Ars chirurgica a compendium of the theory and practice of chirurgery in seven books ... shewing the names, causes, signs, differences, prognosticks, and various intentions of curing all kinds of chirurgick diseases ... : to which is added Pharmacopoeia chirurgica, or, The medical store, Latin and English ... / by William Salmon ...

CHAP. XXVI. The CAESARIAN BIRTH.

I. THis is that which teaches the Extraction of the Foe∣tus out of the Womb by Section, where it cannot otherwise be delivered.

II. And if both Mother and Child be alive, it is so to be done as to respect both, that both may be saved; but if the Mother be dead, and the Child only alive, so as to save it.

III. It is a dangerous Operati∣on, yet has been many times suc∣cessfully done, even where both have been living; the Incision having been so made, to save both Mother and Child, and that several times on one and the same Woman, without preju∣dicing her Breeding again.

IV. If it be done on a living Wo∣man, it is not to be attempted, till all other means has proved un∣successful: Yet it must be before the strength be too far spent.

V. If the Mother be just ready to die, and the Child alive, the Chirurgian ought to be ready at hand, that the work may be im∣mediately performed, as soon as the Woman is dead, to save the living Child.

VI. There are several Causes why this Operation should be done, 1. Those which respect the Child: As, 1. Its being too fat and big. 2. When more than one are striving to come forth toge∣ther, one being dead, and lying in the others way. 3. When it is a Monster with two Heads, more Arms than usual, &c. 4. When dead, and putre••ed or rotten, or is wasted to Bones.

VII. 2. Those which respect the Mother; which are, 1. When the passages are too narrow, she having been Married too Young or too Old. 2. When the Parts by some Scar or Hurt are harden∣ed,

made narrow, or grown to∣gether. 3. When there is a large fleshy Excrescence in the Vagi∣na. 4. When the Os Pubis is grown unnaturally big, or stands out. 5. When there is a fleshy swelling within the Womb, or its Neck, &c.

VIII. Before you begin the Work, have in a readiness all your necessary Instruments; as a Pen and Ink to mark the place, an Incision-knife, four or five Needles threaded with Silk, three soft Spunges, several Bolsters of Cloth, a fourfold doubled Nap∣kin to put round about the Bel∣ly, and two Rowlers six Inches broad, to rowl the Belly, and stop the Blood.

IX. As to Medicines, these must be also had in a readiness. 1. De∣coctum Traumaticum, made only with Red Wine. 2. A Restri∣ctive Pouder, thus made: Take white Starch ʒxij. Olibanum, Mastich, a. ʒx. Rosin ʒvj. fine Bole, Catechu, a. ʒiv. Sanguis Draconis, Comfrey Roots, a. ʒij. make all into a fine Pouder, and mix. 3. A Vulnerary Balsam, as Balsam de Chili, Balsamum Vul∣nerarium, or some such like.

X. This done, and having con∣sidered the strength of the Woman, give her an Emollient Clyster to empty the Guts; let her also make Water to empty the Bladder, and give her a good Cordial, or a Glass of Wine, to fortifie her Spirits.

XI. Then mark the place you intend to open with Transverse Lines, the length of half a Foot; let the Woman lye on her Back near the edge of the Bed; let two strong Persons hold her, keeping her Legs close, laying a great Pillow under her Head; and let the soundest side be pitcht on, unless there be a Rup∣ture, for then that side is to be taken.

XII. But if the Woman be dead, take the place you judge fittest, which let be two or three Inches beneath, and on the side of the Navel, and as much from the Lower Part.

XIII. First cut open the Belly to the Fat, then through the Mus∣cles and Peritonaeum, till you see the Womb; having obtain'd it, open it in the middle, but with great care as to the Child, that it, nor its Bandage or Ligaments be not wounded, and then take forth speedily the Child, Secun∣dine, and Navel-string, deliver∣ing them to the Midwife.

XIV. If the Child be Weak, or Convulsed, sprinkle the Secun∣dine with warm Wine, and lay it to the Childs Belly.

XV. And if the Woman be yet alive, immediately wash the Womb with the before-named Decoctum Traumaticum, which will stay its Bleeding, and cleanse it from the Blood and Filth.

XVI. Presently after you must stitch up the Wound, as you stitch up a Hare-lip, only keep open a place with a Tent, in the most depending part; and lay over the afore-described Restrictive Pouder, mixt with the Whites of Eggs and Vinegar beat toge∣ther.

XVII. The Bleeding being thus stayed, heal the Wound at one In∣tention with the aforenamed Bal∣sam

de Chili, or Vulnerarium, or any other of like Nature and Properties.

XVIII. After the first, and so in the rest you are to use the Bol∣sters, and on them the Napkin, and then the Rowlers.

XIX. The Womb it self is not to be stitched, but to be healed by Injections, but such as may not hinder the Lochies, by which the Pain will be mitigated, Inflam∣mation prevented, and the Womb it self comforted and strengthened, and made able to expel its Recrements.

XX. The Tent is to be kept in t•…•… the great danger is over, and the usual Symptoms are vanished; and such Emplasters, &c. may be used, as are applied to other Wounds of the Belly.

XXI. Lastly, let her Diet be such as is used in other great Wounds and Ʋlcers of the Belly; as good strong Broths, Gellies, Chick∣ens, Poached Yolks of Eggs, Gravy of Mutton, Veal, &c. and more especially the last, to prevent her being costive, which if it should so happen, it must be remedied with Emollient Clysters.