The store-house of physical practice being a general treatise of the causes and signs of all diseases afflicting human bodies : together with the shortest, plainest and safest way of curing them, by method, medicine and diet : to which is added, for the benefit of young practicers, several choice forms of medicines used by the London physicians / by John Pechey ...

CHAP. CXII. Of the Acute Diseases of Women in Child-bed.

THE Fever from Milk, whilst the Child-bed Pur∣gations proceed right, seldom lasts beyond three Days, for about that Time it usually goes off, by a great Sweat coming of its own accord: But this In∣temperies occasioned by the coming of the Milk is somewhat heightned, and continues longer, when the Milk flows plentifully to the Breasts, and is not milkt out, but repelled: For by its going back as well as its coming, there is a Disturbance in the whole Body usually, which comes more certainly, if the Milk be driven violently back by Repelling To∣picks.

Some common Rules are to be observed concern∣ing the Coming of the Milk, or in driving of it back.

If the Milk flow too freely into the Breasts, that the Inflammation of them, and the immoderate Efferve∣scence of the Blood may be prevented, a thin and spare Diet must be ordered, viz. of Broath without Flesh, and the Breasts must be often sucked, and if it be not thought convenient 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 Cere-cloaths: But this kind of Remedy must be used with Caution, lest the Milk should be Excluded altogether, or too hastily, and so cause a disorder in the Blood, and a putrid or malignant Fever, of which we shall speak next.

Women with Child, by reason their Bodies are ill affected, are as it were infected with a Pestilential Contagion, and so are very subject to a putrid, or rather malignant Fever. This Fever seizes Child-bed Women at various Seasons, and upon several Occasions; some∣times presently after Delivery, especially if it has been difficult and hard; sometimes on the first, sometimes on the second, third, or fourth Week; but the later it begins, the better it goes off. It begins and proceeds, most com∣monly, in the following manner: After a previous Indi∣sposition the Fever begins most commonly, with a Sha∣king 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 Disease 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 great Restlessness, so 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 grie∣vous Symptoms; when this Fever is in its State, no Cri∣sis is to be expected; for I never saw this Disease go off by a critical Sweat; for when the Blood has a while Boyled, the adust Matter being presently translated to the Brain, dangerous disorders of the Genus Nervosum are occasioned, and convulsive motions of the Tendons, and inflations of the Bowels, like Mother Fits, and sometimes a Phrensie, or Delirium, and often a Stupo•• and loss of Speech follow, and the Strength is suddenly dejected, almost in all, without any manifest Cause; the Pulse is weak and unequal, and the Sick soon die: And if any chance to escape, the flux of the Courses being restored, or a Loosness happening, they recover diffi∣cultly after a long Sickness.

The acute Diseases of Women in Childbed, are not always according to the manner of the fore-mentioned Fever, but sometimes they are accompanied with some great Symp∣tom, as with a Quinsie, Pleurisie, Peripneumonia, Bloo∣dy-flux, Small-pox, and the like. Of these a Quinsie, Pleurisie, and Peripneumunia, by reason of the great similitude 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 restored to Cir∣culation, lest an Imposthume should be occasioned; wherefore internal Remedies, which free the Blood from Coagulation, must be used, of which sort are Diaphore∣ticks abounding with Volatile Salt, as Spirit of Harts-horne and Soot, Urin, also Testaceous, and Bezoartick Powders, Lapis Prunella, Decoctions and Juleps, made of Vegetables that force Urine and the Courses; with all which must be mixed such things as have been found by Experience to have been proper for Uterine Diseases. Moreover Discutient Medicines, which disperse the Mat∣ter Impacted, such are Liniments, Fomentations and Cataplasms, must be carefully applied to the Parts af∣fected: In the mean while the violent Motion and im∣moderate Effervescence of the Blood must be driven far from thence, and the Filth must be driven, as much as possible, 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 will be best to open a Vein in the Foot, or to apply Leeches to the Hemor∣rhoidal Veins: But if necessity 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 worse con∣dition, the Pulse being thereby rendred weaker.

A Dissentery 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 forbid the use of them. Wherefore in this case

till she has been well Purged by a long flux of the Lo∣chia, the fierceness of the Symptoms must at present be only appeased.

The Indications of the Small-pox are not only con∣trary to those above-described, but also to one another; for the flux of the Lochia must be moderately restrain∣ed; but in the mean while the Efflorescence of the Blood and gentle Sweating must be continued: For seeing a twofold venomous Ferment is in this Disease, and the corrupt Particles of the Blood are to be carried out two ways, we must take care that the least and narrowest Passage do not draw all the Matter, or more than it can let out. Wherefore, lest the Lochia flowing plentifully should turn inward the Venom that is inclined to go off by Sweat, the course of Diet must be somewhat chan∣ged, and first such things as are of an Alexipharmick and astringent nature must be boyled with their Broaths, as the Roots of Tormentil and Bistort, also Powders, Juleps and Electuaries endued with such Vertues must be given at due Intervals; and in this case the Woman must be no ways allowed Flesh, or the Broath of it, not must she Rise, but she must be kept as quiet as is possible, and the whole Business must be left in a manner to God and Nature.

All Women in Child-bed have an inbred Venom, and they ought to be careful 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 with∣out the danger of a Fever; and that the disorders of the Womb may be heal'd, and their strength, weakned by De∣livery, may be restored: To which end three things are to be minded; First, An exact course of Diet must be or∣dered, viz. That they be fed for a Week at least with Water-Gruel, sometimes made with Beer, sometimes made with Water mix'd with Whitewine, or with Pa∣nada, 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; where∣fore let them continue in Bed, at least till the Tenth day. Thirdly, The Lochia must be gently provoked; to this end Midwives, when after hard Labour, there is

danger of a stoppage of the Lochia; give Sperma Caeti, 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 Mug∣wort.