The practice of physick in seventeen several books wherein is plainly set forth the nature, cause, differences, and several sorts of signs : together with the cure of all diseases in the body of man / by Nicholas Culpeper ... Abdiah Cole ... and William Rowland ; being chiefly a translation of the works of that learned and renowned doctor, Lazarus Riverius ...

Chap. 18. Of Hard Child-birth.

HArd Travel in Child-bearing, is such as keeps not the due and ordinary Laws of Nature, taking up longer time than ordinary, and accompanied with more vehement pains than are usual, and other more grievous Symptomes.

Divers causes here of may be assigned both internal and external. The internal depend either of the Mother, of the Womb, or of the Child.

In respect of the Mother, Travel with child may become sore and hard, by the weakness of her Bo∣dy, either Natural, or in regard of Age, as in very yong and very ancient women, or in regard of Diseases wherewith the woman was troubled during the time of her going with Child, or is still trou∣bled. Hereunto also Leanness, and over great driness of the whol body, may be added; as also over fatness, and grossness compressing and straitening the passages of the womb; ill shape of such bones as border upon, and embrace the womb▪ as in such as limp, wind stretching the Guts; stone or pre∣ternatural tumor possessing the bladder, and pressing the Womb; and the ill constitution of the Lungs, and other parts serving for Respiration, because holding the Breath is very necessary to ex∣clude the Child.

In respect of the Womb, divers Diseases thereof may cause a sore Labor, as Swellings, Ulcers, Ob∣structions, Astrictions, Stoppages arising from preternatural Causes.

In respect of the Child, Hard Travel is caused, when there is some fault therein, in respect of its substance, its quantity, its figure, and certain things thereunto belonging.

The Child is faulty in regard of Substance, when it is dead or putrefied, or some waies infected, or weakened with some Disease, so that it hath no ability to contribute to its own exclusion.

In regard of Quantity likewise, the Child doth not further its own Birth, which is either discrete or severed quantity, or concrete and joyned; the former is called Number, the latter Magnitude. In regard therefore of continued quantity, the child is faulty, if the Body or Head of it be over great; which makes the Birth thereof become difficult and laborsom; in regard of the disjoyned quantity of the child or burden, Labor becomes difficult, as when there are more than one in the womb; so the Birth of Twins is more painful than of a single Child, for the most part.

In respect of the Figure, or Scituation of the Child in the Womb difficult Travel happens many waies; as when the Child endeavors to come forth with its feet or its hands foremost, or puts out one hand only, or one foot; or when it endeavors to come forth doubled, with its breech, or its belly foremost.

In regard of the Childs Adjuncts or certain things belonging to the Child, difficulty of Travail happens, when those membranes which enclose the Child are more thin than ordinary so that they come to break, sooner than they should; whence followed an over quick effusion of the waters conteined therein, whereupon the mouth of the Womb remaines dry at the time of the exclusion of the Infant; or where the foresaid Membranes, are more thick and compact than ordinary, by which means, the Child is hardly able to breake them.

External Causes depend upon things necessary and things contingent, the things necessary are such as Physitians commonly call res non naturales, things not natural. So a cold and dry air, and the Northern-wind are very hurtfull to women in travail, because they straiten the whol Body, drive the Blood and spirits inwards, and prove very destructive to the Infant coming forth of so warm a place as the Womb. Also air more hot than ordinary dissipates the spirits and exhausts the strength both of Mother and Child, easily introduceing a feaverish Inflammation into a Body replenished with ill humors, and exagitated.

Meates raw and hard to digest, or of an astringent quality, taken in a large Quantity before the time of travail, may render the same laborious, the stomach being weakened and the common passages stopped, which in this case ought to be very free and open.

Sleepyness and Sottishess do slacken the endeavours both of the Mother and the Child, and shew nature to be weak.

Unseasonable stirring of the woman doth much delay the Birth of the Child, whenas she refuses to stand, to walk, lie down, or to sit upon the Midwifes stoole, as need shall require; or when she is unduely agitated to and fro; whence it comes to pass that the Child cannot l••••ue in a sitting posture, or looses the good posture it had, by reason of the Mothers undue and disorderly moveing her self.

The retention of Excrements at the time of Travail, as of Urin distending the Bladder of hard ex∣crements in the streight Gutt; and hemorrhoids much Swelled, do straiten the neck of the Womb, and divert nature from her endeavour of expelling the Child.

And in a word, vehement Passions of mind, as Fear, Sadness, Anger, may very much encrease the difficulty of Child birth.

To things contingent are referred Blowes, Falls, wounds, which may very much hinder the Birth: hereunto likewise appertain the parties assistant in time of travail to help the labouring woman, viz. strong women and maid servants, which may lift her up and support her when she is in her labours, and especially an expert Midwife, which ought to mannage the whol Business. For if the Midwife err in her office, it is wont to cause difficulty of Birth. For sometimes the Midwises do over soon exhort the Childing woman, to hold their breath and to strain themselves to exclude their Child, while the bands which fasten the Child to the Womb, are as yet unloosed; by which means, the strength of the woman is wasted before hand, which should have bin reserved to the just time of her travail. Yea and the truth is, while the Midwifes do oversoon perswade the Childing women, that the time of their travail is at hand, they bend all their strength to exclude the Child, and oftentimes violently break those bands with which the Child is fastened, and cast themselves into no small Jeopardy.

Hard Travail is known both by the Childing woman, and by the Assistants, but especially by the Midwife. And in the first place, if the woman continue a longer time than ordinary in her Labors, as two, three, four or more daies whereas a truly natural Child-birth ought to be accomplished within the space of 24. Houres. Again, it is a Sign of an hard Labor, if the womans paines be weak, and are long before they return, and if her paines are more about her Back than Privities. And the Causes of hard travail, are known by relation of the Childing woman, and are for the most part evidently to be seen. So the weakness of the woman, her over leanness, or over fatness, is perceived by the habit of her Body. Diseases of the Womb are known by their proper Signes. The Childs weakness is known by its weak and slow moving it self. But the Signes of a dead Child shall be declared in the next Chapter. The greatness of the Child may be gathered from the stature of the Parents, especially when a big-Bodyed man is matched with a little woman. But when there are none of these Signes, and the woman labours stoutly, and the Child stirrs and makes its way suf∣ficiently, and yet the travail is hard and painful; it is a token that the secundine or After-birth is stronger than ordinary, and can hardly be broken, which conjecture is more probable, if no water or moisture come from the woman dureing her Labors. The disorderly posture of the Child is per∣ceived by the Midwife, and the other Causes are visible to the Eye, as we said before.

As for the Prognostick. Hard-Travail, is of it self dangerous in which sometimes the Mother, sometimes the Child and sometimes both do loose their lives.

If a woman be four daies in Labor, its hardly possible the Child should live.

Sleepy diseases and convulsions which befall a woman in Travail are for the most part deadly.

Sneezing which befalls a woman in sore Travail is good. Out of Hippocrates in his Aphorismes.

To cure difficulty in Child-birth first all causes which may delay the birth, are as much as may be, to be removed. And afterwards, such Medicines as further the Birth are Methodically to be administred.

And in the first place it is common among the women to give a groaning wife a spoonfull or two of Cinnamon Water. Or Cinnamon it self in Pouder with a little Saffron may be given, or half a dram of Consectio Alkermes may be drunk in a little Broath. Also Saffron alone being given ten graines in every Mess of Broath the woman takes, or every hour being taken in a little Wine is very good Or.

Take Oyl of sweet Almonds and White Wine of each two ounces. Saffron and Cinnamon of eath twelve graines Confectio Alkermes half a dram. Syrup of Maiden Hair one ounce and an half. Mix all and make thereof a potion.

If this shall not suffice, but that stronger things, must be used, the following potion wil be most effectual, which I have had frequent experience of.

Take Dictamnus Cretensis, both the Birthworts, and Trochiscs or Cakes of Myrrh of each half asc uple. Saffron and Cinnamon of each twelve grains. Confectio Alkermes half a dram: Cinnamon Water half an ounce, Orange-flower and Mugwort Water of each an ounce and an half: Make all into a potion.

Among the more effectual sort of Medicaments are numbred Oyl of Amber Oyl of Cinnamon and extract of Saffron, which do in a little quantity work ••••ch viz. Extract of Saffron to five or six grains, Oyl of Cinnamon to four or five Drops; Oyl of Amber to twelve or fifteen Drops, in VVine, Broth or other Liquor.

Sneezing hastens the Birth, or Hippocrates in the Aphor. 35. Sect. 5. Sneezing which happens to a woman in sore Travail is good. Sneezing may be provoked by the following Pouder.

Take White Hellebore half a dram. Long Pepper one scurple. Castoreum five grains. Make all into a Pouder, and blow thereof into her ••st••••lls the quantity of a Pease.

The same Hippocrates prescribes another Remedy in the first Book of womens diseases, which is omitted by all authors almost. And that is the opening of one of the lower veines of the Body, which he propounds in these words. But if (saith he) a Big-bellied woman be so stopped that she cannot bring forth, but continues divers daies in her ••ains: if she be a yong woman, vigorous and full of Blood, her Anckleveines must be opened, and Blood taken away, according as her strength will bear, Although this remedy be never used by our Practitioners, and it seems much to be feared, be∣cause in Travail nothing is so needful as strength, which may be weakened by Blood-letting: Yet if difficult Travail do arise from fullness of blood, which Hippocrates doth insinuate in those words, where he saies If the woman be yong and in the prime of her strength, and very full of Blood; there is no question, but bleeding may be very profitable, because the Veines being very full of Blood, are wont to make al other inward passages of the Body more strait. Whence it comes to pass, that in pains of the Stone in the kidneys, the like Blood-letting doth often work wonders, and facilitate the expulsion of Stones conteined both in the kidneys and Ureters.

Also hard Travail may be holpen not only by those inward Medicines prescribed, but likewise by outward

Let the Midwife therefore frequently anoint the Womb of the Childing woman with Oyls of Lillies, sweet Almonds, Lin-Seed, and such like.

Also let her belly be fomented on the nether parts with an emollient Decoction of Marsh-mallow and Lilly Roots, Leaves of Mallows, Violets, Mugwort, Seeds of Line and Fenugreek, with the flowers, of Chamomel and Melilot.

Let sharp Clysters be administred, by the provokeing virtue of which the expulsive faculty of the womb may be likewise ••oused up; and the Gutts being emptied will afford larger space for the womb.

Let her Navel be anointed with Oyl of Amber. Some commend the Gaul of an Hen applyed to the same part.

Also such things may be used which are thought by a peculiar property to help the Birth: as Aegle-Stone, Load-Stone, Storax, and the rest being fastened to the Hipps.

Hartmannus Commends the Eyes of an Hare taken in the month of March: which are carefully to be taken out and dried entire with Pepper. Let one of these with Pepper be so tied to her Belly, that the Sight of the Eye may touch her belly: and it will bring forth the Child, be it alive or dead. Which being done take away the Eye least it bring forth the Womb it self. He saies likewise that it is good to bring out the Mole.

Heed is likewise to be taken that the woman carry no Precious Stones about her, either in rings or otherwise, but let her lay them al away: for many of them are conceived by a peculiar property to retain the Child in the womb.

If the Child seem to be weak, it must be refreshed, both with strengthening things given to the Mother, as warm wine, Confectio Alkermes, Cinnamon Water; and also with things outwardly

applied, as with a Crust of Bread, or a Rose Cake strewed with Pouder of Nutmegs, Cinnamon, Cloves, Kermes Berries, and sprinkled with Aqua Imperialis or with warm Wine. Or with a peice of Wether-Mutton a little broiled upon a Gridiron, and sprinkled with Water of Roses or of Orange-flowers; with the call of a wether newly kil'd, not yet cold, and such like.

If the Child begin to come forth in a disorderly manner, as by putting out one Foot, one Hand, or any other way; the Mid-wife must no waies receive it on that manner, but thrust it into the Womb again, and compose it to a right and natural posture or form of egress. Which must be done by laying the Childing woman on her Back in the Bed, with her Head somwhat low and her But∣tocks high: and then gently pressing her Belly towards the short Ribs, and thrusting the Child into the Womb. Afterward let the Midwife endeavour to put the Child into a right posture for coming out, by an artificial Hand procuring that the Child turn its face towards the Mothers Back, and its Buttocks and shighes let her lift up towards the Mothers navel, and so hasten the same unto a natural manner of coming for••h.

When all Hope of the Childs coming forth is past, or when the Mether is almost dead, some Authors proceed to the Caesarean Section [that is to cut the Child out of the Womb, as Caesar was cut out] of which Francilcus Rossetus hath Printed a most elegant Treatise; in which by many reasons and examples he endeavours to shew, that such a thing may be somtimes done with good success. Howbeit, seeing this Operation is very dangerous and terrible, it ought seldom or never to be practised by a discreet Physitian, that would preserve his own reputation.