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. IX.

The signs to know whether the Child be alive or dead.

IF there be any case, wherein a Chirurgeon ought to make the greatest reflection, and use most precaution in his Art, it is this, to know whether the Infant in the Womb be allve or dead; for there have been many deplorable examples of Children being drawn forth alive, after they have been thought to have been dead, with both Arms, or some other Limb lopt off, and others miserably kil∣led by the use of Crochets, which might have been born alive, if they had not been mistaken. Where∣fore, before he resolve on the man∣ner of laying the Woman, to avoid the like misfortune, and the dis∣grace of being Author of such a pitiful spectacle, let him use his utmost endeavour not to be so de∣ceived, and to be fully satisfied whether the Child be alive or dead; always remembring that in this case, timidity is more pardonable than temerity, that is, it is better to be deceived in treating a dead Infant, as if it were alive; than a living one as if it were dead.

The Child may be known to be alive, if it be at the full reckon∣ing; if the Woman has received no hurt; if she has had her health well all her going with Child; if she be at present in good health, and very sure she feels it stir, which may be known by the Mother's re∣lation: and the Chirurgeon may be better assured of it, if he feels it stir himself, laying his Hand on the Mother's Belly; to whose re∣lation he must not always trust. If the Chirurgeon cannot be assured by the Infant's motion that it is alive, he may assoon as the waters are broke, gently put up his Hand into the Womb, to feel the pul∣sation of the Navel-string, which he will find stronger, the nearer he feels it to the Infant's Belly; or if he meets with a Hand he may feel the Pulse, but there pulsation is not so strong as in the Navel∣string, by which it is best to be known. If then he finds thus the beating of the Pulse, he may be confident the Child is alive; as al∣so if by putting his Finger into its Mouth, he perceives it to stir its Tongue, as if it would suck.

But on the contrary, the Child is dead, if it has not a long time stirred; if there flows from the Womb stinking and cadave∣rous Humors; if the Woman feels great pains, and a great weight in her Belly; if it be not supported, but tumbles always on that side as

she lays her self; if she faints, or has Convulsions; if the Navel∣string or Secundine has been a good while in the World; or if by put∣ting his Hand into the Womb, he finds the Child cold, and the Na∣vel-string without Pulse, and its Tongue immoveable; and feeling the Head, he finds it very soft, chiefly towards the Crown, where likewise the Bones are open, and riding the one upon the other at the Sutures, because the Brain shrinks, and is without Pulse when the Child is dead; which cor∣rupts more in two days in the Womb, than it does in two days af∣ter it is born; which the heat and moistness of the place do cause, the two principles of corruption.

But we may only conjecture it, if the Woman has been hurt, or floods much, and be not at her full time; if her water broke four or five days before; if her Breasts flag; if her Complexion be of a Lead colour, her Countenance lan∣guishing and dejected; and if her breath stinks. We say that these things may only make us conje∣cture it, but not, as the rest, cer∣tainly conclude it; many of which hapning together in one person, as∣sure us that the Child is dead, for want of which it cannot be very certain. Wherefore (as I have said) 'tis good to be very careful before they undertake it, that so they may avoid the abovesaid scan∣dals.