinegar, each half a Pound, boyl them in a sufficient quantity of the Waters of Galls, which Tanners use, and Foment the Parts often with it.

The following Water is counted excel∣lent.

Take of Galls, and of Cypress Nuts, each half a Pound, of Allom six Drams, Bole∣armonick half a Pound, of the Meal of A∣corns, and of old Beans, each half a Pound, the Whites of twelve Eggs, of Powder of Brick one Pound; let them be all finely pow∣dered, and infuse them three Days in Smiths

Water, or in a decoction of Sloes, Medlars, or Horse-tail, with half a Pint of Rose Vi∣negar; then Distill them in a cold Still with a gentle Fire; add to the Water that comes off, of the Powders of Mastick, Myrrh, and Dragons Blood, each two Drams. Set the water in the Sun in the Summer for ten days, this straitens the Privities, smoothens the Belly, and makes the Breasts solid.

CHAP. XXXV.

Of Abscesses and Corrosive Vlcers ari∣sing from Distempers of the Womb in Childbed.

THE Womb is sometimes terribly affected in Child-bed, and produces Fevers of very Malignant and Veno∣mous Natures, which soon cause Phleg∣mons, and worse Tumours, in the Womb it self, and sometimes in other parts of the Body, there being none of them on which the Uterine Ferment has not an in∣fluence. The Exhorbitances or Degene∣rations of that, whether from an hurt in Labour, from part of the After∣birth left behind, from cold taken, or the Lochia stopt, soon produce such Vi∣rulent Distempers in the Blood as make it cast out a Tumor, either upon the part it self, or else outwardly upon the Muscles of the Body, where when they

light, they prove corrosive, sometimes eating out the Flesh in which they lodge, which falls off in whole pieces, without that change of colour in the Skin, which is in Gangreens, so that sometimes the Bone it self is laid bare by them.

The Causes are hard Labour, the Womb hurt, or part of the Secundine left behind; Cold taken in Child-bed, and a predisposition in the Humours, by rea∣son of their peccancy in quantity or qua∣lity.

The Prognostick may be taken from the largness, or other qualifications of the Abscess, and the Symptoms that happen to the Body thereupon. If the Tumor happens only from some little distur∣bance in the Womb of a Person other∣wise of a good habit of Body, the cure is hopeful. If part of the After-birth be retained, there is no hope's of Cure till that be removed, nay if it stay so long, as to induce Putrefaction of the part, it will be too late then to remove it.

If the Body be of an ill Habit, the Tumours are apt to Degenerate into very Venomous and Malignant Abscesses, which if they do not suddenly kill, do at least produce ill conditoned Ulcers, hard of Cure, and for the most part mortal in the long course of the Disease.

In the Cure of these Abscesses, you are to inform your self how the Womb is disturbed, and appease that; and if any part of the After-birth be left be∣hind, to endeavour the bringing that away, and by good Sudorificks, Cor∣dials and the like, to expel the Venom, and fortifie the Spirits against the Malig∣nity that is thereby contracted, and to attemperate the heat, and the Acrimony by Julips and Emulsions.

The Swellings arising from these re∣quire to be treated in their beginning with moderate Repellents and Discutients af∣terward, according as the Matter pre∣predominates, make way for its dis∣charge.

A young Woman after Child-bed was seized with a great Pain and Swelling in her Groin, with a Fever. Bleeding and Lenient Purgatives to Evacuate the Humours were prescribed, also Cordial Juleps, and the like, to attemperate the Heat, and fortifie the Spirits; and Mode∣rate Repellents mixed with Discutients in Fomentations, and Plasters with Ban∣dage were used, which dispersed the Hu∣mor in the Thigh, and restored that part to its former temper: But in the mean time the Tumor increased in the Groin, and was suppurated after the manner of a Bubo; it was opened, and a detersion was endeavoured; but the Si∣nus reaching down the Twist, the Matter could not be discharged without laying it more open, as in Sinous Ulcers, by which method it was cured.

A Gentlewoman in Child-bed was seiz∣ed with a Fever, and the Ninth Day complained of a pain in her Foot. Dis∣cutients were prescribed, together with things proper for the Fever to breath out the impacted Matter in her Foot; but the pain increasing, the upper part of the Foot from the Instep to the Toes

were Oedematous; but from the inside of the Ancle to the middle of the Sole of her Foot inflamed, and seeming to apostumate. The ill consequences of an Apostumation in that part amongst the Tendons and Bones, and where the Skin is usually so hard and tough, that our strongest Causticks could difficultly penetrate, being feared; It was resol∣ved to endeavour the restraint of the Influx, and so to dry up the Humour af∣fecting the part; to which purpose was applied the following Plaster.

Take of Barley Meal Six Ounces, of Flax Seeds powdered Six Drams, of the Flowers of Camomile and Elder, each three Drams, of the Flowers of Red Roses and Balaustins, each one Ounce; these with the addition of Honey of Roses and Oyl of Myrtles were boyled to the consistence of a Plaster in red Wine, and at Bed-time an Anodyne Draught was given to cause rest.

The next Morning the Patient was somewhat relieved, and when the Dres∣sings were taken off, the Tumor and Inflammation seemed less. This way of

dressing was continued with Compress and Bandage, and the Humour was in few Days dried up, and the Foot seem∣ed well; but there appeared again a Swelling on the Foot, and Apostumated in the Sole of the Foot in three several places, which were opened with a Cau∣stick, to prevent the increase of the Mat∣ter, and the Eschars were divided to give a vent, and they were dressed with Basilicon and the Plaster as before, and the flowing of the Matter was indea∣voured to be hindred dayly by Compress and Bandage; but the Position of the Foot gave way, and it sunk lower, so that there was a necessity of applying another Caustick, which proved effectu∣al to the Discharge of it; so that the upper Orifices healed, but this last Es∣char separated slowly, and left the great Tendon bare; the Separation was fur∣thered by the use of Oyl of Turpen∣tine with Basilicon applied warm, and the Tendon was incarnated with a Sarcotick composed of a mixture of Powder of Orris, Myrrh, Sarcocoll, and Mercury precipitate, with Honey of Roses and Turpentine, and the Ulcer was cicatrized with the Epuloticks. Af∣ter

it was cicatrized the Sole of her Foot was so relaxed and tender, that upon setting it on the Ground it became very much subject to a pituitous Swelling: But by the use of a Fomentation and a laced Stocking, the weak parts were strengthned, and she was cured.

CHAP. XXXVI.

Of the Falling of the Womb.

FOR the Cure of this Disease, regard must be had to two things; the first is to reduce the Womb to its natural place; the second is to strengthen and to keep it there.

If the Womb be quite out or turned, the Woman must first of all render her Urine, and a Glister must be given to Evacuate the gross Excrements that are in the right Gut, that so the Reduction may be the easier performed: Then place her on her Back with her Hips raised a little higher than her Head, and then foment all that is fallen out, with a lit∣tle Wine and Water luke-warm, and with a soft Rag put it into its proper place, thrusting it back not all at once, but wagging it by little and little from side to side. In case this be too painful, because it's already too big and swell'd, anoint it with Oyl of Almonds, for the more easie reduction of it; but wipe oft

the Oyl, as soon as it is reduced. But if it cannot be put up by reason of the great Inflammation and Tumor, there is great danger that it will gangrene.

As to the second part of the Cure, which consists in the retention of the Womb in its place, and the strengthen∣ing of it, let the Woman keep her self in Bed upon her Back having her Hips a little raised, her Legs crossed, and her Thighs joyned together to prevent the falling of it out again. But the best way is to put up a Pessary into the Neck of the Womb to keep it firm.

Take of Oak Bark two Ounces, boyl it in two Quarts of Fountain Water, add at the latter end an Ounce of Pomgranat-peel bruis∣ed, Red Roses, Pomgranat Flowers, each two handfuls, and then add half a Pint of Red∣wine; strain it, and bath the part affected with Flannels dipt in it in the Morning two hours before the Woman rises, and at night when she is in Bed; continue it till the Symptom is quite gone.

CHAP. XXVII.

Of a Dropsie and Inflation of the Womb.

THE Inflation and Dropsie are con∣founded by almost all Authors; but they are to be distinguished; for there is a certain Inflation of the Womb which ought not to be called a Dropsie, Viz. When the Womb is Inflated, and stretched suddenly by Wind rushing in; upon which account a violent Pain is occasioned; this often happens in Hyster∣ick Diseases. Wherefore a Dropsie of the Womb is two-fold, one from Wind, which is like a Tympany; another from a watery Humour, which is like a Dropsie of the Belly.

As to the Diagnostick of these Disea∣ses, many things are to be enquired in∣to.

First, How they may be distinguished from an universal Dropsie.

Secondly, How the Species of it may be known, viz. Whether it proceeds from Wind, Water, or Flegm▪

Thirdly, If it arise primarily from the Womb, or be occasioned by the fault of some other part.

Fourthly, Whether the peccant Mat∣ter be contained in the Cavity of the Womb, or within the Membranes of it, or in Bladders.

Fifthly, How it may be distinguished from other Tumours of the Womb.

Sixthly, How it may be distinguished from being with Child.

Seventhly, How it may be distinguished from a Mola.

First, It is distinguished from an uni∣versal Dropsie, for that in a Dropsie of the Womb, the Tumour possesses more the bottom of the Womb, and there is not so soon a paleness and wasting of the whole Body, as in an universal Dropsie. Besides, in a Dropsie of the Womb, the thirst and driness of the Tongue is not considerable, and Wind breaks out by in∣tervals, or a little Water flows out, which manifestly shew, that Wind or Water is contained in the Womb.

Secondly, The Species of Dropsies in the Womb are thus distinguished, if it be occasioned by Wind, the bottom of the Belly sounds being struck; there are pricking pains in the Belly, which some∣times

run through the Diaphragm, Sto∣mach, Loins, Navel, and other parts, and sometimes the Wind does evidently break through the Neck of the Womb; the Disease grows worse upon eating and drinking, and they often belch, and are better after it; they sometimes perceive a pain in the Region of the Hypogaster, so that they cannot bear an Hand laid on it; these signs are also in an Inflation of the Womb; but there is this differ∣ence, for an Inflation is but for a small space, and a Dropsie from Wind con∣tinues much longer.

But if a Dropsie of the Womb is oc∣casioned by Water, that Region appears soft and flaccid, for Wind causes a ten∣sion; there is a greater weight in the part, and a sound as it were of Wa∣ter floating, and Water sometimes drops from the part. And if it proceed from Flegm, there is a greater softness and flaccidity of the part, which dayly in∣creases, and afflicts the neighbouring parts with oedematous Swellings.

Thirdly, If there be signs of the whole Bodies being ill affected, as by long or acute Fevers, by immoderate Hemorrhagies, by weakness of the Sto∣mach, swelling of the Liver or Spleen,

or by other obstinate Diseases of those parts, by which the Dropsie of the Womb began, and increased with them; there is good reason to conjecture that the Matter of the Dropsie is received in those parts; but if when the whole Bo∣dy is well, such a Tumour happens, and succeeds particular Diseases of the Womb, as hard Labour, suppression of the Courses, or too large an Evacuation of them, or Ulcers and Tumours, we may guess that the Dropsie of the Womb proceeds from them.

Fourthly, The Matter which is con∣tained in the cavity of the Womb cau∣ses a much greater Tumour than when it is contained within the Membranes.

Fifthly, a Dropsie of the Womb may be distinguished from Tumours that pro∣ceed from a Phlegmon, or an Erysipe∣las, because in these there is a Fever and Pain upon the least touching; it may be distinguished from the Scirrhous, or Cancerous Tumour by the hardness that resists the Finger.

Sixthly, When a Woman is with Child, the Tumour is not equal and de∣pressed, but thrusts it self out above the Navel; and when a Woman is with Child, after some Months she is most

commonly better; but the longer a Drop∣sie lasts, the worse it grows, and the motion of the Child is plainly to be felt after the third or fourth Month; yet in a Dropsie that arises from Wind, a palpitation may be sometimes perceived in the Womb, and when a Woman is with Child, the Breasts swell, but in a Dropsie they wax small.

Seventhly, In a Mole there is a weight felt in the Body, which is not perceived in a Dropsie of the Womb, and when the Sick lies on either side, a weight is per∣ceived, as if a Stone rolled thither. More∣over, in a Mole there are violent Fluxes of the Courses by intervals, namely, eve∣ry third or fourth Month, which does not happen in a Dropsie of the Womb; and lastly, in a Mole the Breasts swell, and have Milk in them sometimes, but there is no such thing in a Dropsie.

As to the Prognosticks, a Simple Inflati∣on of the Womb is not dangerous, but if it continue long, it may turn to a Dropsie.

If Wind or Water is contained in the cavity of the Womb it is easier cu∣red than when it is included in the Mem∣branes, or in Bladders.

This Disease is cured much the same way as a Dropsie or Green-sickness is; but some things peculiar to this Disease must be added: If the Disease be new, and occasioned by an Obstruction of the Courses, and if there be a fulness of Blood, Bleeding may be proper, other∣wise it is injurious; but Purging is al∣ways necessary, and must be often re∣peated, and after sufficient Purging, A∣peritives, Diureticks, and such things as move the Courses must be used, to which may be added the follow∣ing.

Take the Roots of Smallage, and Madder, each half an Ounce, of the Leaves of Savin, Feverfew, and Penny-royal, each one Pugil, of the Seeds of Daucus, one Dram, boyl them in the Broaths of young Pidgeons, and let her take it strained in the Morning for ma∣ny Days. But before she takes the Broath, let her swallow one of the following Pills,

Take of the best Castor, Myrrh and Mad∣der, each half a Dram, of Saffron one Scruple, with the Juice of Lemons, make nine Pills; after the use of which Medicine, violent Exercise must be used, that thereby the Excrements bred in the Bowels, and in

the habit of the Body may be dissipated, and also all that which is contained in the Womb, the Skins being broken by the violence of the Exercise, and if the Woman Vomit easily, it will be proper to Vomit her twice a Week. The following Bolus is very effectual to discuss the Humour contained in the Womb.

Take of Mineral Borax, half a Dram, of Saffron half a Scruple, with the Juice of Savin, make a Bolus, to be taken twice a Week.

Sudorificks are also very proper; in the mean while the heat of the Sto∣mach must be strengthened by things taken inwardly, and outwardly applyed. The Womb must also be strengthened by proper Topical Medicines: First by Fo∣mentations and Baths made of a Decocti∣on of the Roots of Briony, and wild Cucumber, of the Leaves of Dwarf El∣der, Mercury Elder, Wild-marjoram, Calaminth, Wormwood, Rue, Sage, Marjoram, Thym, Bays, Penny-royal, Mugwort, of the Seeds of Broom, Dau∣cus, Cummin, Anise, Fennel, of the Ber∣ries of Lawrel and Juniper, of the Flow∣ers of Camomile, Melilot, Rosemary, of which may be made Bags to be boiled in Wine.

But that the forementioned Fomentati∣on may succeed the better, you must apply it before and behind, and the Sick ought to Sweat, if she can, in the Bed or in a Bath.

In a windy Dropsie dry Fomentations are more beneficial, with Bags made of Grommel, Salt, Cummin and Bran, torri∣fied in a Frying-pan, and sprinkled with Wine.

After the Fomentation, anoint the low∣er Belly with the Oyls of Nard, Dill, Rue, Worm-wood, Southern-wood, and if they are Chimically prepared they will be the more effectual.

After the Anointing the Belly, apply the Plaster of Lawrel-berries, or a Pul∣tiss made of Cows-dung, Sheeps-dung, of the Seeds of Smallage, Parsley, and Cum∣min boyled in Honey. Glisters must be frequently injected, made of a Decoction of Wormwood, Wild-marjoram, Penny-royal, Rue, Centaury, and the like; or of the Oyls of Rue, Nutmeg, Dill, and Whitewine, or in Malago Sack, wherein must be dissolved Benedictum Laxativum, Diaphenicon, Hiera diacolocinthidos, Turpentine, Confection of the Lawrel∣berries, Honey of Rosemary, and the like. Injections for the Womb may be

prepared in the following manner to evacuate the Humours contained in it.

Take of the Roots of Asara-bacca, three Drams, of the Leaves of Penny-royal, and Calaminth, each half an handful, of Savin, one Scruple, of Mechoacan, one Dram, of the Seeds of Anise and Cummin, each half a Dram, boyl them and strain them, and in six Ounces of the Liquor, dissolve of Oyls of Orris and Elder, each one Ounce; make an Injection.

For the same purpose Pessaries may be made thus.

Take of Coloquintida and Mechoacan; each one Dram, of Nitre, half a Scruple, with a sufficient quantity of boyled Honey; make a Pessary. or,

Take of Elaterium, half a Dram, of Figs bruised a sufficient quantity.

When the Inflation proceeds from Wind a Fume from Nutmegs is very good, and is commended by Solinander in these words, A VVoman in Child-bed by exposing her self to the Air too soon, fell into intolerable Pains, nor

could be relieved by any means, at length an Old and Skilful Midwife was called, she ordered three Nutmegs to be grosly beaten, which she put into a Chaffing-dish with live Coals, and placed the Chaffing-dish so, that the Fume of the Nutmegs by the help of a Funnel in∣verted, passed into the VVomans Privi∣ties, and she received the same Fume into her Mouth and Nostrils after the same manner, and as soon as the Fumes had Penetrated, the Woman cryed out presently she must go to Stool, and as soon as she had so spoken a great noise was heard like the shooting of a Gun, and the Woman was Cured in the same moment; and being encouraged by this Success, I used it, says he, often in like Case, and it succeeded well.

A Cupping-glass with much Flame ap∣plyed to the Navel wonderfully discusses Wind: But when the Disease is Hu∣moural, Issues in the Legs evacuate by degrees the filth of the Womb. The Bath waters used inwardly and outward∣ly are also very good, if the Body be not very hot. Amatus Lusitanus com∣mends the VVater or Decoction of Ca∣momile Flowers to ease the Pain of the VVomb: In this Case he orders four

or five Ounces of it to be given at a time.

Lastly, if the Inflation happens after Delivery, there is no need of any other Cleansing, than what is done by the Womb: But if it does not proceed well, it must be helped with Pessaries, and Cupping-glasses applyed to the Thighs, and with other Remedies described for the Suppression of the Courses: And if there be VVind, the Fume of Nutmegs above proposed are very proper.

CHAP. XXXVIII.

Of a Cancer of the Breast and Womb.

A Cancer is the name of a Tumour arising as it is thought from an adust, or atrabilious Humour. It is round, unequally hard, and if not in∣flamed, of a Livid or Brown Colour with exquisite pricking Pain, the Veins ap∣pear turgid in the Skin upon the surface of the Tumour.

The remote cause of this Tumour is either a fault in the original Constitution of the Body, or an acquired one, as by a Bruise, or the like; or by an error in Dyet.

The differences of Cancers are many; some are with Ulceration, others not; some are loose and moveable, and so hard that they have knocked one against ano∣ther like Peebles; some are fixed to the Bones, and some lie superficially; other differences may be taken from the Hu∣mour to which they owe their Original. If the Matter be not very Corrosive, their

growth is slow, and they are not very painful. These are called the milder sort, and some of them affecting the Breast have been palliated a long time with easie remedies.

A Lady laboured many Years of an ul∣cerated Cancer, it eat deep into the left Breast, and was fixed to the Ribs, but not with much pain; in progress of time the Lips inverted, and united as it were, and lay covered with a crusty Scab, the Humour in the mean while spent it self upon the Nerves and caused a Species of the Palsie in some parts of her Body, and the Gout in others. She lived long, and in her latter Age tolerably healthful; this is to be judged a Scirrhous Cancer, yet by ill management, or by an increase of acrimony, this and such like frequently terminate in raging Cancers, and tor∣ment the Patient with exquisite darting pains; an instance or two whereof I shall set down, to make the Young Practi∣tioner more cautious in undertaking the Cure of them.

A VVoman had a painful hard Swel∣ling in one of the Glands of her Breast; she was advised to forbear the use of all Cataplasms and Plasters that might heat her Breast, and to dress it with Va∣lentia

Stramonij, but she was otherwise perswaded, and thereby increased her Misery. About half a Year after she had a stinking sordid Ulcer with lips turned out, and the Breasts fixed to the Ribs, with a hard unequal Swelling reaching to the Clavicle and side of the Neck, Apostu∣mated in some parts and Ulcerated in others, from the pectoral Muscle it crept up to the Shoulder, and affected the Arm-pits, and by the compression of the Vessels the upper part of the Arm Swelled Scirrhous, from the Elbow downwards it was Oedematous to the Fin∣gers ends, she made use of many Eminent Physicians and Chyrurgeons in the City, but dyed miserably.

There is also a sort of Bleeding Can∣cers, which become such either from the eruption of some Vessel, which makes the vent often at the Nipple or some other Pin-hole, the Breast remaining whole, or else from the spreading of in∣finite capillary Vessels in a Fungus, which in ulcerated Cancers is not rare. These do very much spend the Strength of the Patient, so that she soon Dyes ex∣hausted and tabid.

Of all the Diseases which afflict Man∣kind, the Cancer is the most grievous and rebellious, and is generally Incure∣able by reason of its corrosive and ma∣lignant venome fermenting in the Hu∣mours, which so far as we can find, yields neither to Purging, Bleeding, Re∣pellents, Discutients, Suppuratives, nor any other Medicine, inward or outward. Those which lie superficially under the Skin may be attempted by the Chyrur∣geon's Hand, or if they rise from an External Cause, as a Bruise, or the like, tho they lie deeper they may be cut off or otherwise extirpated: But those that a∣rise from a corrosive quality in the Hu∣mours, though they may be cut off, or otherwise extirpated, yet the success is most doubtful.

The Cure of a Cancer in general con∣sists in these Intentions,

First, in the Generation of good Blood.

Secondly, In Correcting and Evacua∣ating the Atrabilious Humours in the Body.

Thirdly, In preventing the Growth of the Tumour, and disposing it to Dis∣cussion.

We endeavour to perform the First intention by an exact regulation of Diet▪ and way of Living, advising to abstain from such sharp, salt, and gross Meats▪ as may dispose the Blood to acrimony▪ and order such as are Cooling and Moist∣ning, of easie Digestion and of good Nourishment.

The Second intention is to prepare and purge all the acrimonious Humours; and if there be a Plethora, or a Sup∣pression of the Hemorrhoids, or Courses, a Vein may be opened and a Glister gi∣ven, and the Humours may be also eva∣cuated by a convenient Purge. as

Take of the three Cordial Flowers, one Handful, of Sena three Drams, of Dodder of Thym, two Drams, infuse them in Whey, and strain it, add an Ounce of the Purging Syrup of Apples, and six Drams of Manna; mingle them.

Traumatick Decoction are also usual∣ly prescribed.

Take of the Roots and Leaves of Avens, of the greater Celandine, of Burnet, Groundsel, Gentian, Plantain, each one Handful, boyl them in two parts of Water and one of Wine to the

quantity of three Pints, sweeten it with Su∣gar, and let a Pint be drunk thrice a∣day▪

The following Electuary is also re∣ckoned very good.

Take of the Powders of Frogs and Snails prepared, each half an Ounce, of the Pow∣der of River Crabs, one Ounce, of the Bone of a Stags Heart, one Dram, of Citron Peel Candied, one Ounce, of the Conserve of Borrage and Wood-sorrel, each two Ounces, of the Syrup of the juice of Citron and of Gilly-flowers, a sufficient quantity, make an Electuary. Take the quantity of a Chesnut, Morning and Evening.

Emulsions, Distilled Milks, and Opi∣ates are also very proper to attemperate the Acrimony and to ease the Pains.

The Third intention is to restrain the growth of the Tumour, and to discuss it moderately. Whilst the Humours are are evacuating, we apply Repellents, and afterwards we add Discutients; the Re∣pellents ought to be of the milder sort, lest they render the Humours too gross and unfit for resolution, as Lettice, Pur∣stain, Plantain, Navel-wort, Night-shade

and Housleek: Lentils boyl'd in Vine∣gar, also Clay tempered with Vinegar.

The Medicines ready Compounded are the White Oyntment, Nutritum Populeon of Tutty and of burnt Lead, and Lead it self.

All the Oyntments prescribed, must be beaten up in a Leaden Mortar. Thin milled Lead is usually worn in this Case; so are Plates of Gold. Oyl of Frogs is commended, and is made by Baking them with Butter in their Mouths. Frogs Spawn Water is proper to be used in Sum∣mer, Cloaths being dipt in it and applyed, but they must be shifted as often as they dry. But in the Winter the following Cerat is better.

Take of a green Frog, three Drams, of the Powder of River Crabs burnt, half an Ounce, of Lytharge of Gold, two Ounces, of burnt Lead and Tutty prepared, each two Drams, of Cerus, six Drams, of the Juice of Night-shade and Plantain, each six Ounces, of Vinegar, two Ounces, of Oyl of Frogs, and of Populeon Oyntment, each three Ounces, of the Suet of a Calf, four Ounces, of Wax a sufficient quantity, make a Cerat. Or,

Take of the Seeds of White Poppy, one

Ounce, of the Seeds of Henbane, half an Ounce, of Opium, one Dram, of Gum Ara∣bick, half an Ounce, powder them, and with the Oyls of Roses and Myrtles, each three Ounces, of Wax a sufficient quantity, make a Cerat.

This is proper in case of Pain, in the extremity whereof you may double the quantity of Opium, or in such Cases you may Foment the Tumour with a Decocti∣on of Poppy Heads, Flowers of Roses, and tops of Mellilot, and apply the fol∣lowing Oyntment.

Take of Old Treacle, one Ounce, of the Juice of River Crabs half an Ounce, of the Juice of Lettice, and of Oyl of Roses, each one Ounce and an half, of the Yolks of Eggs roasted under the Embers number two, of Camphor, half a Dram, beat them in a Lea∣den Mortar▪

The Discutients are Ceterach, Agrimo∣ny, Ducksmeat, Scabious, Thorn-apple, the Juice of Coriander, Frogs, Snails, River Crabs, Raisins of the Sun stoned and beaten, with Rue and Garden Night-shade made into a Pultits are proper to resolve them.

Many such Medicines are designed to this purpose, Cancers requiring variety of Applications.

If notwithstanding all your Endea∣vours, the Tumour increases, and is like to ulcerate, you may do well to forewarn the Patient of the danger, and if it be loose, propose the extirpation of it, pro∣pose it to them, lest afterwards they de∣sire it when it is too late. But to under∣go this Operation Successfully, the Pa∣tient ought to be of a strong Constituti∣on, and of a pretty good habit of Bo∣dy, and not in declining Age, when the Courses are ceased. It were also to be wished that the Cancer took its original from some Accident or Bruise, and the like; and the Operation ought to be performed in the Spring or Autumn of the Year.

For a Cancer of the Womb Topicks must be applyed, which moderately Bind and Cool.

Take of Oyl of Myrtles and of Roses, each two Ounces, of the Juice of Night-shade, and of Housleek, each one Ounce, beat them all in a Leaden Mortar with a Leaden Pestle till they grow black, then add of Ly∣tharge and of Ceruss washed in Scabious wa∣ter,

each three Ounces, of Tutty prepared two Drams, of Camphir, ten Grains, make a Liniment, wherewith Anoint the Part three or four times a-day.

The following is said to be better, and with it the Tumours of the Paps, which are counted Cancerous may be Cured.

Take of the Oyl of Yolks of Eggs, two Ounces, of the Juice of Night-shade and Speedwel, or of Housleek, each half an Ounce, of crude Mercury two Drams, stir them about in a Leaden Mortar with a Leaden Pestle, till they acquire the consistence of a Lini∣ment.

The foresaid Liniments are to be ap∣plyed to the Womb with a long Tent, or with a Wax Candle wrapt round with a Rag: But Injections may be much easier used.

Take of Barley water, half a Pint, of the waters of Night-shade and Plantain, each two Ounces, of the water of speedwel one Ounce, of the white Troches of Rhasis, two Drams, of Sacharum Saturni one Dram, make an Injection.

If the Pain be very violent add to four Oounces of the Injection, one Ounce of Syrup of Poppies. If the Cancer be Ul∣cerated, the Dose of the Mercury to be added to the foresaid Liniment must be increased, and the Ashes of River Crabs may be conveniently added.

But all these things are not sometimes sufficient to appease the violent Pain, which sometimes will not suffer the Sick to sleep or rest, so that we are forced sometimes to use Narcoticks, and in∣deed, they are not injurious in this Disease.

I knew a Woman, that was affected with a Cancer in her Breast, who took every Night for four Months, two or three Grains of Laudanum, and was much relieved thereby.

If much Blood flow from a Cancer ul∣cerated, as it often happens; inject into the Womb the Juice of Plantain with a little Frankincense.

Lastly, Seeing a perfect Cure cannot be expected, whether the Cancer be ulce∣rated or not, we must endeavour to hin∣der the breaking of it, and the increase of it, when it is broken, and in both we must qualifie the violence of the Pain by such things as evacuate the whole Body,

and by other Remedies which alter and evacuate the melancholy Humour, and hinder its growth, as by Bleeding in the Arm, the Hemorrhodial Veins, in the Foot, by the use of Potions, Apozems, Juleps, Broath, Milk, Whey, Mineral Waters, and the like, which are com∣monly prescribed; but Purging must more especially be repeated.

CHAP. XXXIX.

Of Worms, and of the Stone of the Womb.

THough many are of the Opinion that Worms are Generated only in the Intestines, yet it is manifest by Experi∣ence, and the Testimony of Learned Men, that they are Bred in many other parts of the Body, as in putrid Ulcers in the Teeth, in the Ears, in the Reins, and in the Bladder, tho' rarely, by reason of the acrimony and saltness of the Urine. In the Womb also Worms are sometimes generated, tho' it be rare, because the passages of it are so open that they will not suffer the Humours, tho' they are gross and crude, to continue there so long as to generate Worms. They are most commonly Ascarides, and they are most commonly in the Privities, or in the Neck of the Womb, they are very like those that are in the right Gut, per∣haps they creep thither from the A∣nus.

The material cause of Worms, is a cold phlegmatick and crude Humour, which is apt to putrifie.

When there are Worms in the Womb, the whole Body is restless and uneasie, the Mouth of the Womb is always moist, the Women are thin and weak, and sometimes the Worms are expelled with the Courses, and sometimes they may be seen, the Lips of the Privities being opened. Women so afflicted sleep disturbedly, and often wake in a fright, they have disorderly Fevers, and all other Symptoms which appear in Worms of the Intestines.

As to the Cure, we must endeavour to hinder the generation of them, and to kill them when they are generated; this may be done by three sorts of Reme∣dies.

First, By a thin hot and drying Dyet, by acid and bitter Meats, yet they must consist of good Nourishment, and be ea∣sily concocted, and that are free from all crudity; the flesh of Chickens, of Hens, of small Mountain Birds, and the Broath of them with the juice of a Lemon are good: Among Fruits Oranges, Cap∣pares, Olives with Vinegar: Among Herbs, Endive, Sow-thistle, and Ground∣sel:

Let her Drink be a Decoction of Cinnamon, Rubarb, the Seeds of Purslain, the Roots of China, Scorzonera, or Sar∣saparilla. All Meats of Milk, Fish, and whatever generates Flegmatick Humours must be avoided, and full Feeding, and a disorderly course of Dyet.

Secondly, Those things must be used which Concoct, and Purge off Phlegmatick Humours; as Syrup of Wormwood, Suc∣cory, Succory with Rhubarb, of the acid juice of Citron with the waters of the same Herbs, or of Grass, Purslain, and Sorrel, and the Flegm must be constant∣ly Purged off with Pills of Mastick, of Agarick, or the like.

Thirdly, Such things must be used as kill Worms, and uterine Glisters to that purpose must be injected made of a De∣coction of Wormwood, Southernwood, and Centaury with Allom. Or,

Take of Mint, Calaminth, Penny-royal, each one Handful, boyl them till the third part of the Water is consumed, mingle Honey with it and inject it. Or

Take of the Decoction of Lupins six Ounces, of Aloes three Drams, of Honey one Ounce, which may be injected also with the

like quantity of Decoction of Mercury and Wormwood; or the following Pessary may be used.

Take of Bulls Gall, one Dram and an half, of the Powder of Lupins, two Drams, of Oyl of Wormwood, two Ounces, of good White-wine, half an Ounce, mingle them, and dip the Cotton for the Pessary in it.

At the same time apply to the Regi∣on of the Womb the following Oynt∣ment.

Take of the Leaves of Wormwood, Cost∣mary, and Calaminth, each one Handful, of Peach Leaves half an Handful; boyl them in the sharpest Vinegar, or in Wine for the Womb, to the strained Liquor, add of Aloes and Agarick, each half an Ounce, of Colo∣quitida three Drams, of Oyl of bitter Al∣monds, and of Bulls Gall, each a sufficient quantity, with a little Wax, or without it, make an Oyntment. You may also make a Cataplasm of the same Herbs boyled and bruis∣ed with the Meal of Lupins, Oyl of Worm∣wood, and Ox Gall, and the Pill of Aloes, or of Hiera, must be taken often, a Scruple at a time.

That the Stones grow in every part of the Body, Galen testifies, as in the Blad∣der, Reins, Liver, Intestines, Lungs; and therefore it is no strange thing if they should be generated also in the Womb, as Aetius writes: but they are not alto∣gether like the Stones of the Bladder, nor are they loose, for if so they could not continue in the Womb; but they grow to the Tunicks of the neck of the Womb. The causes of them are the same, as of the Stone in the Bladder, namely, gross and viscid Humours. The signs of them are a dull pain in the Womb, and the Courses are inordinate, and a Finger be∣ing put up the Anus, the Stone may be selt. But if the Stone be in the neck of the Womb, the pain is great, and af∣fects the neighbouring parts, and the Womb, and the Woman can not sit with∣out pain.

As to the Cure, an emollient and lubri∣cating course of Diet must be used, and the gross and viscid Humours must be Purg∣ed off: But the chief part of the Cure is to be performed by extracting the Stone, but first the parts must be quieted by an emollient Glister made of a Decoction of Mallows, Marsh-mallows, Fenugreek, of the Seeds of Flax, and a great deal of

Oyl of Roses and of Lillies to make the Manual operation the easier, which must be performed in the following man∣ner.

The Womans Thighs being spread, the Chirurgeon must thrust up two of the Fingers of his Left-hand, and with his Right he must press the upper part of her Belly to force the Stone out, and this may be the easier done, if the Stone be in the Neck of the Womb, but if it be in the Womb it self, the Operation will be more difficultly performed: But if the stone grow to the mouth or neck of the Womb, and cannot be extirpated this way, it must be cut out, the Woman being rightly placed, and the parts dila∣ted with a Speculum Matricis, which be∣ing done, those things must be injected into the Womb which cure Ulcers, first, Astringents, and such things as stop Blood, and afterwards drying things, and an exact Course of Diet must be ordered, and the Woman must be Purged twice in a Year, lest the Stone should grow again.

The Cure of the Stone in the Bladder in Women is to be managed much in the manner as in Men, but it seldomer hap∣pens, and is easier Cured, because the

passage of the Urine is larger, and shor∣ter, and straighter in Women. But if it happen, and must be extracted, the Chirurgeon must put two of the Fingers of his Left-hand, (the VVoman being placed as above directed) into the Privi∣ties, and with his Right he must press the Bladder, and force the Stone to the neck of it, so as to make it pass the Mus∣cle that shuts the neck of the Bladder, and then a little above the wings of the Privities, at which place the Stone oc∣curs he must cut, so that the Stone may be extracted with a pair of Forceps. Lastly, the Ulcer must be Cured by Astringent, and Incarnating Medicines.

CHAP. XL.

Of a Condyloma, of the Hemorrhoids, Warts, Thymus, Acrocordo, and a Ficus, and of Scabs of the Privi∣ties, and of Chaps, and Clefts of the same.

A Condyloma is a Tubercle arising from an Inflammation, and re∣sembles the Knucles when the Hand is shut. It is cured by four kind of Re∣medies, First by Diet and Purging Me∣dicines that respect the antecedent cause; Secondly, By drying and repelling To∣picks, if the Callus be newly bred, as by Baths and Vapours of a Decoction of Vervain, of the Leaves of Brambles, of Acacia, Ivy-leaves, to which must be ad∣ded, by reason of the Pain, Camomile Flowers; and if the Condyloma be Inflamed such things must be used as mitigate the pain, as the following de∣coction.

Take of the leaves of Melilot, Mallows, and Marshmallows, each half an handful, of the Seeds of Flax and Fenugreek, each three Drams, of the Flowers of Camomile two Pugils, boyl them, and to a Pint of the Decoction, add two Ounces of Roses, inject it by a Syringe; or warm Milk may be so injected. If the Condyloma being old is grown hard, and does not yeild to the fore∣said Medicines, Aetius commends as a won∣derful remedy Mineral Misy mixed with Turpentine; or instead of it Roman Vitriol, a Dram of the Troches of Steel reduced to powder, and mixed with the Oyls of Roses and Wax, and made into an Oyntment with half an Ounce of the Juice of Mullein is also very good. The following is also much commended.

Take of Tuty thrice burnt and washed, of Ceruss washed, of the Froth of Silver wash∣ed, each two Drams, of the Yolks of two roasted Eggs, Wax, Sope and Oyl of Roses, each two Ounces; make an Oyntment.

But if these things do no Good, it must be cut off, and if there be many of them, they must be burnt off, and the Ulcer must be regularly cured: but cutting or

burning in these parts is dangerous and must not therefore be used unless there be an absolute necessity.

If there be Hemorrhoids, they are either in the Mouth or Neck of the Womb, or in the Womb it self, or in the Privities; they are as divers as those in the Anus, they are either blind or open; they are with or without Inflam∣mation; they differ also upon their big∣ness, Number and Figure; they are oc∣casioned by Chaps, and by a Condylo∣ma, but chiefly by gross and feculent Humours falling upon the Veins of the Womb, or by an inordinate defluxion of Menstruous Blood into those Veins. This Disease may be known by a weight in those Parts, and Women so affected are weak and subject to Spontaneous Lassi∣tude: But if the Hemorrhoids of the Womb, or Anus flow moderately, they cure and prevent many Diseases, and the unseasonable stopage of them occasions the Falling Sickness, and many other Di∣seases. They are cured as the Piles of the Anus.

There are four sorts of Warts of the Womb and Privities.

The First are Acrocordones, which hang as by a Thred.

Secondly, Thymus which is a rough and oblong Tumour, and without pain, if it be gentle and white, or redish; but if it be Malignant it is livid and painful.

Thirdly, Ficus or Mariscae, which differ from a Thymus only in bigness.

The Fourth is Clavus, which is a hard white and round prominence like the Heads of Corns. These Tumours in general are of a Scirrhous nature, and come by immoderate Copulation, and are sometimes Malignant, by reason of the French-Pox. The gentle are known by their white or redish colour, and by the absence of pain, the Malignant by their hardness, leaden colour and pain.

They are Cured by four sorts of Re∣medies.

First, By a Diet that is not apt to breed gross Humours, and by Catharticks to Purge such Humours off, and by Sweats, if they are obstinate.

Secondly, By discussing Medicines, which are most proper for the Thymus and Clavus as by dried Sage, with fat Figs, or Old-shoes burnt and powdered and mixed with Wine and applyed: But the Soles of Shoes and a dried Gourd powdered by themselves, and afterwards mixed and applied with Wine to Warts do very well, or you may take of Rue and Pennyroyal, each equal parts; let them be burnt and powdered; the Bark of Frankincense, the Leaves of Basil Wine and Vinegar, Shoomakers Ink, boyl them in the VVater that drops out of a Vine cut; moisten the part with this Decoction; this is reckoned an excel∣lent Medicine.

Prick with a Needle the Eye of a Goat newly killed, and anoint daily the part with the Liquor that flows from it, and within Six Days, as Aetius writes; Myrmecies will be extirpated, which con∣sist of broad Roots, and they itch.

Thirdly, Things that burn and eat are proper for Myrmecies and Acrocordos, as the juice of wild Cucumber with Salt, or the like: But corroding things must

not continue long upon the part, for when they have been applied an hour or thereabout, the part must be washed twice or thrice with Astringent Wine; and the Neighbouring parts must be de∣fended by an Oyntment made with Bole∣armenick, sealed Earth, Rose-water and Vinegar.

Fourthly, If they may be cut off, they ought to be so, but some bind the root of these with a Horse-hair; and straight∣en it daily till they fall off.

In the Privities and Mouth of the Womb, especially in such Women, as have the French-Pox, Pustles arise; they often itch; they are occasioned by the abundance, and grossness of a bilious and adust Humour, or by the French-Pox, they may be easily seen by a Speculum Matricis. They are to be cured by four sorts of Remedies.

First, By Meats of good juice, and by abstaining from all acrid, acid and salt things.

Secondly, By Universal Evacuations, as by Bleeding and Purging, and such things,

as attemperate the Humour must be used, as Syrup of Borrage, Violets, Fumitory and Succory, and the like. Decoctions of Sarsa, or of Guiacum with Sweating are also very proper, and Purges and Su∣dorificks must be often repeated.

Thirdly, Topicks must be applyed, and if the Pustles are gentle bathing is proper, and afterwards wash the part with hot Wine and Nitre.

For Pustles and Scabs the following Oyntment of has bin found very successful.

Take of the Roots Elecampane, Burnet and sharp pointed Dock, each three Ounces, of Fumitory Water Six Ounces, of the sharp∣est Vinegar, or of the best Wine, for Di∣seases of the Womb, two Ounces; having bruised the roots well, infuse them a day and a night, then boyl them, and press them strongly; to the strained Liquor add half a pound of Turpentine, of Oyl of Roses three Ounces, of Wax half an Ounce, boyl them again to the Consumption of half, and add of Sulphur one Ounce and an half, of Cerus five Ounces, of Roch-allom half an Ounce, of Sal Gemma two drams, of Oyl of Eggs, six Drams, mix them by beating of them well

together, then wash the whole Composition in Fumitory Water.

But if the Pustles are Malignant, and Obstinate, you must use stronger Desicca∣tives, which correct the Venom of the Pustles, and at the same time you must use sudorific decoctions.

Take of Plantain and Rose Water each four Ounces, of Sal Gemma, Nitre, and Allom, each two Drams, of Sublimate one Dram and an half, boyl them till a third part is consumed; to the strained Liquor, add of Verde-greese one Scruple; after you have used this two or three dayes, you must for∣bear a while, and use gentler things, and return again to the use of it, till the Pustles are quite taken off.

This moreover must be added, which is of excellent use, having first bathed with a decoction of Fumitory, Lupins, Beans, and a little Salt.

Take of the Roots of Elecampane cut small four Ounces, boyl them well in a suffi∣cient quantity of Water with a little Vinegar or Wine, then beat them in a Mortar and Pulp them through a Sieve, and add of fresh

Lard three Ounces, of Juice of ground El∣der, and of Fumitory, each one Ounce and an half, of Quick-Silver extinguished in fasting Spittle, or in the Yolk of an Egg, half an Ounce, of Ceruss and Lytharge, each one Ounce, of Brimstone one Dram and an half, stir them about for an hour, and mix the Powders by degrees.

But because Pustles continue sometimes a long while, you must make an Issue in the Leg, before they are quite dryed up.

Clefts and Chaps are sometimes in the Mouth of the Womb, as in the Anus, Hands, Lips, and Nipples, by reason of violent Cold, a North Wind, and the like; they are small, long and narrow Ulcers, sometimes deep, and sometimes only superficial; they are also ocasioned by hard labour, by Acrid and Corroding Humours, or by a great dryness in the Womb.

They are to be cured by five sorts of Remedies; by a moistening and smoothen∣ing Diet, avoiding such things as are a∣crid, and stop the Belly; therefore let the Woman eat Chicken, Mutton, Veal, and

Broaths made of Succory, Bugloss, Bur∣rage, Spinage, and the like; let her Drink be rather Beer than Wine, she must avoid Cheese and Spices, Violent Exercise, and Copulation: And if Acrid humours be the cause, she must be blood∣ed, if there be a plenitude; afterwards she must be Purged with Cassia, Manna, and the like, and the Humours must be attemperated with the Syrups of Suc∣cory, Roses, Violets, Borrage, Fumitory, and with the Waters of the same Herbs. If they are occasioned by hard labour, and Bleed, the Blood must be stop'd by the following Uterine Glister.

Take of the leaves of Plantain one hand∣full, of Roses four Pugils, boyl them in a sufficient quantity of Water till half is con∣sumed. To six Ounces of the strained Li∣quor add of the Powders of Dragons Blood, Bole armenick, Myrrh, Frankincense, Birth∣wort, each half a Dram.

If the Chaps are dry, hot, and itch, the part must be Fomented with things that moisten, as the following Decocti∣on.

Take of the flesh of Frogs, Snails, and River Crabs, each two Drams, of Barley two Pugils, of Mallows and Ducks meat, each one handful, of Flax Seeds one Ounce, boyl them in a sufficient quantity of Water, and let six Ounces be injected in the man∣ner of a Ʋterine Glister, and anoint the part affected with the Oyntment of Ceruse with Camphor; and if the pain and heat be much, anoint it with the following Oynt∣ment.

Take of the Populeon Oyntment one Ounce, of Camphor two Scruples, of Ceruss washed in Rose Water one Scruple, and the white of one Egg, mingle them.

Oyl of Flax hot is also good for Chaps of the Anus and Womb, so is Pomatum; Oyl of the Yolks of Eggs, or of Flax Seeds stir'd about in a Leaden Mortar is also proper, and if they are occasioned by driness, Barly boyled in Water in Linnen Baggs, and applyed for nine days are very beneficial. But if the Chaps are malignant, apply the following.

Take of good Aqua vitae one point, of Sub∣limate powdered one Scruple, of Verdegrease half a Scruple, the Whites of three Eggs, stir them well together, and anoint the part every other day, and apply over a Plaster of Diachylon.

CHAP. XLI.

Of the Melancholy of Virgins and Widows.

MElancholy befalls Virgins, Wid∣dows, and Barren VVomen, oft∣ner than other VVomen; there are two Causes of it.

First, the Nature of a Woman which is tender, and the Mind easily deject∣ed.

Secondly, Gross Blood.

The signs of it are a Pulsation about the Back, which is a Symptom almost per∣petual in VVomen so affected; the Skin is sometime squalid, wrinkley and rough, especially in the Arms, Knees and joints of the Fingers; much Cogitation, Suspi∣cion, Shame-facedness, Dejection of Mind, disturbed Sleep, frightful Dreams, a preposterous Judgment; the Breast is often very Hot and hath a Pulsation in it, and when the Vapour rises upwards, there is a Palpitation of the Heart, or Fainting; there is a rising in the Throat,

as in Mother-fits, the Belly is most com∣monly Bound, they are Thirsty, and sub∣ject to VVatchings, to Despair, and to VVeeping and Sorrow, and sometimes the Melancholy is so high, as that they grow almost Distracted, and are ready to make away with themselves.

There are three Degrees of this Dis∣ease, according to which the Danger is more or less, and the Cure is to be varied accordingly.

The First, Is when the Signs are small.

The Second, when the Disease has lasted a long while, and has disordered the VVomans Mind so, as that she is continually Sorrowful and Sad.

The Third, Is when the VVoman, is so overcome with it, that she will not speak, nor give any answers, and this is near to Madness.

The First Degree of this may be re∣moved by a sparing Diet, by Exercise, and by variety of pleasant Company, and if she be not Married, she must be Blooded in the Arm every third or fourth

Month, in the middle of the Month: But if she be most Melancholy at the time of her Courses, she must be Blood∣ed in the Foot two or three days be∣fore or after them.

But if the Disease be in the Second De∣gree, the Curative Indications are prin∣cipally four.

The First, to hinder the Congestion of the Blood in the VVomb, by such things as force the Courses.

The Second, is to expel the Melancho∣ly that is heapt up.

The Third, Is to discuss the VVind.

The Fourth, To provide for the Head, Heart, Womb, and the whole Bo∣dy.

It is to be Cured therefore by five sorts of Remedies.

First, By a moistning Diet, as let the Dinner be of a boyl'd Chicken, with the Roots of Fennel, Parsley, red Vetches, and Saffron: And the Supper of new-laid Eggs, roasted, and stewed Prunes, or

Borrage prepared with Almond-milk, by reason of Watchings, wherewith they are much troubled; or a Ptisan with a little Anniseeds and Cinnamon, to expel the Wind. Let the Drink be Rhenish or VVhite-wine with Borrage flowers in it, midling Beer medicated with Elecam∣pane or Balm, or water boyled with the Herb Maiden-hair, with the Roots of Scorzonera, Lemon-peel, and Citron∣seeds. If the Belly be bound, use the following Glister.

Take of the Roots of Fennel and Parsley, each one Ounce, of the Leaves of Mallows, one Handful, of Polypody of the Oak, one Ounce, of the Seeds of Bastard Saffron, Flax, and Fenugreek, each one Dram, boyl them to a Pint, to the strained Liquor add of the Oyls of Dill, Camomile, Violets, and of Brown-Sugar, each one Ounce, of Diacatholicon, half an Ounce.

Secondly, Evacuations must be used, and if there be a plenitude, Bleeding must be ordered, and purging Medicines fre∣quently; but the Humour must be first prepared by the following Medicines, or the like.

Take of Syrups of Borrage, of Apples, and of Epithymum, each one Ounce, of the waters of Borrage and Balm, each two Ounces, min∣gle them, and when the Woman has used this six or eight Days, let her take every other Week one Dram of the Pills of Aloes, of Mastick, or of Agarick; or rather be∣cause the Pills dry and heat, let her take three or four times in a Year a Bolus made with an Ounce of the pulp of Cassia, and two Drams of the Powder of Sena: The following Syrup is much commended.

Take of the waters of Borrage, Succory and Hops, each ten Ounces, of the juice of Borrage clarified eight Ounces, of the juice of fragrant Apples, six Ounces, of the Leaves of Sena three Ounces, of the Cordial Flowers, each one Pugil, of the Roots of Scorzonera cut small, or of Angelica, two Ounces, boyl them over a gentle Fire till the twentieth part is consumed; to the strained Liquor add of choice Rubarb, and of Agarick trothiscated, each four Drams and an half; after it has boyled gently, strain it out, and add of the powder of the Stone called Lazulus prepared, and tied up in a rag two Drams, of Sugar a sufficient quantity, make a Syrup of a mo∣derate consistence: The Dose is three or four Ounces.

The following Medicine is much com∣mended.

Take of the Leaves of Spleen-wort, Penny-royal, Maiden-hair, Thym, Fumitory, Bor∣rage, Mugwort, and Agrimony, each half an Handful, of the Roots of Succory, Endive, Smallage, Angelica, Fennel, Asparagus, and Eringo, each one Ounce, of the flowers of Borrage, Stechas, Rosemary, Violets, each one Pugil and an half, of Epithymum, and of the leaves of Sena, each half an Ounce, of Doronicum, of the Seeds of Anise, Fen∣el, Basil, and Citron, each two Drams and an half, of Cinnamon half an Ounce, of all the Sanders, each half a Dram, boyl them in a sufficient quantity of Water to a Quart; at the end add of the Bark of the Root of black Hellibore, and of choice Rubarb, each four Scruples, of the stone called Lazulus tied up in a rag, one Dram, of sweet smelling Flag, of Zedoary, and of the Seeds of Peony decorti∣ated, each half a Scruple, strain it, and with a sufficient quantity of white Sugar make a clear Potion; aromatize it with one Dram of Diamosh. The Dose is five or six Ounces.

But if these things do no good, four

Grains of Stybium prepared may be safe∣ly given; but it is best to begin with two Grains. But some in a desperate Melancholy have not feared to give three four or five Grains of Vigo's precipi∣tate with an Ounce of good Wine, or in Conserve of Roses.

Thirdly things that discuss Wind must be used, and the following Glister must be frequently injected.

Take of the Roots of Fennel, and Parsley, each one Ounce, of the Seeds of bastard Saf∣fron, Anise, Flax, and Fenugreek, each one Dram, of the Leaves of Mallows, one Handful, of Polypody of the Oak, half an Handful, boyl them in a sufficient quantity of Water to a Pint; add of the Oyls of Ca∣momile, and Dill, each one Ounce, and an half, of Lenitive Electuary, and of brown Su∣gar, each one Ounce; make a Glister.

And it is convenient to anoint the Spleen with the following Liniment.

Take of the Decoction of Tamarisck, Ca∣pers, and Spleen-wort, each two Ounces, of Oyl of Capers, and Lillies, each one Dram, of Treacle and Mithridate, each two Drams,

with a sufficient quantity of Wax make an Oyntment.

Fourthly, Such things must be used as cause Sleep, whereof there is so great want in this Disease, that this Symptom often takes up the whole Cure; it happens by reason of the siccity of the Brain, and therefore things that moisten are to be used. To this purpose, the Feet and Legs are wont to be washed with a De∣coction of Mallows, Roses, Camomile, Violets, and the Flowers of Lettice, and sometimes Henbane, and the heads of whith Poppies are added to it, and the Head is to be Embrocated in the fol∣lowing manner.

Take of the foresaid Decoction a Quart, of the Oyls of Poppies, and Roses, each three Ounces, mingle them, and pour them gently being warm upon the Head; but the Hair must be first shaved off. Afterwards apply to the Head a Rag dipt in the Oyls of Roses and Camomile, or of Poppies, if the Watchings be very great, or in Womans or Goats Milk, and if these things are not sufficient, anoint the Nostrils with Populeon Oyntment; or take of Oyntment of Roses one Ounce, of Opium four Grains, mingle them, and anoint the

Nostrils, the Temples, and the Palms of the Hands, and the Soles of the Feet, and the Pulse, and let her take inwardly the following Emulsion.

Take of Sweet Almonds blanched four Ounces, of the Seeds of Melons, and Gouras, each one Ounce, of the Seeds of Lettice, and Poppies, each two Drams, beat them in a Marble Mortar, and pour upon them a Pint of Barley water, and a little Rose water, sweeten it with Sugar and make an Emulsion; let it be taken just after Supper, and at Bed∣time give the following Anodyne.

Take of Cowslip water, two Ounces, of Diacodium, one Ounce.

Lastly, such things must be used, as strengthen the Brain and Heart, apply the following Epithem to the region of the Heart.

Take of the waters of Balm, Orange flow∣ers, and Borrage, each three Ounces, of good White-wine, two Ounces, of the Juice of fra∣grant Apples, one Ounces and an half, of the Powders of Diamosck, Diambra, of the Bark of Citron, each half a Dram, mingle them; or anoint the region of the Heart with the

Oyntment of Flowers of Oranges, and let her Eat now and then Citron▪ Bark Candied, or the Roots of Bugloss, or Scorzonera Can∣died.

But if the Disease be so high, that the Woman is plainly Delirious, which is the third Degree of this Disease; the same Remedies in a manner must be used, only the most effectual must be chosen, and care must be taken, that a cold and dry Intemperies be not con∣tracted, and therefore less Blood must be taken away, and she must be Purged strongly with a Dram of the Pill De La∣pide Lazuli, or with the like quantity of the following.

Take of Epithymum, six Ounces, of A∣garick, four Drams, of the Bark of black Hellebore, one Dram and an half, of the spe∣cies of simple Hiera, four Drams, with Ho∣ney of Roses make a Mass. But the follow∣ing Electuary is better.

Take of the Stone called Lazulus, one Dram, of the Leaves of Sena, one Dram and an half, of the best Agarick two Drams, of the Syrup of Purslain, or of the Juice of Fumitory or of Hops, three Ounces, of Con∣serve

of Roses or of Violets, one Ounce, min∣gle them; let her take an Ounce once a Week.

And the Body must be moistned by all means, by Baths and the like; where∣with, and with a moistning Diet Galen cured Melancholy, and such things must be used as provoke the Courses; but if they will not flow, the application of Leeches to the Hemorrhoids is very pro∣per, because Hippocrates and Galen say that Melancholy Blood is drawn by these Veins; they may be opened two ways; by rubbing the Fundament with a course Cloth, and by Leeehes, which must be of a moderate bigness, and they must be taken from a clear and running Water, they must not be green, pale, nor hairy; but reddish, and after they are taken they must be pressed, that they may Vomit up the Venom, if they have any; then they must be kept in a Glass full of clear Water sweetned with Sugar, and the Water must be changed once a Week. When they are to be applied, you must Foment the part with a Decoction of Camomile, Mallows, Mullein, and the like; then rub it, that the Mouth of the Veins may appear, and to each of them

apply a Leech; if they will not stick, anoint the place with Chickens Blood, or the like; and whilst they are suck∣ing, let a hot Decoction of Camomile, Dill, Roses, and Mallows be put under them, that the vapour of it may comfort them. A sufficient quantity of Blood being drawn, they generally fall off of themselves; if they do not, pinch them by the Tails, or sprinkle upon their Mouths Ashes, Salt, or Aloes. If the Blood slow too long, apply Rags dipt in stiptick Wine, or the white of an Egg with some astringent Powder.

FINIS.