Chirurgorum comes, or, The whole practice of chirurgery begun by the learned Dr. Read ; continued and completed by a Member of the College of physicians in London.

CHAP. II.

The signs that precede and accompany as well a na∣tural, as an unnatural Delivery.

WHen Women with Child, chiefly of their first, perceive any extraordinary pains in their Belly, they immediately send for their Midwife, taking it for their Labour; who when she is come, ought to be well inform∣ed of the matter, and careful not to put her in Labour before there is a disposition to it. For many times both the Mother and Child lose their Lives, when (by break∣ing the Amnios and Chorion) it is excited before the due time. Those pains, which may be called false, are usually caused by a Colick, proceeding from Wind, which come and go griping the whole Belly, without any forcing down∣wards, or into the Womb, as those do which precede or accompany Labour: And this Colick is dissi∣pated by warm Clothes applied to the Belly, and a Clyster or two, by which, true Labour-pains are rather furthered than hindred. A Woman may feel other kind of pains coming from an Emotion, caused by the flux of the Belly, which are easily known by the frequent Stools that follow.

The signs preceding a natural Labour few days before are, that the Belly, which before lay high,

sinks down, and hinders a Woman at that time from walking as easie as she used; and there flows from the Womb slimy humors, appoint∣ed by Nature to moisten and smooth the passage, that its in∣ward orisice may the more easily be dilated, when it is necessary; which beginning to open a little at that time, suffers that slime to flow away, which proceeds from the humors that strain through the thin substance of the Infants Mem∣branes, and acquires a viscous con∣sistence by the heat of the place, or from the Prostatae.

The signs accompanying pre∣sent Labour, (that is, shewing, that the Woman is effectively in Labour) are great pains about the region of the Reins and Loins, which coming and reiterating by intervals, answer in the bottom of the Belly with congruous Throws. The Face is sometimes red and in∣flamed, because the Blood is much heated by the continual endea∣vours a Woman makes to bring forth her Child; as also, because that during these strong Throws her respiration is ever intercepted; for which reason much Blood hath recourse to her Face. Her privy parts are swelled, because the In∣fants Head (lying in the birth) often th••usts and causes the neighbour∣ing parts to distend outwards, which thence appear swelled in this manner. She is often subject to vomiting, which makes many be∣lieve, who know not the cause of it, that the Women to whom it happens, are in danger: But on the contrary, it is ordinarily a sign of speedy delivery, because the good pains are then excited and redoubled every moment until the business be finished. This vomi∣ting comes from a Sympathy be∣tween the Womb and Stomach, by reason of the ramifications of the Nerves of the sixth pair of the Brain, which are distributed both to the one and the other, and by which it communicates the pain it feels at that time, arising from the agitation, which the violent and frequent motions of the Child cause, and the strong compression the Muscles of the lower Belly make during the Throws, for to help the issuing forth of the Child. Besides, when the birth is near, Women are sometimes troubled with an universal trembling, and principally of the Legs and Thighs; not with cold, as at the beginning of an Ague-fit, but with the heat of the whole Body; and the Hu∣mors which then flow from the Womb, are often discoloured with Blood, which with the signs above∣mentioned, is an infallible mark of the nearness of the birth; 'tis that the Midwives usually call Shows: and if one then put up their Finger into the neck of the Womb, they will find the inner Orisice dilated, at the opening of which, the Mem∣branes of the Infant, containing the Waters, present themselves, and are strongly forced downwards with every pain the Woman hath; at which time one may perceive them to resist, and again press to∣wards the ••inger, being by so much the more or less hard and extended, by how much the pains are stronger or weaker. These Membranes with the water 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 waters) presenting them∣selves at this inward Orifice, do then resemble very well to the touch of the Finger, the 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 impulsion of the waters, which in∣continently flow away, and then the Head of the Child is easily felt naked, and presented at the open∣ing of the inner Orisice of the Womb. Now all these, or the greatest part of them met toge∣ther, at what time soever of a Wo∣mans going with Child it be, whe∣ther full time or no, one may be assured she will soon be delivered; but great care must be taken not to hasten her Labour, before the ne∣cessity of it be known by these signs; for that would but tor∣ment the Woman 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 si∣gure and situation; as when it pre∣sents any otherwise than the Head first; as also when the waters flow away a long time before it is born, because it remains dry in the Womb, and they are absolutely necessary to moisten the passage, and render it more slippery. When the After-burthen comes first, it is an accident, which renders the Labour always dangerous, by rea∣son of the great flux of Blood usually following, of which the Mother may dye in few hours, and the Infant (because it receives no more nourishment) is quickly smo∣thered in the Womb, for want of respiration, which it then needs, if it stay never so little after. The Labour is also grievous, when ac∣companied with a Fever, or any other considerable distemper, which may destroy the Child in the Womb; as also when pains are small, and come slow, with long interval and little profit, by rea∣son of which a Woman is extreme∣ly tired: but the difficulty most frequent and ordinary comes from the Infants wrong posture.