The diseases of women with child, and in child-bed

The First Book. Of the Diseases, and different Dispositions of Women with Child, from the time of Con∣ception to the full time of Reckoning. (Book 1)

MAny Indispositions may arrive to Women from the time of Con∣ception to the full term of La∣bour, because they are then not only subject to those which are caused by pregnancy, but to those also which happen at other times. It is not my design so to enlarge as to examine all, but onely to enquire into the principal and most usual Maladies that accompany Great-Bellies, and have, during their course, some particular Indica∣tions for their Cure; for as for those which have only general Indications, and may happen indiffe∣rently to a Woman at any time, they may easily be known and redressed by the ordinary means, provided that you have all the while regard to the disposition of the Great-Belly.

It would be sufficient to my purpose, of a through examination (in pursuance of my intention) of eve∣ry circumstance of a Great-Belly, to begin with

the explication of a Conception, which must precede it: but, since that cannot happen but to a fruitfull Woman, I will, before I discourse of it, that you may the better understand it from its original, give you some considerable Observations concerning the Fruitfulness and Barrenness of Women; for Barrenness proceeds oftner from Women than Men: for there are many conditions required in a Wo∣man, which Men have no occasion of, who only need to provide a small quantity of their Seed, and that at once, to generate; but Women, besides their Seed, must have a fit place to receive both, as the Womb is when well disposed; and matter ap∣pointed for the Child's nourishment, during its whole stay there, as is the menstruous blood: This is the cause, that for one impotent Man, there may be above thirty barren Women found. Let us therefore first of all see what are the signs of Fruitfulness and Barrenness in Women.

CHAP. I. Of the signs of Fertility and Sterility in Women.

By the Fertility of a Woman, I understand a natural disposition of her Body, by means of which, with the assistance of a Man, she may en∣gender her like: And by Sterility, which is di∣rectly contrary, I intend an* 1.1 Im∣potency, which proceeds from some vice or fault either of her whole body, or of some particular part. We must how

make some enquiries after the most notable signs of the one and the other, and chiefly of those which may be perceived by our sight or touch, by which we may better judge than by many others, that for the most part are uncertain: For those which are taken from different temperaments, may easily deceive us, forasmuch as we may often find Wo∣men of a very ill habit, and full of ill humours, not∣withstanding fruitful.

First, therefore, we affirm the Womb to be a part absolutely necessary to fertility, and the prin∣cipal object to be represented and examined to make a judgment of it: but as we find not every Ground proper to yeeld Fruit, and that some are so ungrate∣ful as to produce nothing; so likewise it is not e∣nough, for a Woman to have a Womb to be ca∣pable of Conception, since we find divers that have them, barren.

We have already* 1.2 shewed you exactly what the composition and natural structure of it ought to be, for to serve to so admirable an end as generation: Wherefore we will now speak no further of that, but refer you to that place to be informed.

You must know then in general that the signs of fecundity in a Women are, that her Womb be well disposed, that she be at least thirteen or fourteen years of age, and at most but 45 or 50 generally and for the most part (though some, yet very rarely, conceive sooner or later according to their different natures and dispositions) that they be of a good temperament and indifferently sanguine, that they have their Courses in due time, of good blood and laudable in coulour, quantity, quality, and consi∣stance, and regularly every month, at once, with∣out

interruption, from the time they begin to flow till the time the evacuation is compleated.

We say that the bloud ought to be good and lau∣dable, because it is a regurgitation and natural eva∣cuation only of what is superfluous in Women not with Child, and yet of age capable of Conception; which hath no malignity in it self, as many falsly imagine: for in healthful women it hardly differs either in colour, consistence, or quality from that which remains in the vessels, except in the small alteration, which is caused by the heat of the place whence it proceeds, and by the mixture of some hu∣mours with which the womb is alwayes plentifully furnisht.

This evacuation (if in order) ought to be every month but once, though some have them every fourtnight, or at the end of three weeks, according as they are more or less sanguine, or cholerick, or have their blood heated: and to continue two or three days together, or six at most, and that by little and little, constant without interruption, and also more or less according to the difference of their par∣ticular temperaments. If a Woman have few of them, as when she grows in years, she becomes bar∣ren, forasmuch as this blood seems to nourish the Child in the Womb: and likewise if she have too many, because the Woman thereby grows too weak and the Womb too cold. There are notwithstand∣ing some Women who void more of them in two days, than others in eight. They must flow by little and little without interruption, and not all at once; for great and sudden evacuations cause great dissipa∣tion of spirits, of which abundance are necessary for generation; and the interruption of these evacuati∣ons

shews some impediment in nature, or some vice or evil disposition of the Womb.

If all these signs concur, we may very probably judge the Woman fruitful; I say probably, because there are many who have them all, and yet cannot conceive, though they do their endeavours, and observe thereto all the requisite and necessary cir∣cumstances which we shall hereafter mention: There are likewise others, who, notwithstanding they have not all these conditions, are fruitful. Now if all the above named patticulars are found in a Woman that is barren, and that you desire to inquire more narrowly, and to be informed more certainly whether she be capable of conception, Hippocrates teacheth a way to know it, to which I give little credit, because the reasons of it are very obscure. It is in his 59 Aphorism of his 5th Book, where he saith, Si mulier non concipiat, & scire pla∣cet an sit conceptura, vestibus undique obvolutam sub∣ter suffito: ac si odor corpus pervadere videatur, ad nares & os usque, non sua culpa sterilem esse scito. If a Woman doth not conceive, and you are desirous to know whether she is capable, or no; wrap her close round with clothes, and put a perfume under her; and if she perceive the sent to pass through her body to her nose and mouth, be assured (saith he) it is not her fault she is barren.

Fertility was anciently so esteemed by our fore-fathers, that they believed Barrenness to be a mark of reprobation; by reason of which the fruitfull Servant despised her barren Mistress; as we reade in the 16th Chapter of Genesis, where mention is made of Sarai, Abraham's Wife, who, seeing that she could have no Children, and being past the age

of hoping for any, and that her Husband was dis∣pleased at it, bid him take her Aegyptian Chamber-maid, named Agar, to lie with him, that by her means the might give him lineage, which good Father Abraham quickly did, and had by her af∣terwards a Son, which was called Ishmael: but from the time this Maid had conceived, she began to despise her Mistress Sarai, who was as yet barren. The Women of our times are not so earnest to have lineage after this fashion, there being but few that will suffer their Husbands to caress their Chamber-maids, much less* 1.3 charitably to excite them to follow this example, which custom is abolished amongst us.

I also admire the great passion which many have, who complain of nothing with greater regret than to the without Children, especially without Sons. For my part, I believe they that descend from Cae∣sar, or the Family of Bourbons, may with some rea∣son be led away with this superstitious and com∣mon inclination of preserving their kind, and be vexed with these sorts of inquietudes, which no wayes become ordinary people; though excusable, and may be permitted to great Monarchs and il∣lustrious men.

When we perfectly understand the natural dis∣positions, we may the easier discern those contrary to nature; wherefore the signs of fruitfulness easi∣ly teach us those of barrenness. The signs and causes of barrenness proceed either from the age, or evil temperature and vicious conformation of the Womb, and parts depending on it, or the indis∣position and intemperature of the whole habit. The evil conformation of the Womb renders Women

barren, when its neck (called the Vagina) is so nar∣row, that it cannot give way to penetration; and when it is wholly or in part closed by some external or internal membrane, (which is very rare, if at all) or by any tumour, callosity, or cicatrice, which may hinder the Woman from the free use of copulation.

But it is not sufficient that the Man's Yard enter the Vagina, which is the anti-chamber to the Womb: for, if in the act of copulation, he knocks at the door, which is the internal orifice, and it be not opened, all is to no purpose. This orifice is like∣wise hindred from opening by some callosity, pro∣ceeding from abundance of ill humours, which usu∣ally slow down from the Matrix, or by some tu∣mour which may happen to it; or also, by some part, which may so compress it, that it cannot di∣late to receive the Seed, as doth the Epiploon (or cawl) in fat Women, according to the opinion of Hippo∣crates in his 46th Aphorism of his 5th Book, where he saith, Quae praeier naturam crassae, non concipi∣unt, iis os uteri ab omento comprimitur, & prius∣quam extenuentur, non concipiunt. Women ex∣ceeding fat do not conceive, because the Cawl com∣presseth the orifice of their Womb, neither can they till they grow lean. I do not willingly admit a∣mongst the causes of barrenness, this compression of the inward orifice by the Epiploon, forasmuch as Aritin hath very well remedied it, by some of the postures invented by him, by which this orifice need not be so compressed in the action.

The most frequent reason why this orifice opens not in this act to receive the Man's Seed, is the in∣sensibility of some Women, who take no pleasure in the venerial act; but when they have an appetite,

the Womb desirous and covetous of the Seed, at that instant opens it self to receive it, and be de∣lighted with it. But though the Vagina, or neck of the Womb, and the inward orifice opens to give passage to the Seed; yet may they very often con∣tinue barren, if the scituation of this orifice be not rightly placed, but either backwards towards the* 1.4 Intestin rectum, or towards either side; all which hinders the Man from† 1.5 darting his Seed directly into it, and consequently the Woman from conceiving.

Hippocrates seems to have noted all the signs and causes of barrenness, which usually proceed from the evil temper of the Womb, in his 62 Aphorism of the 5th Book, where he saith, Quae frigidos & densos habent uteros, non concipiunt, & quae praehu∣midos habent uteros, non concipiunt: extinguitur enim in ipsis genitura. Et quae plus aequo siccos & adurentes: Nam alimenti defectu semen corrumpi∣tur. Quae vero ex utrisque nactae sunt moderatam temperiem, eae faecundae evadunt. All such Women whose Womb is cold and close, cannot conceive; nor they who have it too moist: because the Seed is extinguished in it. And likewise such who have it too dry and hot; because, for want of aliment the Seed corrupts: but such as are of a moderate temperament are fruitful. Of all these which Hip∣pocrates recites in this Aphorism, the most common, according to my opinion, is the continual Humi∣dity of the Womb, fed by an abundance of the Whites, with which many are very much incon∣venienced, the humours of the whole Body being accustomed to steer their course this way, which

can very hardly be turned away when inveterate, and the Womb being imbued with these vicious moistures, becomes inwardly so unctuous and slip∣pery, that the Seed (though viscous and glutinous) cannot cleave to it, nor be retained within it, which is the cause that it slips immediatly away, or in some short time after it is received.

Barrenness may also proceed from the whole ha∣bit of the Body, as when a Woman is too old, or too young: for the Seed of the young is not yet prolifick, neither have they the menstruous blood; which two things are requisit to fruitfulness: and that of the aged is in too small a quantity, and too cold, who likewise want the menstruous blood. An universal intemperature (though the Woman be of convenient years) renders them however bar∣ren, as it happens when they are hectick, hydro∣pick, feaverish and sickly, and especially so much the more as the noble parts are fallen from their temperament and natural constitution: There are however many Women which seem barren for a long time, because of some of the fore-mentioned Reasons, yea, till they are thirty five or forty years old, and sometimes longer, who yet at last conceive, being cured of the indispositions which hindred them, and having changed their tempera∣ment by their age, of which we have had a remar∣kable example in the person of Queen-mother, lately deceased, who was above two and twenty years married, and without Children, and yet after∣wards, to the great joy and content of all France, she had our invincible Monarch Lewis the 14th, now reigning, to whom God grant a long and happy life.

Some of these Barrennesses may sometimes be cu∣red by removing their causes, and procuring the dispositions we have said are necessary to fruitful∣ness; yea, of those which proceed from an uni∣versal intemperament, by reducing the Body with a good and convenient regimen to a good order, and this according to their respective indispositions. Wherefore if a Woman have naturally the Vagina too narrow, and not from some of the causes above∣mentioned, she ought to be joyned to a Man whose Member is proportionable, if possible: and if that will not do, (which happens very seldom) she must endeavour to relax it and dilate it with emolient Oyls and Oyntments; if the neck of the Womb be compressed by any humour, it must be resolved and suppurated according to its nature and scitua∣tion, having alwayes care to prevent the corruption of these parts, which being hot and moist, are very subject to it; because the womb serves as a sink by which all the ill humours of the body are purged; so that you must take great care, that these kind of Tumours turn not to a Cancer, which is a very mischievous malady, and causeth the poor Women miserably to languish which are afflicted with it, and which after many insupportable pains, brings them almost alwayes to an inevitable death.

When the Vagina is not clear in its capacity, be∣cause of any scar after a rent, caused by some force or violence to the Woman, or of some hard labour, or after an ulcer which caused the two sides to be agglutinated, whether inwardly or outwardly, it must be separated the best that may be with a* 1.6 Bistory, or some other Instrument, according as

the case requires, hindring, by interposed Linnen, that it do not again agglutinate.

When a Woman hath no Vulva, or outward entry of the Womb pierced, which is very rare, it must be opened by making a long Incision.

Fabricius recites the like case in a Girl of thirteen years of age, who was like to die of it, because her Terms could not come down, there being no per∣foration, wherefore he did the like operation, which succeeded very well, and made her by that means capable of generation. As to the in∣ward orifice of the Womb, if it be displaced either towards the back or sides, it may be in some sort remedied, by making the Woman to observe, in the act of generation, a convenient posture, that the Man's Seed may be ejaculated towards the orifice; and if the Whites, or other Impurities of the Womb cause barrenness, as it is for the most part by the discharge of the whole habit on this place; it must be helped by Evacuations, Purgations, and a regu∣lar Diet, according to their different causes, and qualities of these ill humours.

Having thus discovered the most certain signs of Fertility, and the marks of Sterility, I will now (the better to pursue the order I have proposed) treat of Conception.

CHAP. II. Of Conception, and the conditions ne∣cessary for it.

IT is most certain, according to the Rule of Na∣ture, that a Woman is incapable of conceiving, if she have not the conditions requisit for fruitfulness: we have mentioned them in the foregoing chapter: let us now examine in this, what is Conception, and how it is caused. Conception is nothing else, but an action of the Womb, by which the prolifick seeds of the Man and Woman are there received and retained, that an infant may be engendred and for∣med out of it. There are two sorts of Conceptions; the one true, according to Nature, to which suc∣ceeds the generation of the Infant in the Womb: the other false, which we may say is wholly against Nature, and there the seeds change into water, false-conceptions, moles, or any other strange matter.

The qualifications requisit, for a Woman to con∣ceive according to Nature, are, that the Woman receive and retain in her Womb the Mans and her own prolifick seed, without which it cannot come to pass; for it is necessary that both seeds should be there; nor is it at all true, what Aristotle and some other of his followers affirm, that the Woman neither hath nor can yeeld any seed, a great absur∣dity to believe: for the contrary may easily be dis∣covered, by seeing the Spermatick Vessels and Testicles of a fruitful Woman, appointed for this use, which are wholly filled with this seed, which

in coition they discharge as well as Men. Such a will not open their eyes to behold a verity so clear, may make reflection on the resemblance of Infants to their Mother, which could not be unless her seed had been more praedominant than the Fathers, when he begot them; which likewise happens after the same manner when the Fathers hath more force and vertue. Which may evince, that the Womens seed contributes as well to the formation of the Infant as the Fathers. If they will not agree to a thing so common, let them make another reflection on the generation of certain Animals, which participate of the nature of the Male and Female (of which they are engendred) though of different kind; as we daily see Asses and Mares produce by their coupling Mules, which are Animals of a middle nature resem∣bling both the one and the other, that produced them. We may then learn by this, that both Seeds are necessary for a true Conception, provided they be prolifick, that is, containing in them the Idea of all the parts of the body, and then the Womb being greedy of it, delights it self in it, and easily retains it when received, else it soon afterwards rejects it.

It is not absolutely necessary, that both the Seeds be received and retained intire, without the loss of some part; for, provided there be a moderate quan∣tity of it, 'tis sufficient: Nor must we imagin, that (though all of it be not received into the Womb) the Child, formed out of it, will want some limb, as an arm, a leg, or other member, for want of suffi∣cient matter: inasmuch as the forming faculty is whole in every part of the Seed, of which the least drop contains in it potentially the idea and form of

all the parts, as we have lately made appear: but indeed when the Seeds are received but in small quantity, the Child may be the less & weaker for it: Or if either or both of them have not the requisit qualities; or, though well enough conditioned, if the Womb be imbued and stuft with ill humours, as the menstrues, whites, and other filth, or any other fault; if then there be a conception, it will be contrary to Nature, and there will be ingendred false births, Moles, or dropsies of the Womb, mixed with some other strange bodies, which are very troublesome to Women, till they void them.

It is therefore without cause, that many Women are blamed, when their children are born with red and livid spots, which very much disfigure the faces of some of them: It is usually said (but without reason) that this proceeds from the mothers longing to drink Wine; for, though some have, by chance, been in effect harrassed (as they affirm) with these passionate desires during their being with child, yet we must not superstitiously believe (as many do) that these spots are so caused, but rather from some other cause, which must be searcht for elsewhere: And that which makes it appear, it cannot pro∣ceed from hence, is, that almost throughout all Italy, where nothing but white wine is drunk, as also in Anjou in France, I have seen divers persons marked with these red spots: and in case it proceeded from their Mothers longing to drink Wine, they ought to be white spots, or of an Amber colour, being the colour of the wine of these Countries: but we ought rather to conclude that they are caused, from some extravasated blood, at the time the Infant is form∣ed; which marks the skin, yet very tender with these

spots, and colours it in whatsoever part it toucheth, much after the same manner as we see it marked with Gunpouder, or some waters producing the like effect when it is washt and bathed with them. I will not however deny that the imagination hath a power to imprint on the body of the Infant, marks of this nature; but that can only be when young with Child, and principally at the very moment of conception; for when the Child is compleatly for∣med, the imagination can in no wise change its first figure, and Women must wean themselves from these vain apprehensions, which they say they have to such things (every moment) and serves some of them for a pretext to cover their liquorishness.

Since my discourse is fallen upon this subject of Marks, with which oft times the bodies of Infants are spoted in their birth, and which comes, as is ordinarily believed, from the imagination of their Mother, it seems to me not much from my purpose, to recite you a circumstance very particular sound on Me, when I came into the world, as my Father and Mother have often told me, which is, that my Mother being with Child of me, and almost at the end of her reckoning, as it appear'd afterwards, the eldest of her three Sons (which she then had of six years old, and her first-born, whom she loved with an extraordinary tenderness and passion) dyed in seven dayes of the small Pox, all which time she continned night and day by his bed side tending him in all his necessities, not suffering any other to do it, whatsoever desires were made to her, not to weary and trouble her self, as she did, for the Childs sickness, alledging that in her present condition, she ought to be careful of her self, and not be the cause

of death to the Infant she went with; in fine, at the end of seven dayes her Son dyed, upon which the next day she was delivered of me, who brought effectively into the world with me six or seven of the small Pox. Now it is certain, that it would be irrational to say, that I had then contracted these small Pox in my Mothers Womb, by her strong im∣magination: But if I were asked whence they pro∣ceeded? I should answer, that the contagious air she breathed without discontiuuance, during the whole sickness of her deceased Son, had so infected the mass of her blood, with which at that time I was nourished, that I, rather than she, easily recei∣ved the impression of this contagion, because of the tenderness of my body. Let us therefore assert, that the imagination cannot produce any of the above mentioned effects, but at the moment of con∣ception, or within few dayes after, and that we ought for the most part to search elsewhere (if we desire the truth of it) the cause of most of these Spots, Marks, and Signes with which many In∣fants are born.

CHAP. III Of the Signs of Conception.

AS it is very hard and belonging only to expert Gardeners to know Plants as soon as they be∣gin to spring forth of the Earth; so likewise there are none but expert* 1.7 Chirurgeons can give a Woman certain assu∣rance of Conception from its begin∣ning: although some of these signs, resembling those of the suppression of the Terms and other maladies in Women, cause many to be deceived in it.

I will not trouble my self to make a recital of a great number of signs of conception, which rather tend to superstition, than an effective verity: but only the most essential and ordinary, by which a Chirur∣geon may be assured of it; of which some may pre∣sently be perceived, others not till afterwards. He shall first examine and inform himself, whether the Woman hath all or most part of the signs of fertility, which are already named in the discourse of them, if not, he must impute them to some other cause; and supposing she be fruitful, you may then know whether she have conceived, by their agreement, and more then ordinary delight in the act.

It is not enough for a Woman to be certain she hath conceived, and to yeeld and receive her seed with the Mans into her Womb, unless it close at that instant, and retain it. There is an Article a∣mongst the customs of Paris, in which it is said,

that to give and keep is not good: but it is not so in Conception; for a Woman gives and casts her Seed into her Womb, and there retains it. She may know whether she retains the Seeds, if she per∣ceives nothing flow down from the Womb after Copulation: The Woman some few months after perceives also some small pain about her Navel, and some little commotions in the bottom of her Belly, caused by the Womb's closing it self to retain the Seeds, and contracting it self so as to leave no em∣pty space, the better to contain them, and embrace them the closer. The light pain of the Navel comes from the Blader of the Urine (from the bottom of which proceeds the Urachus, which is fastened to the Navel) which is a little agitated by that con∣traction and kind of motion that happens to the Womb, when it is closed to retain the Seeds, and from the like agitation comes also those little com∣motions of the Belly.

These are the signs of Conceptions, which may be known at the moment they happen, and may be yet more certainly known if you perceive the in∣ward Orifice exactly close. Besides these signs, there are others which cannot be known till some time after, as when the Woman begins to have loathings, having no other Distemper, loseth her appetite to meats which she did love: longs to eate strange things, to which she was not accustomed, which happens according to the quality of the humours predominating in her, and with which her stomach abounds: She hath often nauseatings and vomitings, which continue a long time: the Tearms stopping, no other cause appearing, having alwayes before been in good order: her Breasts

swell, wax hard, and cause pain, from the flowing of the blood and humours to them, wanting their or∣dinary evacuation, their upper parts are firmer and larger, because of the repletion; the Navel starts: her Nipples are very obscure or dark coloured, with a yellowish livid circle round about: her Eyes are dejected and hollow, the whites of them dull and troubled: her blood, when she hath conceived some time, is alwayes bad, because the superfluities of it not being then purged, as accustomed, is altered and corrupted by their mixture. Moreover, there is a sign, which all the Women esteem and hold in this doubtful case for very certain, which is, en ventre plat enfant y a, in a flat Belly there is a Child. Indeed there is rime in this proverb, and something of reason, but not as they imagin, that the Womb closing it self after Conception draws in a manner the Belly inwards and flatten's it, which cannot be; because the Womb free and wavering, not fastened forwards to the Belly, whereby to draw it back after that manner: but it may possibly be by reason that Women grow lean by the indispositions of their pregnancy, and wax thinner and smaller, not only in their Belly, but also throughout their whole body, as may be known the two first months of their pregnancy, during which time that which is contained in the Womb, is yet very small; but when the Womans blood begins to flow to it in abundance, then the Belly waxeth daily bigger and bigger afterwards, until her reckoning be out.

All these signs concurring in a Woman who hath used copulation, or the most part of them to∣gether and successively, according to their seasons;

we may pass our judgment, that she hath conceived, notwithstanding that many of them may happen upon the suppression of the Terms, which usually produce the like: for every one knows, that it cau∣seth also in Virgins, disgusts, nauseatings and vo∣mitings, but not so frequently; the swelling, hard∣ness, and pains of the breasts, as also extravagant appetites, a livid colour of the Eyes, and others, to which you must have regard. The Matrix may be yet exactly close, and the Woman not conceived: Yea there are some, in whom they almost never open, unless very little to give passage to the Tearms; which happens to some naturally, to others by accident, as by some callosity proceeding from an Ulcer, or other malady.

If all these signes of Conception (which some∣times may deceive us, though rarely, if they concur together) do not give us a sufficient assurance of it, and that we desire a better, Hippocrates teacheth us a way to know it, which I believe to be no more certain than the rest: it is in his 42^d Aphorism of his 5th Book; where he speaks in this sort, Si ve∣lis noscere, an conceperit mulier, dormiturae, aquam mulsam potui dato: & si ventris tormina patiatur, concepit; sin minus, non concepit: If you desire to know whether a Woman hath conceived or no, give her, going to rest, a draught of Metheglin; and if afterwards she feels pains in her Belly, caused by wind she hath conceived; if none, she hath not, as he saith. Which is grounded (as I believe) upon the supposition that Metheglin breeds wind, which cannot pass easily downwards, because the Womb (being full) compresseth with its greatness

the* 1.8 Intestin rectum, on which it is scituated, and causeth those winds to rumble, which are constrained to recoyl back into the other Intestines.

If there be any occasion where Physicians or Chi∣rurgeons ought to be more prudent, and to make more reflections upon their Prognosticks for an af∣fair so important as this is, it is in this which con∣cerns their Judgments as to conception and Womens being with child, to avoid the great accidents and misfortunes, which they cause who are too precipi∣tate in it without a certain knowledge. The faults which are committed through too much fear at such a time, are in some sort excusable and to be pardoned; but not those caused by temerity, which are incomparably greater. There are but too ma∣ny poor Women who have been caused to miscarry by Medicines and bleeding, not beleiving they were with Child, which are so many murders they are guilty of who caused it, either through igno∣rance or rashness: besides the death which they bring to those little innocent creatures, by destroy∣ing them in their Mothers belly, they often there∣by put the Mothers into great danger. We have lately had in Paris, in the year 1666, a miserable example of this kind, in a Woman hanged, and af∣terwards publickly dissected, near the Kitchen-Court of the Louvre, who was found four months gone with Child, notwithstanding the report of such persons as had visited her by the Judges Or∣der before her Execution, who affirmed, contrary to the Truth, that she was not with Child. That which deceived them was, the Woman's having ef∣fectually her Courses, though with Child. Where∣fore

'tis not good to be too confident, forasmuch as there are many with Child who have their Cour∣ses; and I have known some who have had them all the time of their Great-Belly till the fifth or sixth month, which happens according to the Wo∣mans being more or less sanguine; though the greatest number usually have them not: but there are very few general rules, which may not some∣times be excepted against.

This accident made such a noise in Paris, that it quickly came to the knowledge of the King and all his Court, who very much blamed those persons, that by their ignorance had caused the* 1.9 precipitated Execution of this poor unfortunate Creature, with whom perished the Infant, innocent of the Mothers crimes. Nor must the Chirurgeon much trust to what these sort of Women may tell him concerning it, for, being afraid of the punish∣ment of their crime, to delay it, do almost all say they are with child, which is a reason very conside∣rable, why the persons, to whom such matters are committed, should be very knowing. There are yet another sort of Women, who having been ill treated, send for the Chirurgeon that he may give them a Certificate, the better to be revenged on their adversary; which that they may the easier obtain, they also affirm themselves with child, and having received blowes on their Belly, feign that they find their great pain, and if by chance they have at that time their Courses, they endeavour to perswade that it is a flooding, or showes, where∣fore he must be careful not to be deceived: and yet, that he may not be esteemed ignorant, nor fall into

the like disgrace, when there is any cause of doubt, it is better to delay a little, then rashly to pro∣nounce his prognostick at a venture; for as there are Women, who would be thought to be with Child, though they are not; so there are others who will deny it, till they are brought to bed, as in this following example. About the year 1654, be∣ing in the Citty of Saumur, there was near my Lodging a young and very handsom Daughter of a Citizen, who was five whole months under a Phy∣sician's and Apothecaries hands, to be cured of a Dropsie which she complained of: at length after she had taken many violent Remedies they had or∣dered her, she was cured in a moment, by bringing forth a Child at its full time, notwithstanding all they had given her; which much astonished the Physician and Apothecary, who were so grosly de∣ceived, in trusting to the Maids relation, who coun∣terfeited the Dropsie so well, that they could never perceive the truth till she was brought to bed.

Some Women themselves are deceived in their being with Child, as lately the Wife of a Coun∣sellour of the Court, who after having been in a course of Physick of six or seven whole months for the Dropsie, under an eminent Physician, was at length brought to bed of a Child.

I knew another Woman, a Merchant of Squared-Timber at Paris, who never had a Child, though she so passionately desired it, as to be at the point of hoping for one at 55 years of age, under the colour that she had still her Courses. This Woman was once perswaded (upon the recital of such signs as she said she had) for the space of ten whole months, that she was with Child, of which the Midwife and

many others assured her, and she her self likewise believed it (for it is easie to be perswaded to believe what one hopes for with a strong passion) she had a big-belly, and said also that she felt the Child stir; and believed it so truly, that finding her self one day worse than ordinarily (after having prepa∣red very fine necessaries for the Child she imagined she went with) she sent for the Midwife, who when she was come, assured her it was her Labour: but the next day (having alwayes till then expected a Child) she voided only a quantity of Water, with some Wind from the Womb, and nothing else: af∣ter which she was forced to fold up her fine Toilets again which she had provided. By these Examples we may learn not to be too ready to rely upon Womens Relations, if there be no other Reason, which may be known by the Examination of the Signs already declared.

Now since after Conception (of which we have just done speaking) there follows Generation, let us consider what it is, and how it is performed.

CHAP. IV. What Generation is, and what is necessa∣ry to it.

IT is a very great Truth, and generally known, That whatsoever is in this lower World, is subject to corruption, and at length constrained to suffer death: which hath obliged Nature, provi∣dent and careful of its preservation, to endue all things with a certain desire of eternizing themselves,

which not being possible in individuals, because mortal by an indispensible necessity, is therefore done by the propagation of their forms and kinds. She obtains her end, in respect of Animals, by the means of Generation successively reiterated: for so all creatures seem to immortalize themselves, in some sense, by producing their like. And Fathers imagin themselves not quite dead, if they leave their like behind them after their death, to wit, their Children.

By Generation, we understand generally, a progress of that which is, to that which is not. But this definition is a little too ample for to come to the knowledge of what we desire concerning the generation of perfect Animals, and chiefly of Man∣kind; wherefore that our intention may be the easier conceived, we must search some other, or ra∣ther a description, which may more exactly discover the thing: to this purpose we say that by the ge∣neration of Mankind, we mean a proper and par∣ticular action of the Womb; by which working upon both seeds there retained, it forms and shapes a body out of them, composed of divers parts, which it disposeth in order, to become in time the Organ of the Soul, which must be infused into it. There are many things requisit to make the Gene∣ration perfect, without which it would be wholly and absolutely impossible: there are usually three principally reckoned, to wit, diversity of sex, their congression, and the mixture of both Seeds, which we will a little particularly examine. Although some define a Woman to be an Animal which can engender in it self, and that this may be true; yet it is most certain, that she cannot engender without

a Man that hath discharg'd his Seed into her womb. And though we daily see Pullets have Eggs, and other Fowl, without the Cocks treading them, yet of those Eggs there will never come Chickens, be∣cause the Male never had made an impression on them, nor given them this prolifick vertue, which is absolutely necessary to this purpose. This may convince us that diversity of sex is necessarily re∣quisit, as well to those Animals, as to the more per∣fect, which is Man.

Diversity of sex would profit little, if copulation did not likewise follow; though some subtile Wo∣men, to cloak their shamelesness, would perswade one that they were never touch'd by any Man who could get them with Child, as she of whom Averroes speaks, who conceived in a Bath in which a Man had washt himself a little before, and had cast forth his Seed into it, which was drawn and suckt in (as he saith) by the Womb of this Wo∣man: but this is a story fit to amuse little children.

Now to the end these different sexes should be obliged to come to this touch, which we call Co∣pulation, besides the desire of begetting their like, which naturally incites them to it, the parts of Men and Women destined to Generation, are en∣dued with a delightful and mutual itch, to stir them up to the action, without which it would be impossible for a Man (so divine an Animal) born for the contemplation of heavenly things, to joyn himself to a Woman, in regard of the unclean∣ness of the parts, and of the act. And on the o∣ther side; If Women did but think of a thousand pains and inconveniences which their great Bellies cause them, of the pains they endure, and the hazard

of their lives when they are in labour, to which may be added the loss of their beauty, which is the most precious gift they have, and which makes them be beloved by those that possess them, cer∣tainly it might also afright them from it: But nei∣ther the one nor the other make these reflections till after the action (whence comes the saying, Post coitum omne animal triste) considering nothing before but the mutual pleasure they receive by it. It is then from this voluptuous Itch, and the desire of begetting their like, that Nature obligeth both these sexes to this congression.

As to the mixture of both seeds; it is certain that the diversity of sexes and their congression, are but for this end, without which Generation cannot be; though some would have Womens seed serve to no purpose; yea, that they neither have any, nor eject any, as Aristotle saith: but we have proved the contrary in the Chapter of Conception, by the ex∣ample of daily experience, to which you may have recourse, to avoid repetition.

All these three Circumstances, to wit, the di∣versity of sexes, their congression, and the mixture of their matters, which is called Seeds, must pre∣cede Conception, to which succeeds Generation, on this fashion: As soon as the Woman hath con∣ceived, that is, hath received and retained in her Womb the two prolifick seeds, it is every way com∣pressed to imbrace them closely, and is so exactly closed, that the point of a Needle (as saith Hip∣pocrates) cannot enter it without violence; after which it reduceth by its heat, from power into action, the several faculties, which are in the seeds it contains, making use of the Spirits with which

these frothy and boyling seeds abound, and are as instruments with which it begins to trace out the first lineaments of all the parts, to which after∣wards (making use of the menstruous blood flow∣ing to it) it gives in time growth, and the last per∣fection.

Generation may be divided into three different seasons, which are, the beginning, middle, and the end. The beginning is, when there is no other mat∣ter in the Womb but the two seeds, which conti∣nue so to the sixth day, as Hippocrates notes; and calls them for that time the geniture, as much as to say, from whence generation must proceed: he speaks of it in his Book De Natura Pueri: and he saith, that by the experiences he brings of it, one may judge of the other times. He relates a story of a Woman, which at six dayes end cast forth with a noise at once out of her Womb the seeds she had conceived, resembling a raw egg, without a shell, having only the small skin over it; or, to the abor∣tive eggs, which have no shell: which little mem∣brane was on the outside a little coloured with red, and involved in it this seed, which was of a round figure: in the internal part might be seen white and reddish fibres, with a thick humour, in the midst of which was found something like the umbilick ves∣sels. Hippocrates calls this first time of generation, Geniture, as is already mentioned, during which time neither figure nor distinction can be observed, but only some beginning of a disposition to receive the form of the parts; after which follows the second time, which begins where the first ends, that is, at the sixth day, and lasts to the 30th. The time that the same Hippocrates assures us the males are com∣pleatly

formed, and the females not till the 42^d. After the first six dayes are past, and the Womb hath wrought, according to the fashion we have ex∣plained, upon the seeds, which are there yet with∣out any mixture of blood, having disposed them to receive it; it is brought thither, in some sooner, in some later, according to the Womans being nearer to or further from her time of having her Courses when she conceived, which produceth effects ac∣cording to these different dispositions: for if they flow too soon, or in too great abundance, as it be∣fals such as conceive at the point of having their pur∣gations, the seeds are drowned and corrupted by it, which often causeth a flooding, or at least the generation of a false-conception; but if they are far from their having them, the conception is so much the more stable. Now then, this blood di∣stilling by little and little into the Womb of the Woman, who hath sometime since conceived, serves as a fit matter to form and figure out all the parts of the Infant, which was only traced out by the seed; and yet doth it (according to my opinion) much like a Painter, who after he hath drawn the out-lines with a chauk upon his cloth, begins to lay colour upon colour, to paint by degrees all the parts of the person whose picture he draws. Some little space after the beginning of this second time, appears as it were the figure of those three bubbles, of which Hippocrates speaks, or rather three mas∣ses of this matter, which grosly represent the three parts called principal, the first of which composeth the Head; the second, in the middle, the Heart; and the other the Liver: there may be likewise seen the after birth, with the umbilick vessels fastened to it,

and the membranes which wrapt up the whole; after which from day to day all the other parts of the body are figured in such sort, that at thirty dayes end the males are compleatly formed, and the females the 42th day ordinarily, which is about the time the Faetus begins to be animated, though as yet there is no sensible motion.

Hippocrates seems by these different terms to be of an opinion that the Males have sooner life than the Females, because (he saith) their heat is greater: but for my part I do not beleive that the Male is sooner formed than the Female, and that which thus perswades me, is, because, if it were so, the Male must likewise be at its full term, sooner than the Female, proportionable to the same time, that the one is animated sooner than the other; which wee see the contrary, in that the Women are brought to Bed indifferently both of Sons and Daughters at the ordinary terme of nine months. Let us therefore say, that towards the fifth or sixth week, as well Males as Females have all the parts of their body (though small and very tender) en∣tirely formed and figured, at which time it is not longer than a finger, and from thence afterwards, which is our third time, the blood flowing every day more and more to the Womb (not by Intervals, as the Courses, but continually) it daily grows bigger and stronger to the end of the ninth month, which is the full term of ordinary labour. Having expli∣cated Conception and Generation, let us now con∣sider great Bellies and their differences.

CHAP. V. Of big Bellies, and their differences; with the signs of the true and false great Bellies.

THE great Belly of a Woman properly taken, is a tumour caused by the Infants scituation in the Womb. There are natural great Bellies, which contain a living Child, and these we call true; and others against nature, in which, instead of a Child, is ingendred nothing but strange matter, as Wind mixed with Waters, which are called Drop∣sies of the Womb, False-Conceptions, Moles, or Membranes full of blood and corrupted seed; for which reason they are called false great Bellies. We have already, where we treated of Conception and Generation, mentioned the causes and signs of a great Belly in its beginning, notwithstanding we will again repeat the most certain and ordinary of them, which are nauseousness, vomittings, loss of appetite to things the Woman was accustomed to eat and like; longings for strange and naughty things; suppression of the Terms, without Feaver or Shiverings, or other cause; pains and swelling of the Breasts: all which may be found in Vir∣gins, by the retention of their Courses: but the most certain is, if putting the finger into the Vagina, you perceive the inward Orifice exactly close, as also the distention of the body of the Womb consi∣derable, more or less, according to the time the Woman is gone with Child, and the Childs stir∣ing

in the Womb, gives us indubitable proofs of it. It is fit we should be alwayes careful not to be de∣ceived by what we feel stir in the Womb, foras∣much as the Infant of it self hath a total and a par∣tial motion; the total is, when it removes the whole body, and the partial is when it moves but one part at a time, as the Head, Arm, or Leg, the rest of the body lying still: but the Womb blown up in fits of the Mother, yea, and some Moles have by accident a kind of total motion, but never a partial one. That of a Mole is rather a motion of falling down than otherwise, to wit, a motion by which heavy things fall downwards: for a Woman who hath a Mole of any bigness considera∣ble, whatsoever side she turns her self to, her belly falls immediatly the same way, like a heavy bowl. About the time (or very near) when the Infant quickens, if the Woman be certainly with Child, these humors (which are carried to the Breasts by the stoppage of her Courses) are turned to Milk, which when it happens, is usually an assured testi∣mony of pregnancy; though some Women have been found with Milk in their Breasts (but rarely) and yet not with Child, nor ever having had any: which Hippocrates also confirms in his 39th Apho∣rism of his 5th Book, where he saith, Si mulier quae nec praegnans, nec puerpera est, lac habet, ei men∣strua defecerunt. If a Woman hath milk in her Breasts, and is neither with Child, nor ever had any, it comes from the stoppage of her Courses. But it is rather whey than milk, which in that case hath not the consistence as the Milk of a Woman in Childbed, nay the Milk of a Woman with Child is yet but waterish, and becomes neither thick nor

very white, till after labour she begins to suckle her Child.

The Infant moves it selfe manifestly about the fourth month: or sooner or later according as it is more or less strong: some Women feel it from the second, others about the third month, yea some before that time. In the beginning these first mo∣tions are very small, and very like to those of a lit∣tle Sparrow when first hatched, but grow greater, proportionably as the Infant grows bigger and stronger, and at last are so violent, that they force the Womb to discharge its self of its burden, as in Travail. The common opinion is, that the Males quicken before the Females, because their heat is greater, but that is almost equal; for there are some Women perceive their Daughters, others their Sons soonest, which happens indifferently to Males and Females, according as there was a more or less vigorous disposition at their Generation. Very often Women who daily use Copulation, are subject to be deceived; for they usually believe they are with Child if their Courses stop, and withal are a little qualmish, which is not always true, for false con∣ceptions cause almost the same accidents as true; which cannot easily be distinguished but by its consequences. This false great-Belly is, as we have already said, often caused by wind, which blows up and distends the Womb, and which Women oft-times discharge with as much noise as if it came from the Fundament: sometimes 'tis nothing but water which is gathered there in such abundance, as some Women have been seen to void a pail full without any Child; though they verily believed they were with Child, as did that Wood-Mer∣chant,

whose story you have in the end of the third Chapter, who did not void it till the end of the tenth mouth, till when she alwayes believed her self with Child. There are others who conceive only fals-conceptions and Moles, which may be known by the Infants different motions, already mentioned, and by the Moles continuing in the Womb often after the ordinary time of labour, some Women having them a whole year, yea many years, according as these Moles are more or less adhering to the inner parts of the Womb, and are there entertained and nourished by the blood that flows thither.

Moles alwayes proceed from some false-con∣ceptions, which continuing in the Womb, grow there by the blood that flows to them, by the ac∣cumulation of which they are by little and little augmented: if the Womb expels it before two months, it's call'd a fals-conception, & some are on∣ly but as it were the Seed involved in a membrane, like that geniture which that Woman voided after six or seven dayes, of whom Hippocrates speaks in his Book, De natura Pueri. The others are a little more solid and fleshy, resembling in some sort the Gizard of a Foul, and are greater or less, according to the time they stay in the Womb, and also ac∣cording to the quantity of blood with which they are alwayes soaked. Women expel these fals-con∣ceptions sooner or later, according as they cleave to the Womb, which makes them almost alwayes flood in great quantity at those tunes.

It is of great importance to distinguish well between a true and a false Belly; for the faults committed by a mistake, are ever very considerable:

forasmuch as in a true great Belly the Child ought to continue in the Womb, till Nature* 1.10 expels it by a natural labour: but contrarily, the false great-Belly indicates to us, to procure the expulsion of what it contains as soon as may be: Wherefore we ought to be very careful.

CHAP. VI. How to know the different times of Pregnancy.

IF prudence be necessary to enable a Chirurgeon or Midwife to assure a Woman that she is with Child, or not, and of a true or a false-conception; it is likewise as much requisite for them to know how far she is gone, to the end they may be cer∣tain whether the Infant be yet quick or no, which is of great moment: because, according to the Law, if a big-bellied Woman miscarry by a wound, he that struck her, deserves Death, in case the Child were quick, otherwise he is only condemned in a pecuniary punishment: they ought likewise to take heed lest they cause the death of the Infants, and sometimes of their Mother, by hastening* 1.11 their labour before its time, by imagining that when the big-bellied Woman complains of great pains in her Back and Belly, they are the

pains of her Labour, and instead of endeavouring to hinder them, they contrarily provoke them, and cause them to miscarry unfortunately before their time, I knew a Woman called Martha Rolet, who being six months gone with Child or there∣abouts, was surprized with great pains, much like throws of Labour, which made her send for her Midwife, who as soon as she was come, and under∣standing the case no better than they use to do, endeavoured all she could to bring her to bed, aug∣menting her pains, by sharp Clysters, making her walk about her Chamber, as if she had been at her full time; but finding at two dayes end no for∣wardness, notwithstanding the continual pains, she sent for me to know what was fit for her to do in that case: I went to the Woman, and found the inward orifice of the Womb dilated enough for the top of my little Finger to enter into its inward part, and yet wider towards the outward part; but considering that she had no other accident but those pains, I caused her immediatly to go to bed, where she continued eight or nine dayes, in which time her pains ceased, the Womb closed exactly, as I found some dayes after, and she went on with her Child three full months longer, and was then brought to bed of a Daughter at the full time, strong and robust, which is yet living, and now five years old or thereabouts. Now had I pursued what they began, this Woman without doubt would have miscarried at six months, which would have* 1.12 killed the Infant in her Belly, and soon after she should have miscarried. It is fit to follow

this example in the like occasion, provided the pains are not accompanied with accidents, which may endanger the life of the Mother if not presently delivered; as frequent Convulsions, considerable floodings, of which we shall speak in its place.

To be well informed of the different times of pregnancy, the Womans own relation may some∣times serve turn, yet 'tis not fit alwayes to trust it; it may help to conjecture, because many Women are themselves deceived, concluding themselves with Child, from the staying of their Courses, or from their quickning, which is not alwayes a certain rule. We usually judge of it by the bigness of the Belly: but more surely by touching the inward ori∣fice of the Womb. When they are young with Child, we can only know it by the signs of concep∣tion, because what is then in the Womb is of no considerable bigness to swell a Belly; but rather on the contrary, at that time it grows slatter, for the reasons before recited: but after the second month the Belly begins by degrees to wax bigger, till the ninth month. At the beginning, in touch∣ing the inward orifice, you find it exactly close and somewhat long, resembling the muzzle of a Puppy new pup'd; and is then very thick: but by little and little, through the extension of the Womb, it diminisheth so in all its proportions, that when the Woman cometh near her reckoning, it is perfectly flat, and almost equal with the globe of the Womb, and in that manner, that it becomes like a small cir∣cle, a little thick at its entry, where the Garland is made at the time of Labour.

Neither may the time of pregnancy be alwayes judged by the great swelling of the Belly; because

some Women are bigger when they are half gone, than others are at their reckoning; it depending much on the bigness of the Infant, and also on their number; and yet again, according as there is more or less water inclosed with them in the Womb; but much rather by the internal Orifice, which grows daily thinner and flatter, and so much the more by how much the Women come nearer their reckon∣ing: much in the same manner as we see a tender skin diminish in thickness, according as it is extend∣ed and dilated; even so this orifice grows thinner by the extension which the head of the Infant caus∣eth to it, which usually presseth hard against it in the last months. This remark is often useful to us in the admission of big-bellied Women, that desire to lie in in the* 1.13 Hostel de Dieu at Paris, which I very often observ∣ed in my practise there of Delive∣ries in the year 1660, through the permission which my Lord, the first President, was pleased to give me, (for there is no place so fit to perfect one in a short time, in the practice of so necessary an operation, because of the great number which are there daily delivered of all sorts) the order is, that any Women with Child shall be there charitably received fifteen dayes, or thereabouts, before their reckoning; to which pur∣pose they are searcht before they are admitted, be∣cause many, glad of a good entertainment for no∣thing present themselves there two or three months before they should, saying and affirming they are near their time; but by the above-mentioned con∣siderations, one may easily judge and know within a very little, who are fit to be received and who not,

that is, when they are near their time; and by this means may likewise know when 'tis necessary to forward Labour, or retard it, as much as ought to be, when Women are not yet gone their full time.

As to what respects the several terms, to which a Woman may go with Child; there is a great controversie amongst Authors, but all agree that the most ordinary terms are either the seventh or the ninth month, which is known and also approved by all. Hippocrates is of an opinion that the Child born in the eight month cannot live, because he cannot support two such puissant endeavours so near one to another, having already endeavoured to be born the seventh month, which is (as he saith) the first legitimate term of Labour; and fail∣ing then, if, reiterating the same endeavours the eighth month, he be born, he is thereby so weak∣ned, that he seldom lives, as he often doth, when born by the first endeavours in the seventh month, his strength not being before exhausted by vain attempts. This seems very likely to many: but if they that practise Deliveries, make a true reflection on it, they will find, that it is the Ma∣trix alone, assisted with the compression of the mus∣cles of the lower Belly and Diaphragma, which cause the expulsion of the Child, being stirred up by it's weight, and not able to be further ex∣tended to contain it; and not, as is ordinarily believed, that the Infant (being no longer able to stay there for want of the nourishment and re∣freshment) useth his pretended indeavours to come forth thence, and to that purpose kicking strongly, he breaks with his feet the membranes which con∣tain

the waters, inasmuch as when the Child is na∣turally born, the membranes are alwayes rent be∣fore the head, which pressing and thrusting each throw the waters before it, causeth them to burst out with force. The same Hippocrates likewise admits the tenth month, as also the beginning of the eleventh, at which time he saith the Children live: but he will by no means that Children can live if born before the seventh, forasmuch as they are then too feeble, and not capable to support the external injuries, as indeed we see and find it every day.

I do boldly affirm, and it is also very true, that the ordinary term of going with Child is nine whol months: but I cannot consent that Children born in the seventh month, do oftner live than those of the eighth; but much to the contrary I believe, that the nearer they approach to the natural term of nine months, the stronger they are; and there∣fore that Children born in the eighth month rather live than those of the seventh: which is wholly contrary to the opinion of many persons, who blindly follow in this the sense of Hippocrates and all Authors, without making any reflection upon the thing, for to disabuse themselves of this vulgar belief, founded upon the pretended vain endea∣vours, which (they say) are made by the Infant in the seventh month: for, as we see, not only in the same Country and Field, but also on the same Vine-Grapes, sometimes six weeks ripe before their ordinary season, and others not till above a month after, which happens according to the Territories, the different regards of the Sun, and according as the Vine is cultivated: So likewise we see Women

brought to bed of their Children six weeks and two months before, and sometimes as long after their ordinary tearm; If it be not, that the Womb not being capable of an extention beyond a certain de∣gree, cannot bear its burden, but a little while af∣tet the reckoning is out, although there have been Women, as Hippocrates acknowledgeth, who have gone ten or eleven whole months with Child, which notwithstanding is so much the more rare, by how much it exceeds its limits. These things hap∣pen also to Women according to the different dis∣positions either of their whole body, or of their Womb alone, or as well according to their rule of living, and the greater or lesser exercise they use, and may likewise happen on the Childs part: for by example, if at seven months he is so big, that the Womb can no longer contain him, nor dilate it self more without bursting, it is then provoked by the pain which this violent extention causeth, to discharge it self of him; and so likewise in the eighth month, if there be the same reason, and some weeks sooner or later, according to a multi∣tude of other circumstances; or also by any out∣ward cause, as a violent shaking of the whole body, blow, fall, leap, or any other causes what∣soever, hastening the pains of Delivery; that which makes these Children live a longer, or a lesser while, is, according as they are at that time more strong and perfect, and the Woman nearer her time, which is at the end of the ninth month.

There are many Women that believed they were brought to bed at the 7th and 8th month; as like∣wise others, that they went 10 or 11 whole months

with Child (which may some times be) when not∣withstanding they are effectively delivered at the due time. That which deceives them, usually is, their believing (as we have already said) them∣selves with Child from the time of the retention of their courses, having had them during the two first months of their pregnancy, yea and sometimes lon∣ger; and others also misreckon themselves, when their courses are stopped two months before they conceive. It is also easie to know that a Woman, though well regulated, cannot exactly know by the suppression singly, the certain time of her being with Child: for example, if she lies with her Husband upon the point of the coming down of her terms, and she conceives upon it, then she may make her reckoning from the time of their suppressi∣on, which may be very near the truth: but if she conceives immediatly after she hath had them (which happens oftenest) and that all along the whole month she daily copulates with her Hus∣band, at the end of which time her courses not coming down, she may very well reckon her self with Child; yet for all this she cannot know by this sign which night she conceived; and so for three weeks or a month more or less she may be mistaken in the time.

As we have said, that Children are more or less long-lived, according as they approach nearer the ninth month; so we may easily know, that they of six months, and much less those that are younger, cannot be long-lived, because they are yet too weak to resist the outward injuries. There hath often been great contestations amongst the Physitians, to determine, whether a Child born the eleventh or

twelfth month after its pretended Fathers death, can be legitimately born, and consequently admit∣ted to Inheritance, or rather disinherited as a sup∣posed Child.

This question hath been well debated sometimes by the Romans as well as by us, and there have been parties both for and against this opinion; as for my part I will, to avoid prolixity, leave it unde∣cided, and add nothing upon this point to what I have mentioned before.

CHAP. VII. Whether it may be known that a Woman is with Child of a Boy, or a Girl, and the signs whether she shall have many Children.

IT is no great matter to satisfie the curiosity and disquiet of a Woman, who desires often to know whether she be with Child or no; but there are many, and almost all, that would have one proceed further, and tell them whether it be a Boy or a Girl, which is absolutely impossible; though there is hardly a Midwife which will not boast her self able to resolve it (in effect it is easier to guess, than to find the truth) for when it happens, it is cer∣tainly rather by chance, than by any knowledge or reason they could have to enable them to foretell it. But sometimes one is so pressed and importuned to give judgment, chiefly by Women who never had Children, and often by their Husbands, who are not less curious, that one is obliged to satisfie

them as much as possible in that case, by the exa∣men of some signs very incertain.

There are many signs upon which this knowledge is grounded (if there can be any, which I do not believe) of which the two principal are taken out of Hippocrates; the first is in his 42th Aphorism of the fifth book, which is, Mulier gravida, si ma∣rem gerit, bene colorate est; si vero faeminam, male calorata: A Woman with Child of a Boy is well coloured; but of a Girl, ill coloured. And the other is in his 48th Aphorism of the same book, which is, Faetus mares dextra uteri parte, faeminae finistra magis gestantur: For the most part the Male Children lye in the right side, and the Fe∣males in the left. Moreover, they say, a Woman with Child of a Boy, is more merry and jockond, goes with it much better, is not so disgusted, finds it quicken sooner, and her right Breasts fill before the left, and is also more firm, and that all the right parts of her body are stronger and more active; as for example, if she sate, kneeled, or stood upright, she would make her self first step with her right foot; but if it be a Girl, she would have all the signs contrary to these above mentioned.

There are some persons pretend to know it by in∣specting of Urines, which is as uncertain; for we daily find Women well coloured, and they have all the signs of being with Child of a Boy, and yet are brought to bed of Girles, contrary to the hopes given them: And others, though they have signs directly opposit, bring forth Boys. Some believe they understand it better than any other, by considering the time of conception; for say they, if the Woman conceives at the increase of the

Moon, she shall have a Boy, and contrarily a Girl, if at the decrease: but this falls out as seldom, as may easily be known, by the observation I have made of it at the Hostel de Dieu at Paris, and may be daily observed by others as wel as my self; which is, that having in one and the same day delivered 11 Women there, all at their full time, five of them had Boys, and the other six Girls. Now we may well judge that they all conceived at one time, be∣cause all were brought to bed at the same time; and ought (if this rule were true, and that they were all governed by this Planet) to have had either all Boys, or all Girls; and not some Boys, and some Girls, as here it happened, and doth every day in the same place; whereas in all other places are indifferently born both Boys and Girls.

Others again believe the Males to be begotten of the Seed which comes rather from the right Testi∣cle than the left, esteeming it hotter and not so wa∣terish, because the right Spermatick vein comes from the trunck of the Vena cava; and that of the left side takes its rise from the Emulgent; but if they know after what manner the blood is circula∣ted, they would find that the blood of the emulgent is not more serous, than that of the vena-cava, for∣asmuch as it is purged of its superfluous serosity by the Reines, before it enters this emulgent; they would likewise know that the Seed of both Testicles is the same exactly, being made of the same blood, brought to them not by the Reins, but only by the two Arteries, which arise out of the trunck Aorta, otherwise called the great Artery; wherefore the left is as well disposed to produce Males as Fe∣males; and therefore those Husbandmen abuse

themselvs, in knitting up one of the testicles of their Bulls according as they desire either Males or Fe∣males. I knew an Italian at Rome who had but only his left Testicle, having lost the right upon a good occasion, who after that accident married, and begat two Children, which I saw alive, and very well, one of which was a Boy and the other a Girle; besides all those he may have begotten since that time: nor needed he to suspect his Wife had the assistance of any other in that business, as it very often happens in this Country.

Such persons as desire to foretell before the Child be born, whether it will be Boy or Girl, do usu∣ally adhere by complacency, to the desires of the big-bellied Woman and her Husband in this case; for if the Midwife knows they desire a Boy, she will assure them it will be a Boy, and swear to it also; And if they wish for a Girl (as it also hap∣pens to some Women, who love Girls best) they will say it shall be a Girl, and lay wagers of it too. If this happens luckily according to her pronostick, she will not be backwards to affirm she knew it ve∣ry well: but when it happens contrary to her prediction, she makes her self reputed ignorant and presumptuous, and remains ashamed.

For my part I should do quite otherwise: for knowing beforehand the desires of the persons, I should give my advice alwayes quite contrary to them; because if it happen to be true (although by chance) what was foretold, they will then con∣clude me to be knowing, and to have said well: and if otherwise (which may be once in twice) the Woman and her Husband obtaining what they de∣sired, will not take so much notice of it, because

one alwayes receives with a good welcom what they desire, though unhoped for.

Having shewed that it is impossible to know whether a big-bellied Woman shall have a Boy or Girl, because of the uncertainty of the signs, upon which they ground their predictions; We will assert that it is not the same in the knowledge one may have, whether a Woman is conceived of more than one. There are many Authors who have affirmed that a Woman cannot bring forth above two Children at once, because they have but two Breasts; as also, because that there are but two cavities in the Womb, different from most other Animals, which hath many little cells in it, and also many teats, wherefore they bring forth many young ones, who usually answer the number of the little cells of their Womb: this is very true in re∣spect of other Animals, but the Womb of a Wo∣man hath but one only cavity (unless they would have the two sides taken for cavities) for there is in the Womb only a simple long line, without any other separation.

We see daily Women brought to bed of two Children at once, sometimes of three, and very rarely of four. Yet I knew one Mr. Hebert, Couverer of the King's Buildings, who was so good a Couverer, that his Wife about seventeen years since brought forth four living Children at a birth; which the Duke of Orleans deceased coming to hear of, to whom (because of his jovial humour) he was very welcom; the Duke asked him (in the presence of divers Persons of Quality) whether it were true, that he was so good a Fellow as to get his Wife with Child of those four at one bout? He answered ve∣ry

coldly, Yes; and that he had certainly begat at the same time half a dozen, if his foot had not slipt; which made them all laugh very heartily.

But I esteem it either a Miracle, or a Fable, what is related in the History of the Lady Margaret, Countess of Holland, who in the year 1313 was brought to bed of 365 Children at one and the same time; which happened to her (as they say) by a poor Womans Imprecation, who asking an Alms of her, related to her the great misery she was in by reason of those Children she had with her: To which the Lady answered, She might be con∣tent with the inconvenience, since she had had the pleasure of getting them.

Now since the most usual number is two, that Women have at once, (who have more than one Child at a time) We will give the signs of it, which do not appear in the first months, nor sometimes till they are quick. There is some likelihood of it, if the Woman be extraordinary big, and yet suspects no Dropsie; and more, if there be on each side of the Belly a little rising, and as it were a line a little depressed, or not so elevated about the middle; and most of all, if at the same time one feels many and different motions on both sides; and if these motions are more frequent than usually, which is, because the Infants being straitned, inconvenience one the other, and cause each other to move in that fashion: If all these signs concur, 'tis then very pro∣bable the Woman goes with more than one Child.

CHAP. VIII. Of SuPERFAETATION.

THere is a great dispute, whether a Woman (who hath two or more Children at once) conceived of them at one, or at several Coitions. We see indeed daily that Bitches, Sows, and Ra∣bits have divers young with but once copulating, which may very well make us judge the same of a Woman. Some will have this to be by Superfae∣tation: but there are signs by which we may know the difference, whether both Children were be∣gotten at once; or successively one after the other.

Superfaetation, according to Hippocrates, in his Book which treats of it, is a reiterated conception, when a Woman being already with Child, con∣ceives again the second time. That which makes many beleive there can be no Superfaetation, is; because, as soon as a Woman hath conceived, her Womb closeth and is exactly firm, so that the Seed of the Man, absolutely necessary to conception, finding no place nor entry, cannot (as they say) be received, nor contained in it, so to cause this second conception. To this may be added, that a preg∣nant Woman dischargeth her Seed (which is as necessary for it as a Mans) by a vessel which termi∣nates on the side of the exteriour part of the inward orifice; which Seed by this means is shed into the Vagina, and not into the bottom of the Womb, as it should for this purpose. However, it may be

said in answer to these objections, which are very strong, that (though the Womb be usually exactly shut and close when a Woman hath conceived, and besides, that she then sheds her Seed by ano∣ther conveyance) yet this general rule may have some exceptions, and that the Womb, so closed, is sometimes opened to let pass some serous slimy ex∣crements, which by their stay offend it; or prin∣cipally, when a Woman is animated with an ear∣nest desire of copulation, in the heat of which acti∣on she sometimes dischargeth by the passage that terminates in the bottom of the Womb, which be∣ing dilated and opened by the impetuous endea∣vour of the Seed, agitated and over-heated more than ordinary, and this orifice being at the same time a little opened, if the Mans Seed be darted into it at the same moment, it is thought a Woman may then again conceive, which is called Superfae∣tation. This is confirmed by a History of a Servant, related by Pliny, who having the same day copu∣lated with two several persons, brought forth two Children, the one resembling her Master, the other his Proctor. And also of another Woman, who likewise had two Children, the one like her Hus∣band; and the other like her Gallant: but this different resemblance doth not altogether prove Su∣perfaetation, because sometimes different imaginati∣ons may cause the same effect.

This second conception is effectively as rare, as we find the decision of it uncertain; nor must we imagine that alwayes, when a Woman brings forth two Children or more at once, there is a Superfae∣tation; because they are almost alwayes begot in the same act, by the abundance of both Seeds recei∣ved

into the Womb: nor believe neither, that it may be at all times of a Womans being with Child: for when it happens, it cannot be either the first or second day of conception; because, if the last Seed be received into the Womb, it would make a mixture and confusion with the first, which is not yet involved with this little pellicle, that might otherwise separate it; nor is it formed perfectly till the sixth or seventh day, as Hippocrates saw in a Woman, who about that time expelled this geni∣ture: Besides, the Matrix again opening it self, could not hinder the first Seed from slipping out, being not as yet wrapt up in this little membrane, which could preserve it. This makes me not be∣lieve the History of the Woman, whom Pliny men∣tions, that it happened for the reasons alledged by him, to wit, that she used copulation the same day with two several persons: for the last would cer∣tainly have caused this confusion of Seed, as I have said, and so destroyed the work begun; but I ra∣ther believe, that this Superfaetation may happen from the sixth day of conception, or thereabouts, till the thirtieth or fourtieth at the most; be∣cause then the Seeds are covered with membranes, and that which is contained in the Womb is not yet of a considerable bigness: but after this time, it is impossible, or at least very difficult, because the Womb being extended more and more by the growth of the Child, can hardly receive new Seed, and as hardly retain it, or hinder it from being cast forth by reason of its fulness, having received it in that estate.

When a Woman brings forth one or more Chil∣dren at a birth, begotten at once, which usually

are called Twins, (and differs from Superfaetation) 'tis known by their being both almost of an equal thickness and bigness, and having but one only and common after-birth, not separated the one from the other, but by their membranes, which wrap each apart with their waters, and not both in the same membrane and waters, as some have believed, contrary to the truth: but if there are several Chil∣dren, and a Superfaetation, they will be also sepa∣rated by their membranes, but not have a common burthen, but each his apart; neither will they be of an equal bigness, for that which is the Superfae∣tation, will alwayes be lesser and weaker, than that which was engendred at first; who, because of its force and vigor, draws to it self the greatest and best part of the nourishment: Just as we find in fair and great Fruit, that have often near them very little ones; which happens, because those that are first knotted and fastned to the Tree, take away all the nourish∣ment from their neighbours, who did but blossom when the first had already acquired some bigness. Sometimes Twins are not of an equal bigness, which happens according as the one or the other hath more strength to draw to it in greater abundance the best part of the common nourishment.

Six years since I layed a Woman at her full time, whom I delivered of a very great living Girl by the feet, which first came to the birth; and fetching the after-birth, I brought with it another Child, a dead Boy, as little again as the first Girl; and which seemed not to be, respecting his bigness, above five or six months; although they were both begot∣ten at one and the same act of Copulation, as was manifest by their both having but one and the same

burthen, which is the true sign of it, as I have already said; and this second Child was so little, that it came together with the burthen, and wrapt up in the membranes; which I presently opened, to see whether it were alive; but it had been a long time dead, as appeared by its corruption.

I am not willing to say that there never is any Superfaetation, but I say, that it happens very rare∣ly; for of an hundred Women that have Twins, ninety of them have but one burthen common to both; which is a very certain sign they had no Superfaetation, and much more certain than the Indications taken from the greatness or strength of the Child, which is but conjectural.

CHAP. IX. Of a MOLE, and its Signs.

OF all the several sorts of Great-Bellies in Wo∣men, there remains that yet to be examined which is caused by a Mole, of which we must al∣wayes endeavour the expulsion assoon as we come to know it, being altogether contrary to nature. The Mole is nothing else but a fleshy substance, without bones, joynts, or distinction of members; without form or figure, regulated and determined; engendred against Nature in the Womb, after Co∣pulation, out of the corrupted Seed of both the Man and Woman. Notwithstanding, there are sometimes some that have some rudiments of a rough form.

It is very certain, Women never engender Moles

without the use of copulation, both Seeds being re∣quired to it, as well as for a true generation. There are some, truly, who never having had to do with a Man, do naturally cast forth, after a flouding, some strange bodies, which in appearance seem to be flesh; but if one take special notice thereof, they will find it but clods of blood coagulated, without consistence or fleshy texture, or membra∣nous, as are the Moles and false-Conceptions.

Moles are ordinarily engendred, when either the Man or the Womans Seed, or both together, are weak, or corrupted, the Womb not labouring for a true conception, but by the help of the Spirits with which the Seed ought to be replenished: but so much the easier, as the small quantity found in it is extinguished, and as it were choaked, or drowned by abundance of the gross and corrupted men∣struous blood, which sometimes flows thither soon after conception, and gives not leisure to Nature to perfect, what she hath with great pains begun, and so troubling its work, bringing thither confusion and disorder, there is made of the seeds and blood a meer Chaos, call'd a Mole, not usually engendred but in the Womb of a Woman, and never or very rarely found in that of other Animals, because they have no menstruous blood, as she hath.

A Mole hath no burthen, nor navel-string fast∣ned to it, as a Child alwayes hath; forasmuch as the Mole it self adheres to the Womb, by which means it receives nourishment from its vessels: it is likewise cloathed usually with a kind of mem∣brane, in which is found a piece of flesh confusedly interlaced with many vessels; it is of a bigness and consistence more or less according to the abundance

of blood it receives, according to its disposition, and also according to the temperature of the Womb, and the time it stayes there; for the longer it stayes, the harder it grows, and becomes schirrous, and difficult to be expell'd. For the most part there is but one, yet sometimes more; of which, some cleave very strongly, others very slightly to the Womb. When Women miscarry of them before the second month, they are called false-Conceptions: when they keep them longer, and that this strange body begins to grow bigger, they are called Moles. False-Conceptions are more membranous, and sometimes full of corrupted Seed; but Moles are altogether fleshy. One may find in a Woman that hath a Mole, almost all the signs of Conception, and of a Woman with Child; but there are likewise some other which differ, because her belly is harder and sorer, than when she is with Child. The Mole be∣ing contrary to Nature, is very troublesome to a Woman: and as it hath no true life, nor animal motion; so it is very painful to go with: for the Mole falls on whatsoever side she turns, when she is a little big, just like a heavy Bowl: She hath a great weariness in her legs and thighs, and sup∣pression of urine from time to time, and finds a great heaviness in the bottom of her belly, foras∣much as this mass of flesh by its weight weighs down the Womb, which compresseth the bladder of urine: her breasts are not so swell'd, neither have they any, or very little milk. It may be yet easier known, if with all these signs she finds no motion after the 4th or 5th month of her Great-Belly; and certainly, if after her reckoning is out, all the afore∣said signs remain and continue in the same manner.

These Moles are nourished in the womb, to which they almost alwayes adhere, and are sustained by the blood with which it is alwayes furnished, just as Plants are by the moisture of the Earth. Some∣times there is a Child together with a Mole, from which it is sometimes divided, and sometimes cleaving to its body; which puts it in great danger of being mishapen or monstrous, because of the compression which this strange body causeth to the Infant yet very tender. In the year 1665, being at Mr. Bourdelots, Doctor in Physick of the Facul∣ty of Paris, where was every Monday held Aca∣demical Conferences: As they fell upon the dis∣course of the Circulation of the Blood, which I ex∣plained according to my opinion, they brought thither the Infant of a Woman newly brought to bed at her full time, which wanted all the upper part of the head, having no skull, no brain, no nor any hairy scalp; but had only, in lieu of all those parts, a Mole, or fleshy mass flat and red, of the thickness and bigness of an after-burthen, covered with a simple membrane strong enough: This In∣fant had however all the other parts of the body fat, and well composed and shap'd. This monstrous disposition was the cause of its death assoon as it was born, and yet it was very wonderful and a∣stonishing to consider, how it could live so with∣out brain; as also very difficult to understand, how this fleshy mass could serve in stead of it, whilst it was in the Mothers belly. It was interwoven with many vessels, like a kind of* 1.14 Placenta, yet of a more firm substance. Mr. Clerk and Mr. Juillet, my Brethren and good Friends,

were then present, and saw this Prodigy as well as my self.

A Woman having a Mole, hath a much worse colour, and is every way more inconvenienced, than a Woman with Child; and if she keeps it long, she lives all the while in danger of her life. Some have them two or three years, and sometimes all the rest of their lives: As hapned to a Peuterer's Wife, of whom Ambrose Paré makes mention in his Book of Generation, who had one seventeen years, and at last died of it. We will declare the Reme∣dies convenient for it in another place, where we speak of its extraction.

CHAP. X. In what manner a Woman ought to govern her self during her being with Child, when it is not accompanied with other considerable accidents, to endeavour to prevent them.

A Woman with Child in respect of her present disposition, although in good health, yet ought to be reputed even as though she were sick, during that neuter estate (for to be with Child, is also vulgarly called a sickness of nine months) because she is then in daily expectation of many inconveni∣ences, which pregnancy usually causes to those that do not govern themselves well.

She should in this case resemble a good Pilot, who being imbarqued on a rough Sea, and full of Rocks, shuns the danger, if he steers with prudence; if

not, 'tis by chance, if he escapes Shipwrack: So a Woman with Child is often in danger of her life, if she doth not her best endeavour to shun and pre∣vent many accidents to which she is then subject; all which time there must be care taken of two, to wit, her self, and the Child she goes with: for from one single fault results double mischief, inasmuch as the Mother cannot be any wayes inconvenienced, but the Child partakes with her.

Now to the end she may maintain her self in good health, as much as can be in that condition, which alwayes keeps a middle state, let her observe a good dyet, suitable to her temperament, custom, condition and quality, which the right use of all the six non-natural doth effect.

The Air, where she ordinarily dwells, ought to be well temper'd in all its qualities: if it be not so naturally, it must be corrected as much as may be by different means; she must avoid that which is too hot, because it often causeth, by dissipating too much the humours and spirits, many weaknesses to Women with Child, & particularly also that which is too cold and foggy; for, causing great Rhumes and distillations upon the lungs, it exciteth a cough, which by its sudden and impetuous motions, forcing downwards, may make the Woman miscarry. She ought not to dwell in narrow Lanes very dirty, nor near common Dunghils. For some Women are so nice, that the stink of a Candle not well extinguisht, is enough to bring them before their time, as Lie∣baut assures us he himself had seen: which likewise may be caused, if not sooner, by the smell of Char∣coal, as hapned once to a Laundress, whom I knew, hat miscarried the fourth mouth; being in extream

haste to finish some Linen on a Saturday night, she had not patience to kindle the Charcoal in the Chimney, but in the Room in a Chafingdish, which flew up into her head, and made her miscarry the same night, and in danger of dying. Let the Wo∣man therefore endeavour, as much as her conveni∣ence will permit, to live in an Air free from these inconveniencies.

The greatest part of Women with Child have so great loathings, and so many different longings, and strong passions for strange things, that it is very difficult to prescribe an exact dyet for them: but I shall advise them in this case to follow the opinion of Hippocrates, in his 38th Aphorism, 2^d Book, where he saith, Paulo deterior & potus & ci∣bus, suavior tamen, melioribus quidem, sed insuavio∣ribus, praeferendus. Meat and Drink though not so wholsome, if it be but pleasant, is to be preferred before that which is wholsom, if not so pleasant: which in my opinion is the rule they ought to ob∣serve, provided what they long for, is commonly used for dyet, and not strange and extraordinary things; and that they have a care of excess. If the Woman be not troubled with these loathings, let her then use such a dyet, which breeds good juyce, and in quantity sufficient for her and her Child: her appetite may regulate that. She must not then fast nor be abstemious, because overheating the Mothers blood thereby, renders it unfit to nou∣rish the Child, which ought to be sweet and mild, and makes it tender and weak, or constraius it to come before its time, to search what is fit for it else∣where: she must not eat too much at a time, and chiefly at nights, because the Womb by its extent

possessing a great part of the belly, hinders the stomach from containing much, which causeth thereby a difficulty of breathing, because it com∣presseth the Diaphragma, which as then hath not an intire liberty to be moved. Wherefore let her rather eat a little and often; let her bread be pure Wheat, well baked and white, as is that of Go∣nesse at Paris, or the like; and not course hous∣hold Bread or Bisket, which swells up the stomach, nor any other of the like nature that's very stuffing. Let her eat good nourishing meat, as are the ten∣derest parts of Beef and Mutton, Veal, Fowl; as fat Pullets, Capons, Pidgeons and Partridge, either roast or boyled as she likes best; fresh Egs are also good: And because big-bellied Women have never good blood, let her put into her Broths those herbs which purifie it, as Sorrel, Lettice, Succory, and Borrage; she must avoid hot-seasoned Pyes and baked Meats, and especially Crust, because being hard of digesti∣on, it extreamly overchargeth the stomach: If she hath a mind to Fish, let it be new, and not salted; Fish of Rivers and running streams, forasmuch as Pond-Fish tasts of mud, and breeds ill juyce. But if big-bellied Women cannot absolutely refrain their extravagant longings, it is better (as we have al∣ready said) to suffer them to deviate a little from this rule or dyet (provided it be moderate) than too much to oppose their appetites. They may drink at their meals a little good old Wine well temper'd with Water, and rather Claret than White-wine; which will help make a good digestion, and com∣fort the stomach, which is alwayes weak during prenancy; and if they were not used to drink it before, let them accustom themselves to it by de∣grees;

and as well in drinking as eating, they must shun all things hot and diurectick, because they provoke the courses, which is very prejudicial to the Child.

By moderate sleep, all the natural functions of a Woman are fortified, and particularly the con∣coction of food in the stomach, which then is very subject to loathings and vomitings. We say, it must be moderate; because, as excessive watchings dissi∣pate the Spirits, so too much sleep choak them. Let therefore Women with Child sleep nine or ten hours at least in four and twenty, and twelve at most; and let it be rather in the night-time, as most fit for rest, than in the day, as persons of quality are accustomed, who frequenting the Court, ordinarily turn night into day. However they who have got∣ten this ill habit, had better continue it than change too suddenly, because this custom is become natural to them.

For what respects exercise and rest, let them govern themselves according to the different time of their being with Child; for at the beginning of the con∣ception (if the Woman perceives it) she ought (if she can) to keep her bed, at least till the fifth or sixth day, and by no means to use copulation all the time; forasmuch as the Seeds being not yet co∣vered with the membrane, which is formed in that time (as we have said already) are in the beginning, by the agitation of the body, very apt in some per∣sons to slip forth. She ought neither to go in Coach, Chariot or Waggon, nor on Horseback, whilst with Child; and much less the nearer she comes to her time: because this kind of exercise doubles the weight of what is contained in the

Womb, by the jolts she receives, and often makes her miscarry: But she may walk gently, go in a Sedan or Litter; She ought neither to carry or lift heavy burdens, nor lift up her arms too high: and there∣fore she ought not to dress her own head, as she used to do, because it cannot be done without stretching her arms too much above her head, which hath caused many to miscarry before their time; because the ligaments of the Womb are at once loosned by these violent extensions. Let her exer∣cise be gentle walking, and the heels of her shoes low; because Women cannot, for the bigness of their bellies, see their feet, and so are subject to stumble and fall: In short, she must govern her self in these exercises, rather to err in too much rest, than in too much exercise; for the danger is greater by immoderate motion, than in too much rest. It is impossible for me in this point to be of the opinion of all Authors, although all the World follows them in this their evil and dangerous counsel, who would have a pregnant Woman exercise her self more than ordinary toward the latter end of her rec∣koning, that so, as they say, the Child may sink lower: But if they consider the point well, they would without doubt find it to be the cause of more than half of the hard Labours; and that on the con∣trary, rest would be more advantagious to them, as I shall prove by the following explication.

First, We must know and take for granted that the birth of a Child ought to be left to the work of Nature well regulated, and not to provoke it, by shaking it with this exercise, for to dislodge it before its full time: which hapning (though it be but se∣ven or eight dayes sooner) proves sometimes as pre∣judicial

to the Infant, as we see it is sometimes to Grapes, which we find four or five dayes before they are full ripe, to be yet almost half Verjuice. But to explain more clearly than by this comparison, that these kind of exercises often cause hard labours, (as we have already said) consider that the Infant is naturally scituated in the Womb with the head uppermost, and the feet downwards, with its face towards the Mothers belly, just till it hath attained to the eighth month; at which time, and sometimes sooner, and sometimes also later, his head being very great and heavy, he turns over, his head downward and his heels upwards, which is the sole and true scituation, in which he ought to come in∣to the World, all other postures being contrary to Nature. Now just when the Child is about to turn according to custom into his intended posture, Instead of giving her self rest, she falls a jumping, walking, running up and down stairs, and exer∣cising her self more than ordinary, which very of∣ten causes it to turn cross, and not right as it ought to be; and sometimes the Womb is depressed so low, and engaged in such sort towards the last month, in the cavity of the Hypagastres, by these joltings, that there is no liberty left the Infant to turn it self naturally; wherefore it is constrained to come in its first posture, to wit, by the feet, or some other worse. Moreover, it would be very convenient that the Woman to this end should ab∣stain from Coition, during the two last months of her reckoning, forasmuch as the body is thereby much moved, and the belly compressed in the action, which likewise causeth the Child to take a wrong posture. I believe that they that will seri∣ously

reflect on these things, will make no diffi∣culty to quit this old error, which hath certainly caused the death of many Women and Children, and much pain to divers others, for the reasons a∣bove-mentioned.

Some Women have miscarried only with the noise of a Cannon; as also with the sound of a great Bell; but especially with a clap of Thunder, when of a sudden it surpriseth them, and frights them.

Big-bellied Women are sometimes subject to be costive, because the Womb by its weight pressing the Rectum; hinders the Belly from discharging its excrements with ease. They that are troubled with this inconvenience may use Damask-Prunes stewed, Veal-Broth, and Herb-Pottage, with which they may gently moisten and loosen the Belly. If these things are not sufficient, they may give her gentle Clysters of Mallows, Marsh-mallows, Pellitory and Anise-seeds, with two ounces of brown Sugar dissolved in it, adding a little Oyl of Violets, or else a Decoction made with a handful of Bran, two ounces of Honey of Violets, and a piece of fresh Butter; or any other as occasion might require: but there must be great care taken that no sharp Clysters be given her to this purpose, nor other Drugs to cause a loosness, or too great an evacua∣tion, lest it endanger her to miscarry: as Hippo∣crates very well warns us in the 34th Aphorism of his fifth Book, where he sayes, Mulieri in utero gerenti si alvus plurimum profluat, periculum est ne abortiat. If a big-bellied Woman have a violent loosness, she will be in danger of miscarrying.

If she ought to govern her self well in the obser∣vation of what we have lately mentioned, she ought

no less to be careful to overcome and moderate her passions, as not to be excessive angry; and above all, that she be not afrighted; nor that any melan∣cholly news be suddenly told her: for these passi∣ons, when violent, are capable to make a Woman miscarry at the moment, even at any time of her go∣ing with Child; as it hapned to my Cousins Mo∣ther, named Mris Dionis, a Merchant, dwelling in the Street Quinquampois, whose Father being sud∣denly killed with a Sword by one of his Servants, who meeting him in the Street traiterously run him through out of spite and rage, because he had some few dayes before turned him out of doors: they brought immediatly this ill news to his Wife, then eight months gone, and presently after brought her dead Husband; at which sudden fright she was immediatly surprised with a great trembling, so that she was presently delivered of the said Dionis, who is to this day (which is very remarkable) troubled with a shaking in both hands, as his Mother had when she was delivered of him, having yet no o∣ther inconvenience, notwithstanding he was born in the eighth month by such an extraordinary acci∣dent; nor doth he seem to be above fourty years old, though near fifty. When he signed his Con∣tract of Marriage, they who knew not the reason of it, when they saw his hands shake, thought it was through fear of his ill Bargain, of which they were disabused when they had heard the Catastro∣phe that hastened his birth. Wherefore if there be any news to tell a big-bellied Woman, let it ra∣ther be such as may moderately rejoyce her, (for excessive joy may likewise prejudice her in this con∣dition) and if there be an absolute necessity to ac∣quiant

her with bad news, let the gentlest means be contrived to do it by degrees, and not all at once.

Assoon as a Woman finds her self with Child, or mistrusts it, let her not lace her self so close, as she ordinarily doth, with Bodies stifned with Whalebone, to make her Body shapely, which very often injures her Breast, and so inclosing her Belly in so strait a mould, she hinders the Infant from taking its free growth, and very often makes it come before its time, and misshapen. Those Women are so foolish as not to mind, that making themselves slender when they are with Child, quite spoils their Belly, which therefore after Childbed remains wrinkled, and pendent as a Bag, and then they cry, It is the Midwife or Nurse that did them that mischief, in not swathing and looking to them as they ought to do; not considering that it came by their strait lacing whilst they were big upwards, which causeth the Belly, finding no place to be e∣qually extended on all sides, to dilate it self onely downwards, whither all the burthen is in that manner thrust and carried: to avoid which, let them use habits more large and easie; and wear no Busks, with which they presse their Bellies to bring them into shape. Let them also forbear Ba∣thing in any manner, after they know they have conceived, lest the Womb be excited to open before the time. Almost all big-bellied Women are so infatued with the custom to bleed when they are half gone, and in the seventh month, that if they should neglect it, (although they were otherwise well) they vvould never believe they could be well delivered. I will not in the mean time justifie and

make them believe by that, what Hippocrates saith in his 31th Aphorism of his 5th Book, Mulier in utero ferens, secta vena abortit, eoque magis si sit fae∣tus grandior. If (saith he) a Woman be blooded, she miscarries; and the rather, if she be far gone. This Aphorism must not prohibit us the use of bleed∣ing when the case requires, but only warns us to use it with great prudence; forasmuch as some Women want bleeding three or four times, yea, and oftner sometimes, whilst they are with Child, when twice may be sufficient to others: For as there have been some that have been blooded nine or ten times for diseases during their pregnancy, and yet go on with their Infant to their full account; so others have miscarried by bleeding but once a little too copiously, as in this Aphorism speaks Hippocra∣tes. Now since all are not of the same nature, they must not be all governed after the same man∣ner, nor believe that it is necessary to bleed all big-bellied Women; one may judge of the neces∣sity according as they are more or less sanguine. It is the same in purging, which ought to be prudent∣ly administred as well as bleeding, according to the exigency of the case, using alwayes gentle and be∣nign remedies when they are necessary; as Cassia, Rhubarb, Manna, with the weight of a dram or two at most of good Senna. These Purgatives may serve turn for a Woman with Child, she ought not to use others more violent: If she observes all that we have above mentioned, she may then hope for a good issue of her great-Belly.

Having amply enough declared, how a Woman with Child should be governed when accompanied with no ill accident, and given the Rules she ought

to keep to prevent them, We will now examine se∣veral Indispositions, to which she is subject parti∣cularly during her pregnancy.

CHAP. XI. The means to prevent the many Accidents, which happen to a Woman during the whole time of her being with Child; and first of Vomitings.

VOmiting, with the suppression of the Terms, is for the most part the first Accident which happens to Women, and the means by which they themselves perceive their pregnancy. It is not al∣wayes caused, as is believed, from ill humours col∣lected in the stomach, because of this stoppage of their Courses: these corrupted humours do often cause a depraved appetite in pregnant Women, when either they flow thither, or are there engen∣dred; but not this Vomiting which happens im∣mediately after Conception, and which comes by succession: it cannot be meant of those which are there afterwards corrupted; but these first Vomit∣ings proceed from the sympathy between the Sto∣mach and the Womb, because of the similitude of their substance, and by means of the Nerves in∣serted in the upper orifice of the Stomach, which have communication by continuity with those that pass to the Womb, being portions of the sixth pair of those of the Brain. Now the Womb, which hath a very exquisite sense, because of its mem∣branous composition, beginning to wax bigger,

feels some pain, which being at the same time com∣municated by this continuity of Nerves to the upper orifice of the Stomach, cause there these nauseatings and vomitings which ordinarily happen. And to prove that it is thus in the beginning, and not by pretended ill humours, appears, in that many Wo∣men vomit from the first day of their being with Child, who were in perfect health before they con∣ceived, at which time the suppression of the Terms could not cause this Accident, which proceedeth from this sympathy in the very same manner; as we see those that are wounded in the Head and Bowels, and that have the Stone-Cholick, are troubled with Loathings and Vomitings, and yet have no cor∣rupt humours in the stomach. Loathings and Vo∣mitings, which are motions of the stomach con∣trary to nature, happen to big-bellied Women from the beginning, for the reasons above recited.

Loathing or Nauseousness, is nothing but a vain desire to vomit, and a motion by which the Sto∣mach is raised towards the upper orifice, without casting up any thing. And Vomiting is another more violent endeavour, by which it casts forth of the mouth what humour soever is contained in its capacity. In the beginning Vomiting is but a single symptom not to be feared; but continuing a long time, it weakens the stomach very much, and hindring digestion, corrupts the food instead of con∣cocting it, whence afterwards are engendred those ill humours, which need purging. These Vomitings ordinarily continue to the third or fourth month of being with Child, which is the time the Child ap∣pears manifestly to quicken in, after which it begins to cease, and Women to recover the appetite they

had lost during their being young with Child; because the Infant growing stronger and bigger, having need of more nourishment, consumes abun∣dance of humours, which hinders the flowing of so much superfluity to the stomach; besides, at that time the Womb is by degrees accustomed to exten∣tion: It continues in some till they are delivered, which often puts them in danger of miscarrying, and the rather, the nearer the Woman is to her full time. Others again are more sometimes tormented with it towards the end of their reckoning than at the beginning: because the stomach cannot then be sufficiently widened to contain easily the food, being compressed by the large extention and big∣ness of the Womb. Such a Vomiting which comes about the latter end of the reckoning to Women whose Children lie high, seldom ceaseth before they are brought to bed.

You need not wonder, or be much troubled at the Vomitings in the beginning, provided they are gentle and without great straining, because they are on the contrary very beneficial to Women; but if they continue longer than the third or fourth month, they ought to be remedied, because the Aliment being daily vomited up, the Mother and the Child, having need of much blood for their nourishment, will thereby grow extreamly weak, besides the continual subversion of the stomach, cau∣sing great agitation nd compression of the Mothers Belly, will force the Child before its time, as is already mentioned.

To hinder this Vomiting from afflicting the Woman much or long (it being very difficult to hinder it quite) let her use good food, such as is

specified before in the Rules or Diet; but little at a time, that the stomach may contain it without pain, and not be constrained to vomit it up, as it must when they take too much, because the big-belly hinders the free extension of it; and for to comfort and strengthen it (being alwayes weak) let her season her meat with the Juice of Orenges, Lem∣ons, Pomegranets, or a little Verjuce or Rose-Vi∣negar, according to her appetite. She may take likewise a Decoction made of French-Barley∣flower, or good Wheat-flower, having dryed the flower a little before in an Oven, mixing the yolk of an Egg with it, which is very nourishing and of easie digestion: she may likewise eat after her meals a little Marmalade of Quinces, or the Jelly of Goosberries; let her Drink be good old Wine, rather Claret than White, being well mixed with good running Fountain-Water, and not that which hath been long kept in Cisterns, as is most of the Water of our Fountains of Paris, which acquire by that stay an evil quality: If she cannot get such fresh Waters, let her rather use River-Water taken up in a place free from filth, in which she may sometimes quench hot Iron: Above all, let her for∣bear all fat Meats and Sauces, for they extreamly moisten and soften the Membranes of the Stomach, which are already weak enough, and relaxed by the Vomitings, as also all sweet and sugered Sau∣ces, which are not convenient for her, but rather such as are a little sharp, with which it is delighted and comforted.

But if notwithstanding these Precautions, and this regular Dyet, the Vomiting (as it some∣times happens) continues still, although the Wo∣man

be above half gone, it is a clear sign there are corrupt humours cleaving to the inward sides of the Stomach, which being impossible to be evacuated by so many preceding Vomitings, because they ad∣here so fast, must be purged away by Stool, to effect which they need a Dissolvent, which may be a gentle Purge, made by infusing half a dram of Rhubarb, a dram or two at most of good Senna, and an ounce of Syrup of Succory; which Purge dissolves the hu∣mours, and in evacuating them, comforts the parts: Or, it may be made with young Mallows, Cassia, Tamarinds, or any other gentle Purgers, according as the case requires, alwayes adding a little Rhu∣barb, or compound Syrup of Succory; observing likewise what humours ought to be purged: For, as Hippocrates saith, in the 12th Aphorism of his first Section, In perturbationibus ventris, & vomi∣tibus sponte evenientibus, si quidem qualia oportet purgari, purgentur, confert & facile ferunt: sin mi∣nus contra, &. In perturbations and dejections of the Belly, and in spontaneous Vomitings, if the matter be purg'd away, which ought to be, the Pa∣tient finds ease and comfort: if not, the contrary. Therefore we are to consider, that it is not enough to purge, unless we evacuate the peccant humours; for otherwise purging more weakens the Stomach, which it would not if it were well ordered, and convenient to evacuate the vicious humour. If once be not sufficient, it may be repeated, giving the Woman some few dayes respit between both; if the Vomiting continues daily, almost without in∣termission, although the Woman observes a good dyet, and after that she hath been reasonably well purged, we must rest there, lest something worse

happen, of which we may incur the blame; for she is then in great danger of miscarrying: and when the Hiccough takes them through emptiness, pro∣ceeding from too much evacuation, caused by these continual vomitings, it is very bad, as the third Aphorism of the second Book teacheth us, A Vomitu singultus malum.

Some advise, that after all these things have been tryed in vain, great Cupping-glasses should be ap∣plyed to the region of the stomach, to keep it firm in its place: but I believe it to be a Chip in Pottage, which doth neither good nor hurt; because the sto∣mach is loose, and no wayes adhering to this upper part of the belly: but since these Vomitings cool it, and daily weaken it, I should advise a big-bellied Woman to wear in the Winter, upon its region, a good piece of warm Serge, or soft Lambskin, which would a little warm those parts, and help digestion, which is alwayes weak. The Italians have a Cu∣stom, which is not bad; they wear to the same pur∣pose a fair piece of Stuff under their Doublets upon the region their stomach, of which they are so care∣ful, that if they should leave it off but two dayes in the Winter, nay even in the Summer, they would think themselves sick; and they are so grear lovers, and so curious of it, that this Stomacher is often their greatest bravery, enriching it with Gold and Silver Embroidery, and Ribonds of very fine co∣lours.

We have discoursed enough about Vomiting caused by Pregnancy, wherefore we will pass for∣wards to some other Accidents.

CHAP. XII. Of Pains of the Back, Reins, and Hips.

ALL these Accidents are but the effects of the dilatation of the Womb, and the compres∣sion it makes by its greatness and weight on the neighbouring parts; which are much greater the first time the Woman is with Child than after∣wards, when the Womb only receives the same di∣mensions it had already before: but when it hath not yet been dilated, it is more sensible of this ex∣tention, and the ligaments, which hold it in its na∣tural scituation, suffer a greater stress in the first pregnancy, having never before been forced to lengthen to answer the extent of the Womb, than in the following Great-Bellies, to which it obeys more easily the second time.

These ligaments, as well round as large, cause these pains, being much straitned and drawn by the bigness and weight of the Womb, which con∣tains a Child, to wit, the large ones, those of the back and loyns, which answer to the reins, because these two ligaments are strongly fastened towards these parts; the round ones cause those of the groins, share, and thighs, where they terminate. They are sometimes so violently extended by this extream bigness and great weight of the Womb, especially of the first Child (as I said before) that they are lacerated and torn, being not able to yeeld or stretch any farther, and chiefly if the Woman in that condition makes a false step, which causeth in

them almost insupportable pains, and other worse accidents; as it happened two years since to a near Kinswoman of mine, who being six months gone, or thereabouts, of her first Child, felt the like af∣ter she had stumbled, and perceived at the same mo∣ment something crack in her Belly towards the re∣gion of the Reins and Loins, which was one of these large ligaments, with a kind of noise, by the sudden jolt she received. At the same instant she felt ex∣tream pains in her Reins and Loins, and all the one side of her Belly, which made her immediately vo∣mit very often with much violence, and the next day she was taken with a great continued Feaver, which lasted seven or eight dayes, without being able to sleep or rest one hour, all which time she continued to vomit all she took, with a strong and frequent Hiccough, having also great pains, which seemed as if they would hasten her Labour, which (for her sake) I was very apprehensive of, as also of her death: but with the help of God, having put her immediatly to bed, where she continued twelve whole dayes, in which time I bled her thrice in her Arm on several dayes, and made her take at two several times a small grain of Laudanum in the yolk of an Egg, a little to ease her violent pains by giving her rest, alwayes ordering her from time to time good strengthning Cordials; all these symp∣toms, which at first seemed desperate, ceased by little and little, and she went on her full time, when she was happily delivered of a Son, which lived fifteen months notwithstanding all those mischievous acci∣dents she met with, which were enough to have kill'd half a dozen others: but God sometimes is pleased to work Miracles by Nature, aided with

Remedies fit for the purpose, as well as by his Grace.

This History informs us (I think) very well how these Pains of the Loins, Back, and Reins come; and the pregnant Womb causeth also those of the Hips by its greatness and weight, in compressing them, and bearing too much upon them. There is nothing will ease all these sorts of Pains better, than to rest in Bed, and bleed in the Arm, if there were any great extension or rupture of any ligament of the Womb, as was in the case recited: And when the Womb bears and weighs too much upon the Hips, if the Woman cannot keep her Bed, she ought to support and comfort her Belly with a broad Swaith well fitted for the purpose, and to bear it as patiently as she can to the time of her Labour, which will free her from all these accidents.

CHAP. XIII. Of the Pains of the Breasts.

AS soon as a Woman conceives, her Tearms wanting the ordinary evacuation, the passages being stopt, and the Woman breeding daily blood, there is a necessity, she consuming but little whilst young with Child, the fruit being yet very little also, that the vessels which are too full, should dis∣gorge part, as it doth upon the parts disposed to receive it, such as are the kernels, and glandulous parts, especially the Breasts, which imbibe and re∣ceive a great quantity of it, which filling and ex∣treamly

swelling them, causeth this Pain in them, which Women feel when they are with Child, and happens also to those whose Terms are only suppres∣sed.

In the beginning we ought to leave the whole work to Nature, and the Woman must only have a care she receives no blows upon those parts, which are then very tender, nor be straight laced with her Bodies, or other stiff Wastcoats, that might bruise and wound her; upon which follow Inflamations and Abscess: But after the third or fourth month of going with Child, the blood being still sent to the Breasts in great abundance, 'tis much better to eva∣cuate it by bleeding in th'Arm, than to turn or drive it back on some other part of the Body by repercus∣sive or astringent Medicines; because it cannot flow to any part, where it can do less hurt, than in these. Wherefore I should rather prefer the Wo∣man being very plethorick, to evacuation, by bleed∣ing in the Arm, than any other way, because of shunning thereby the Accident, of which speaks Hippocrates in his 40th Aphorism of the 5th Book, Quibus Mulierilbus in Mammas sanguis colligitur, furorem significat: If the blood be carried in too great abundance to the Breasts, it signifies that the Woman is in danger of being frantick, because of the transport which may be made thence to the Brain; which accident is avoided by moderate bleeding in the Arm, as also by a regular cooling dyet, moderately nourishing, for to diminish the quantity, and temper the heat of the humours of the whole habite.

CHAP. XIV. Of Incontinence, and difficulty of Urine.

THe scituation of the Bladder, which is placed just upon the Womb, is sufficient to instruct us wherefore pregnant Women are sometimes troubled with difficulty of urine, and the reason why they cannot often hinder, nor scarce retain their water; which is caused two wayes: 1. Because the Womb with Child by its bigness and weight compresseth the Bladder, so that it is hindred from having its ordinary extension, and so incapable of containing a reasonable quantity of urine: Which is the cause that the bigger the Woman grows, and the nearer her time she approaches, the oftner she is compelled to make water, which for that reason they cannot keep. 2. If the weighty burden of the Womb doth very much compress the bottom of the Bladder, it forceth the Women to make water every moment: but contrarily, if the neck of it be pressed, it is filled so extreamly with urine, which stayes there with great pain, being not able to expel it, forasmuch as the Sphincter, because of this compression, cannot be opened to let it out. Sometimes also the urine by its acrimony excites the Bladder very often by prick∣ing it, to discharge it self; and sometimes by its heat it makes an inflamation in the neck of the Blad∣der, which causeth its suppression. It may be like∣wise that this Accident is caused by some Stone con∣tained in the Bladder; then the pains of it are al∣most

insupportable, and much more dangerous to Woman with Child, than to one that is not; be∣cause the Womb by its swelling causeth perpetually the stone to press against the Bladder; and so much the violenter are these pains, as the stone is greater, or the figure of it unequal and sharp.

It is of great consequence to hinder these violent and frequent endeavours of a big-bellied Woman to make water, and to remedy it, if possible, both in one and the other indispositions; because by long continuance of alwayes forcing downwards to make water, the Womb is loosned and bears very much down, and sometimes is forced (the inconvenience not ceasing) to discharge it self of its burden be∣fore the ordinary time. This is that should be en∣deavoured to be hindred, having respect to the different cause of the distemper; as when it comes from the bigness and weight of the Womb, pressing the Bladder, as it is for the most part: the Woman may remedy it, and ease her self, if when she would make water, she lift up with both her hands the bottom of her belly: she may wear a large Swaith accommodated to this use, which will bear it up if there be occasion, and hinder it from bearing too much upon the Bladder; or, to do better, she may keep her Bed.

If it be the acrimony of the urine that makes the inflammation on the neck of the Bladder, it may be appeased by a regular cooling dyet, drinking only Ptisan, and forbearing the use of Wine, and all sorts of Purgations, because they send the filth of the whole body to the part affected, and by their heat do yet more augment the acrimony and inflamma∣tion: but she will do well to use, mornings and

evenings, Emulsions made with the cold Seeds, or Whey mixt with Syrup of Violets. This Remedy is proper, by refreshing gently, to cleanse the urina∣ry passages, without prejudicing either the Mother or Infant. If the inflammation and acrimony of the Urine be not removed by this Rule of Dyet, they may let her blood a little in the Arm, to pre∣vent, any ill accident that may happen: they may likewise bath her outward entry of the neck of her Bladder with a Decoction of emollient and cooling Herbs, as the leaves of Mallows, Marsh-mallows, Pellitory, and Violets, with a little Linseed, which being viscous, will help the conduit of the Urine to dilate it self the easier; there may be also Injections given into the Bladder of the same Decoction, to which may be added Honey of Violets, or else of lukewarm Milk.

But if the Woman, notwithstanding she observes these Directions, cannot make water, recourse must be had to the last remedy, which is, to draw it forth by a Catheter, represented and marked with the Letter M in the Table of Instruments, at the end of the second Book, which being anointed with Oyl Olive, or sweet Almonds, having first lifted up and thrusted the Belly a little upwards, must be gently introduced by the urinary passages into the very hollow of the Bladder, and then the Urine will immediately pass away; which being finished, the Catheter must be taken forth, and if the sup∣pression continues, it may be used again in the same manner until the accident quite leave her, and then they may try whether she can urine naturally. If she be in very great extremity, she may use an half-Bath luke-warm, provided she be not too much

moved by this Remedy, abstaining also from all Diureticks, which are very prejudicial to big-bellied Women, because they provoke abortion. If on the other side, this evil arises from the Stone, which presenting it self to the neck of the Bladder, stops the urinary passage, whilst with Child; she must be contented to have it only thrust back with a Ca∣theter: but if it be small, one may try to draw it forth with a small Probe fit for the purpose, putting the fore-finger into the Vagina, to keep it in sub∣jection that it recoyl not back towards the Bladder, which is only to be done to the small ones; for she must be delivered before the great ones can be drawn forth, it being better to leave her in that condition, than to endanger her life or the Childs, by draw∣ing it.

CHAP. XV. Of the Cough, and difficult breathing.

WOmen whose Children lie low, are oftener troubled with difficulty of Urine (as we have mentioned in the foregoing Chapter) than they whose Children lie higher, who are indeed exempt∣ed from this and the like inconvenience, but are then more subject to a Cough and difficulty of breathing than the former.

A Cough, if violent, as sometimes, even to vo∣miting, is one of the most dangerous accidents, which contributes to Abortion, because it is an es∣say by which the Lungs endeavour to cast forth of

the Breast that which offends them, by a compressi∣on of all its Muscles, which pressing all the inclosed air inwards, with which the Lungs are much ex∣tended, thrusts also by the same means with a sud∣den violence the Diaphragma downwards, and con∣sequently all the parts of the lower Belly, but par∣ticularly the Womb of the pregnant Woman, which accident continuing long and violent, often causeth her to come before her time.

This Cough proceeds sometimes from sharp and biting rheumes, which distill from the brain upon the sharp Artery and the Lungs, and sometimes from a blood of the like nature, which flowes from the whole habit towards the Breast, upon the sup∣pression of the Terms; as also from having breathed in too cold an air, which irritates the parts, and excites them to move in that manner; but being be∣gun by these causes, it is very often augmented by the compression the Womb of the pregnant Wo∣man makes upon the Diaphragma, which cannot have its free liberty in those that bear their Chil∣dren high, because by its great extension it bears up almost all the parts of the lower Belly towards the Breast, and principally the Stomach and Liver, forcing them against the Diaphragma, which is thereby compressed, as we have said.

This may be remedied by the Womans obser∣ving a good diet something cooling: if sharp hu∣mours cause it, avoiding all meats salted, spiced, or hautgoust; she must forbear sharp things, as Oren∣ges, Citrons, Pomgranats, Vinegar, and others of the like nature, because they yet more and more by their pricking quality excite the Cough: but she may make use of Lenitives and such as sweeten the

passages, as juice of Liquorish, Sugarcandy, and Sy∣rup of Violets, or Mulberries, of which they may mix some spoonfuls with a Ptysan made with Juju∣bes, Sebestens, Raisons of the Sun and French Barly, alwayes adding a little Liquorish to it: It may not likewise be amiss to turn the abundance of these hu∣mours, and draw them downwards by some gentle Clyster. If this regimen prevails nothing, and that there appears signs of fulness of blood, it will be necessary, at whatsoever time it be of her going with Child, to bleed her in the Arm, and though this remedy be not usually practised when they are young with Child, yet in this case it must: for a continual Cough is much more dangerous than mo∣derate bleeding. If the Cough comes of cold, let her be kept in a close Chamber with a Napkin three or four times double about her Neck, or a Lamb∣skin, that it may keep her warm; and going to bed let her take three or four spoonfuls of Syrup of burnt Wine, which is very pectoral, and causeth a good digestion, if it be made in the following manner:

Take half a pint of good Wine, two drams of good Cinamon bruised, half a dozen Cloves, with four ounces of Sugar; put them together in a Sil∣ver Porenger, and cause them to boil upon a Chafin∣dish of coals, burn it, and afterwards boil it to the consistence of a Syrup, which let the Woman take at night, an hour or two after a light supper. It must alwayes be observed from whatsoever cause the Cough proceeds, that the Woman go loose in her clothes, for being strait-laced, the Womb is the more thrust down, by the endeavours the Cough causeth it to make. And because sleep is very pro∣per to stay defluxions, it may be procured (if there

be occasion) by some small Julip using by no means the strong Stupesactives, which are dangerous to a Woman with Child, if there be not a very great nece••sity, as there was in my Kinswoman, who had furious accidents by the hurt she got from the stum∣ble, of which I gave you an account in the 12th Chapter of this Book.

There are Women that carry their Children so high (especially their first, because the large Liga∣ment, which support the Womb are not yet relax∣ed) that they think them to be in their Breast, which causeth so great an oppression and difficulty of breathing, that they fear they shall be choaked as∣soon as they have either eaten a little, walked, or gone up a pair of Stairs: which comes (as I said before) by reason the Womb is much enlarged, and greatly presseth the Stomach and the Liver, which forces the Diaphragma upwards, leaving it no free liberty to be moved, whence is caused this difficul∣ty of breathing. Sometimes also their Lungs are so full of blood, which is driven thither from all parts of the body when with Child, that it hardly leaves passage for the air: if so, they will breath more easi∣ly as soon as a little blood is taken from the Arm, because by that means the Lungs are emptied and have more liberty to be moved: But if this diffi∣culty of breathing comes from a compression made by the Womb against the Diaphragma, in forcing the parts of the lower Belly against it; the best re∣medy is to wear their clothes loose about them; and rather eat little and often, than to fill their Bellies too much at once: because it is thereby more pressed against the Diaphragma, and so augments the acci∣dent. Neither must she use any viscous or windy

meats, as Pease, &c. but only such as are of an easie digestion: she must all the while avoid any occasion of grief and fear, because these two passions drive the blood to the Heart and Lungs in too great abun∣dance, so that the Woman, who can hardly alrea∣dy breath, and hath her Breast stuft, will be in dan∣ger of being suffocated: for the abundance of blood filling at once and above measure the Ventricles of the Heart, hinders its motion, without which one cannot live.

CHAP. XVI. Of the swelling and pains of the Thighs and Legs.

IT is very easie for them that are acquainted with the Circulation of the Blood, to conceive the reason why many big-bellied Women have their Legs and Thighs swelled and pained, and sometimes full of red spots, from the swelling of the Veins, all along the inside of them, which extreamly hinders their going. Many think (which is in some measure true) that the Woman having more Blood than the Infant needs for its nourishment, Nature, by vertue of the expulsive faculty of the upper parts, which are alwayes most strong, drives the superfluity of it upon the lower, which are the Legs, as most feeble and aptest to receive it, because of their scituation: to explain it thus is something to purpose; but I think the Circulation. of the Blood will teach us better how this comes, than that we need to have recourse to this expulsive faculty.

It is then thus, according to my opinion, Follow∣ing the ordinary motion of the Blood, the Crural and the Saphene Veins receive into them what is brought to the lower parts by the Arteries, and convey it along the Leg and Thigh, ascending still by the Iliacks towards the Heart, which are empti∣ed, into the Cava, to ascend again by it to the Heart, and so successively. This being so de facto (as need not be doubted, since it is a verity founded upon experience) when a Woman is with Child, and chiefly towards the last months, and the Womb is much extended, and possesseth a great part of the lower Belly, then it begins to press the Iliack Veins by its greatness and heaviness, and so hinders the Blood, from following its course, and having its motion so free, as before she was with Child; which being so, the inferior parts, which are the Crural and Saphene Veins, become swelled, much in the same manner as the Veins of the Arm do upwards when bound with a Ligature for bleeding, or by any strong compression upon the upper parts; which happens, because the Veins being compressed, the Blood is there stopt, finding its passage more diffi∣cult. The Iliack Veins being then so pressed by the bigness and heaviness of the Womb, all those of the Legs and Thighes swell in such a manner, as that they empty themselves into the substance of the parts, and throughout the five Coverings, which thence become swelled; yea and these Veins, and amongst the rest the Saphenes, dilated and become varicose, sometimes from the inward and upper parts of the Thigh to the very extremity of the Foot, in which the Blood stagnating without its free circu∣lation, is altered and corrupted, which causeth great

pains and swellings in all these parts. This oftner befalls Women that are very sanguine, walk much, and use great exercise, which aided with a fulness of the Vein, makes a rupture of the Valvules, which serve to facilitate the motion of the Blood; as the suckers of a Pump, which retain the water when it is raised thither: which Blood falling down again, not being so supported, causeth by its quantity and stay, these dilatations of the Veins, which are called Varices.

For to remedy this, when a Woman hath her Veins dilated, let her only use, whilst she is with Child, a palliative cure, in swaithing this Varicos-part with a swaith three or four fingers broad, ac∣cording to the bigness of it, beginning to swaith from the bottom, and conducting it upwards to the beginning of the Varices, that by this means these varicos Veins, which are alwayes outward, being moderately closed, should be hindred by this com∣pression from further dilating, and the Blood not be corrupted by the stay it makes there, which af∣ter this will not want its circular motion, because the greatest part of it passeth then by the Vessels deeper placed. A Woman in this condition should likewise keep her bed, if she can, because by this scituation, her body being equally layed, the Blood circulates much the easier, and is not then so much troubled to return by these Veins to the Heart, as when it must ascend by them, the Woman stand∣ing upright; which is the cause the Legs alwayes are more swell'd at night than mornings: if there be in any other parts of the Body signs of plenitude and abundance of Blood, they may bleed her with∣out danger.

There are other Women, whose Legs only swell because of their weakness, and not for the reason just above mentioned, and are so oedematous, that when you press them with your Finger, the print of it remains there; which is, because they want natu∣ral heat sufficient to concoct and digest all the nou∣rishment, sent to them, and to expell the superfluities of it, which by that means remaining there in great quantity, leaves them so oedematous. For, to resolve these sort of Tumours, you may use a Lee made with the Ashes of Vines, and the Decoction of Melilot, Camomile and Lavender; afterwards they may be somented with Aromatick Wine, in which they may moisten their compresses to be laid up∣on them, repeating them three or four times a day to fortifie them; which may be made with Rosemary, Bayes, Tyme, Marjoram, Sage, and Lavender, of each an handful; of Province-Roses half a handful, Pomegranat flowers and Alum, each an ounce; boil them together in strong Red-Wine, three pints, to the consumption of a third part, strain it, and keep it for the use above mentioned. But since Pregnancy for the most part causeth these tu∣mours, they likewise ordinarily cease when the Woman is brought to bed, because then she purgeth forth the superfluity of her whole habit by means of her Lochia.

CHAP. XVII. Of the Hemorrhoids.

THe menstrous Blood, that used to be purged away every month, being collected in a great quantity near the Womb (which permits it not now to be evacuated by the usual passage, being so exact∣ly closed during Pregnancy) is forced to flow back into the whole habit, and chiefly upon the neigh∣bouring parts of the Womb, and causeth in many the Hemorrhoids both internal and external. All the several sorts of them, which we shall not de∣scribe, may as well happen to them at this time as at another: but we will only speak of that sort which is caused by pregnancy, because our design is only to make known some particulars of the maladies Women are in this condition subject to.

Hemorrhoids are tumours and painful inflamma∣tions, ingendred by a flux of humours upon the ex∣tremities of the Hemorrhoid Veins and Arteries, and are caused in great-bellied Women by the a∣bundance of Blood which is cast upon these parts, because the body at this time is not purged of its superfluities, as it was accustomed before: It is like∣wise very often caused by the great endeavours that Women sometimes make to go to stool when they are costive; because the Womb being placed upon the Rectum, hinders by pressing it, the excrements contained in it from being easily extruded; and by these endeavours the Blood, which is in the neigh∣bouring Vessels, being likewise expressed, swells and

blows up their extremities, upon which comes these painful inflamations, call'd Hemorrhoids, of which some are internal, some external, some small and with little or no pain, and some extreamly big and painful. This may suffice for their general differen∣ces, without coming to their particulars, which would require a more ample explication.

If they are small and without pain, either inter∣nal or external, it is easie enough to prevent their further growth, by Remedies, which hinder and turn the flux from those parts: but there is more reason to cure the great and painful ones, by easing first the great pain, for as long as that con∣tinues the Flux is ever augmented. To this purpose, if the big-bellied Woman have in the rest of her bo∣dy other signs of repletion, she may safely be once let blood in the Arm, and sometimes (if there be great necessity) twice, for to turn away the humours, and to evacuate the fulness, by which the pain will like∣wise be appeased: If the gross excrements retained in the right Gut be the cause of it, and that she be costive, let her take an emollient Clyster of the De∣coction of Mallows, Marshmallows, Pellitory, and Violets, with Hony of Violets, to which may be added, Oyl of sweet Almonds, or sweet Butter; be∣ing careful to add nothing that may irritate, lest it augment the Disease, especially when they are in∣ward Piles: And to the end the Women may then the better receive the Clyster, tis fit that a small end of a Pullets gut be put upon the end of the pipe, to cover it on the outside, that so it may be put up the Fundament with less pain, afterwards let her keep a moderate and cooling diet, and continue in bed till this flux of humours be passed, and the mean

time anoint the Piles with hot stroakings from the Cow, or foment them with the Decoction of Marsh∣mallows, White-broth, and Linseed: Oil of sweet Almonds, Poppies, and Water-Lillies well beaten together with the yolk of an Egg, and ground in a leaden Mortar, are very anodine and proper to ease pain; and if the inflammation be great, anoint it a little with Uuguentum Refrigerans Galeni, and Populean, equally mixed.

After a good diet, bleeding, and the application only of these cooling and anodine Remedies (Re∣percussives being not then to be used, lest they re∣pel the impure Blood, or harden the Piles) if their swelling doth not abate, Leeches must be applied, to draw and empty the Blood there gathered; or they may be opened with a Lancet, if soft, or any kind of inundation: but Leeches is more proper for hard Piles, and as it were fleshy, because they do not put one to so much pain as the Lancet: Al∣though some men by the help of these Piles, have an evacuation, almost natural, being relieved by it when they bleed moderately, Nature being ac∣customed to it: yet it is not so in Women, but al∣wayes contrary to Nature; because the evacuati∣on which happens to those men by the Piles, ought always to be made by the Womb in Women, if not with Child: but if they are, it may in some man∣ner, in case the Woman be plethorick, supply al∣so the defect of the natural; for, provided they bleed moderately and without pain, she may there∣by be also relieved: but if they flow in too great quantity, there is danger that both Mother and In∣fant will be weakened by it; and to avoid it, 'tis convenient to make astringent Fomentations with

the Decoction of Granat flowers, the rinds of Pome∣granates and Province-Roses, made with Smiths∣water and a little Alum; or this Cataplasm may be applyed to it, made with Bole-armonack, Dragons∣blood, and Terra Sigillata, with the white of an Egg: As also to turn back the Blood from these parts by bleeding in the Arm, and by dry cupping-glasses, applied to the region of the Reines, and other remedies convenient for this distemper, and such as the accident requires.

CHAP. XVIII. Of the several Fluxes which may happen to a Woman with Child, and first of a Loosness.

THree several Fluxes may befall a great-bellied Woman, to wit, the Flux of the Belly, the Flux of the Terms, and Floodings. We shall first speak of the Flux of the Belly, and afterwards we will examine the other two, in the two following Chap∣ters.

There are ordinarily reckoned three sorts of Loos∣nesses, which in general is a frequent dejection of what is contained in the Guts, by stool: the first is called Lienteria, by which the Stomach and the Guts, not having digested the nourishments received, lets it pass almost quit raw. The second is called Diarrhaea, by which they simply discharge the hu∣mours and excrements which they contain. And the third, which is the worst, is Dysenteria, by which the Patient, together with the humours and excrements, voids Blood with violent pains, caused by the ulceration of the Guts.

Of what kind soever the Flux is, if it be great, and continue long, it puts the Woman in great danger of miscarrying; which Hippocrates tells us in the 34th Aphorism of his 5th Book: Mulieri in utero gerenti, si alvus plurimum profluat, periculum est ne abortiat. For, if it be a Lienteria, the Stomach not containing the Food received, and letting it im∣mediatly pass away before it be turned into Chyle, of which Blood ought to be made for the nourish∣ment of Mother and Child, it is not possible but they must be both thereby extreamly weakned for want of nourishment: If it be a Diarrhaea, and con∣tinues long, it will occasion the same accident; be∣cause there is a great dissipation of the Spirits, toge∣ther with the evacuation of humours: But the dan∣ger is much greater when a Dysenteria, forasmuch as the Woman hath then great pains and gripes in the Guts caused by their ulceration, which excites them continually by constant stimulations to dis∣charge themselves of the sharp and bilious humours, with which they are extreamly annoyed; which causeth a great disturbance and violent commotion of the Womb, being placed upon the right Gut; and to the Child contained in it, and by the com∣pression which the Muscles of the Belly make on all sides, as also those that are made by them of the Diaphragma, which force themselves down∣wards in the endeavours a Woman makes so often to go to stool with pain, the Child is constrained because of this violence to come before its time, which arrives so much the oftner, by how much these stimulations and needings are greater, as the same Hippocrates notes in the 27th Aphorism of his 7th Book, Mulieri utero gerenti, si tentio superve∣nerit,

facit abortum. If there happens a tenesme (saith he) to a Woman with Child, it make her miscarry. This tenesme is a great passion of the right Gut, which forceth it to make these violent endea∣vours to discharge it self, without being able to avoid any thing, but cholerick humors mixt with Blood, with which it is continually irritated.

When this Flux of the Belly happens to a big∣bellied Woman, it is ordinarily, because they have alwayes the digestion of their stomach weak, by reason of their bad dyet, which their strange appe∣tites cause them often to long for: by the continual use of which being at length weakned, it suffers the food to pass immediately without digestion; or if it stay longer, it is converted into a corrupted Chyle, which descending into the Guts, irritates them by its acrimony to discharge themselves as soon as they can.

Now to proceed safely to the cure of these diffe∣rent Fluxes of the Belly (to which 'tis fit care should be taken in good time, lest the Woman miscarry, as we have already said) the nature of it must be con∣sidered, to the end the cause, which maintains it, should be remedied. If it be a Lienteria following (as is usual) continual Vomitings, which have so debilitated the Stomach, and relaxed its membranes, that having no longer strength to vomit up that food, it suffers it to pass downwards without di∣gestion: In this case a Woman must abstain from all those irregular appetites, and accustom her self to good food of easie digestion, and little at a time, that so her Stomach may be able the easier to concoct and digest it; she should drink a little deep Claret-Wine, mixed with Water in which Iron hath been

quenched, instead of Ptysan, which is not proper in this case, provided she have not a strong Feaver; for if it be but a small Feaver, Wine on this man∣ner is to be preferred, forasmuch as the fewer she hath at that time, is but symptomatick, caused by this debility of Stomach, and will vanish as soon as this is fortified; which will be yet more promoted, if the Woman before and after meals takes some Corroberatives, as a little of that Burnt-Wine we mentioned for the Cough in the 15th Chapter of this Book; or a little good Hippocras, or right Ca∣nary, of any of them according to her pallat; nei∣ther will it be amiss if she eats a little good Marma∣lade of Quince before meals: She may likewise wear upon the pit of her Stomach a Lamb-skin with the wool, for to preserve it, and augment its natural heat, which is very necessary to digest food; observing above all, to give no purging Medicine, when this Flux is only caused by weakness, lest it be thereby augmented.

If it be a Diarrhaea, and only an evacuation sim∣ply of such excrements as are retained in the Guts, and some superfluous humours, which Nature hath sent thither to be expelled, and that it continue no long time, and is gentle; the Woman will find no inconvenience by it; nor is she in that danger as when it passeth those bounds; and therefore 'tis good to leave the operation to Nature, without in∣terrupting it in the beginning: but if it continues above four or five days, it is a sign then, that there are ill humours contained and cleaving to the inside of the Guts, which provoke them often to be dis∣charged, and ought to be removed with some purg∣ing Medicine that may loosen and evacuate them,

after which the Flux will certainly cease, some light infusion of Senna and Rubarb, with Syrup of Suc∣cory, or an ounce of Diacatholicon, with a little Ru∣barb for a Bolus, to be taken in a Waser.

But if, notwithstanding fit purges and a regular diet, this flux continues, and changes into a Dysen∣teria, the Patient voiding every moment bloody stools, with much pain and needing, she is then in great danger of miscarrying, & its prevention ought it be endeavoured, if possible. Therefore, after having purged away the ill humour, (with the Medicines above mentioned) which were in the Guts, and hindering, by a good dyet, that no more be engendred; to which purpose let her use good broths made of Veal or Chicken, with cooling Herbs, temper the acrimony of these hot humours; let her eat Pap with the yolk of an Egg new layed, being well boiled: such dyet softens and sweetens the Guts within. Let her drink be Water, in which Iron or Steel was quenched, with a little Wine, if she be not feverish, for then half a spoonful of Syrop of Quince or Pomegranats is better to mix with the foresaid Water; She may likewise eat a little Marmalade of Quince, or other astringents and strengtheners, provided her body was well purged before: and because there is always in these Fluxes great pains and gripes all over the Belly and Guts, and chiefly the Rectum, all the humours being discharged upon it, which irritating it extreamly, causeth continual stimulations, that ought to be appeased (if possible) to prevent Abortion, and may be effected by Clysters made of the Broth of a Calves-head, or Sheeps-head well boyled, mixing it with two ounces of the Oyl of Violets, or else

of good Milk, mixed with the Yolk of a fresh Egg. After the use of these strengthening and anodine Clysters, as long as is judged necessary, which the Patient ought to keep as long as she can, the better to appease these pains, you must proceed to the use of Detersives, made with the Decoction of Mallows and Marsh-mallows, with Honey of Roses; and afterwards Astringent Clysters, in which must be neither Oyl nor Honey mixed, because they relax instead of binding; beginning first with the gent∣lest, made with Rose-water, mixed with Lettice and Plantain-water; afterwards to stronger, com∣posed with the Decoction of the Roots and Leaves of Plantain, Tapsus Barbatus, Horse-tail, with Provence-Roses, the rind of Pomegranats in Smiths-water; to which may be added, of Terra Sigilla∣ta, and Dragons-blood, each two drachms: You may likewise foment the Fundament; but there must be care, before you come to use the strong Astrin∣gents, that the Woman be first well purged with the Remedies before mentioned, lest (as the Pro∣verb is) the Wolf be shut in with the Flock; and, endeavouring to prevent Abortion, the death of the Mother, and consequently of the Child, be caused by a greater mischief; retaining within a∣bundance of ill Humours, of which Nature would willingly be discharged: All which may be avoid∣ed, if what I have said be well observed.

CHAP. XIX. Of the Menstruous Flux.

HIppocrates, in the 60th Aphorism of his 5th Book saith, Si Mulieri utero gerenti Purga∣tiones prodeant, impossibile est foetum esse sanum; If a big-bellied Woman have her Courses, it is impossible the Infant can be in health. This Apho∣rism must not be taken literally, but must be under∣stood when they come down immoderately: for though, according to the most general and natural rule, the Courses ought not to flow when a Woman is with Child, because their ordinary passage is stopt, and also because the Blood is then imployed for the nourishment of the Infant, of which, if it flows away, it is defrauded, and consequently much weakened: Yet there are some Women, who notwithstanding they are with Child, have their Courses till the 4th or 5th month; about which time, the Infant being already pretty big, draws a good quantity of blood for its nourishment; where∣fore there cannot so easily remain a superfluity, as when young with Child. I knew one that had four or five living Children, and had, of every Child, her Courses duly from month to month, as at other times, onely in a little less quantity, and was so till the 6th month; yet notwithstanding, she was alwayes brought to bed at her full time. I likewise saw another, who not believing she was with Child, because she had her Courses; and

finding her self out of order, because she had con∣ceived, imagining it was some other Distemper, pre∣vailed with her Physitian to bleed and purge her very often, which he did, till he had indeed cured her; but 't was after she had miscarried, being three months gone. This evacuation usually befalls ve∣ry Sanguine or Phlegmatick Women, who breed∣ing more blood than the Infant hath need of for its nourishment at the beginning, discharge themselves at those times of that superfluous quantity, more or less, according to their dispositions, but not by the bottom of the Womb, as formerly when they were not breeding, because those passages are effe∣ctually closed by the after-birth which adheres to it, and the Womb is then exactly close; but by a couple of Branches which Nature (provident and careful of the preservation of Individuals, as well as of the Kind) hath destined to this use, which pro∣ceed from the Spermatick Vessels, and (besides those they send to the Testicles and other parts) before they arrive at the Womb, divide themselves on each side into two Branches very considerable; of which, the one terminates in the Fund of the Womb, by which the Courses pass, when the Woman is not with Child; and the other, not entering there, couching along the body of it, is terminated in the side of the neck of the Womb, by which the Courses are discharged, whilst they are breeding, in case the Woman be Plethorick.

When a Woman voids blood downwards, it must carefully be considered whence it proceeds, and in what manner; whether it is the ordinary Courses, or a real Flooding: If it be the ordinary Courses, the blood comes away periodically at the

accustomed times, and flows by degrees from the neck, near the inward Orifice of the Womb, and not from its Fund; as may be discovered, if try∣ing with a finger one finds the inward Orifice ex∣actly closed; which could not be, if the blood proceeded from the bottom, as also if it proceeds without pain; all which circumstances do not meet in a flooding, but others very different, as will ap∣pear in the following Chapter. It must likewise be considered, whether these Courses flow, onely because of the superfluity, or because of the acri∣mony of the Blood, or the weakness of the Vessels which contain it, that so fit Remedies may be ap∣plyed. If they proceed from the sole abundance, being more than the Fruit can consume for its nou∣rishment, it is so far from hurting either Mother or Child, that being moderate, it is very profitable to them; because, if the Womb were not discharged of this superfluous blood, the Fruit which is as yet but little, would be drowned by it, or, as it were, suf∣focated: And if it should chance that they were unduely stopt or retained, bleeding will supply the defect of the natural evacuation, which ought to have been; but if there be no sign of abundance or plenitude; and that before she was with Child, she had her Courses in a small quantity, which still continue to flow, after she hath conceived, it is a sign that the flux proceeds from the heat and acri∣mony of the blood, or the weakness of the Vessels appointed to receive it. It is of this sort of Wo∣men that Hippocrates pretends to speak, in the 6th Aphorism before mentioned, whose Children can∣not be healthful, when their Courses flow, whilst they are breeding; because there remains not blood

enough behind for her, and the nourishment of her Infant, which puts her in great danger of miscar∣rying, for as the proverb saith, Hunger drives the Wolf out of the Wood; so likewise want of nourish∣ment forceth the little prisoner out of his hiding∣place before his time.

To hinder this Flux from effecting so evil and si∣nister an accident, the Woman must keep her self very quiet in bed, abstaining from all things that may heat her Blood, shunning Choler above all the passions of the mind, using a strengthening and a cooling diet, feeding on meat that breeds good Blood, and thickens it; as are good broths made with Poultry; necks of Mutton, knuckles of Veal, in which may be boiled cooling Pot-herbs; newlayd Eggs, Gelly's, Rice-milk, Barly-broths, which are proper for her: let her Drink be Water in which Iorn is quenched, with a little Syrup of Quince: she must refrain from Copulation, be∣cause by heating the Blood it excites it to flow more. If notwithstanding all this the Flux continues, some commend large cupping-glasses under the Breasts to make a revulsion, and to turn the Blood: according to Hippocrates Aphorism 50 of the 5th Book, Mu∣lieri si velis menstrua sistere, cucurbitulam quam maximam ad Mammas appone: but it will do no great matter; however, to satisfie the Patient, and to shew that nothing is omitted that may make for her cure, they may be applied. I should rather choose to make this Revulsion by bleeding in the Arme, if her strength permitted: And because in this condition the Child is very weak through this great evacuation, it must be fortified by applying to the Mothers Belly about the region of the Womb,

Compresses steeped in strong Wine, in which is boyled a Pomegranat, with its peel, Provence-Roses, and a little Cinamon: but the best way to strengthen it, is to correct the Mothers Blood, and hinders its evacuation.

CHAP. XX. Of Floodings.

THere is a great difference between the menstru∣ous Blood, of which we have discoursed in the preceeding chapter, which happens sometimes to Women with Child, and this Flooding which we have now in hand: for (as I have said) the Courses come periodically at the times accustomed, without pain, destilling by little and little from the neck of the Womb, during pregnancy, after which it to∣tally ceaseth: but much the contrary, this loss of Blood comes from the bottom of the Womb, with pain, and almost of a sudden, and in great abun∣dance, and continues flooding daily without inter∣mission, except that some clods (formed there) which seem somtimes to lessen the accident, by stop∣ping for a little time the place whence it flows; but soon after it returns with greater violence, after which follows death both to Mother and Child, if not timely prevented, by delivering the Woman, as shall be hereafter declared.

If this Flooding happens when young with Child, it is usually because of some Fals-concepti∣on, or Mole, of which the Womb endeavours to discharge it self, by which it opens some of the

Vessels in the bottom of it, from whence the Blood ceaseth not to flow, until in hath cast forth the strange bodies it contained in its capacity: and the hotter and subtiller the Blood is then, the more abundantly it flows. But when this Flouding hap∣pens to a Woman truly conceived, at whatsoever time it be, it proceeds likewise from the opening of the Vessels of the fund of the Womb, caused by some blow, slip or other hurt, and chiefly because the Secundine in such cases, and sometimes in others, separating in part, if not totally, from the inside of the bottom of the Womb, to which it ought to ad∣here, that it might receive the Mothers Blood, ap∣pointed for the Infants nouriture, by which separa∣tion it leaves open all the orifices of the vessels where it was joyned, and so follows a great flux of Blood, which never ceaseth (if so caused) till the Wo∣man be brought to bed: for the Secundine being once loosened, although but part of it, never joyns again to the Womb to close those Vessels, which can never shut till the Womb hath voided all that it contained: for then compressing and closing its self, and as it were entering within it self (as it happens presently after delivery) the orrifices of the vessels are closed and stopt up by this contraction, where∣by also this flooding ceaseth, which alwayes con∣tinues as long as the Womb is distended by the Child, or any thing else it contains, for the reason aforesaid: much like to a Spunge, whose pores or holes being very large when swelled, disappear and close with their own substance when squeezed and compressed; so likewise by this contraction of the Matrix (which during pregnancy became as it were spongeous) in the place whence the Secundine was

separated, the orifices of the vessels are closed, as∣soon as it is cleansed from whatsoever it contained in its capacity.

Although I have said that a Woman in this con∣dition, for the reasons alledged, must necessarily be delivered, that the Flooding may be stopt; I do not intend it should be done assoon as perceived: because some small Floodings have sometimes been suppressed by keeping quietly in bed, bleeding in the Arme, and the use of the Remedies specified in the precedent Chapter; it may likewise be but an ordinary and menstruous Flux. If then the Blood flows but in small quantity, and continues a little while, 'tis good leaving the labour to the work of nature, provided the Woman hath sufficient strength, and that it be accompanied with no other evil acci∣dent: but when it flows in so great abundance, that she falls into Convulsions and Faintings, then the operation must not be defer'd; and 'tis absolutely necessary she should be delivered whether she be at her reckoning or no, whether she have pains or throws, or not; because there is no other way to save her life, and the Childs, then presently to do it. Extreman fundet cum sanguine vocem; she casts forth with her Blood her last breath. Hippocrates knew very well the danger of it, when he said in his 56th Aphorism of the 5th Book, In fluxu muliebri si convulsio & animi defectus advenerit, malum: If Convulsions and Faintings follow Floodings, it is a bad sign.

There must not alwayes in these unfortunate ac∣cidents be expected pains and throws to force and bear down to forward labour; for though they come at the beginning, they usually cease assoon as

the Flooding comes to Syncope's and Convulsions; neither must it be defer'd, till the Womb be enough opened, forasmuch as this effusion of Blood very much moistens it, and the weakness relaxeth it, so that it may be then as easily dilated as if there had been abundance of strong throws. Wherefore, ha∣ving placed the Woman in the situation we shall di∣rect when we treat of deliveries, let the Chirurge∣on, having his hands anointed with Oyle or fresh Butter, introduce his Fingers joyned together, by degrees into the Matrix, and spread them open the one from the other when they are in the entry, for to dilate it sufficiently by little and little, without any violence, if possible; which being done, and his hand quite within, if he finds the Waters not broke, let him break them, and then, whatsoever part of the Child presents, though the Head (pro∣vided it be not just in the Birth) let him search for the Feet, and draw it forth by them (observing eve∣ry curcumstance, that shall be shewen in the 14th Chapter of the second Book, where is described the way how to deliver a Woman, the Child coming with the Feet first) because there is better hold, and more easie to deliver by them, than by the Head or any other part of the body. Wherefore if the Feet lie not ready, the Chirurgeon must seek for them, which at that time is easier done than at another, because the great Flooding makes the Womb loose and slippery by its humidity, so that it will not be difficult for him to turn the Child and bring it by the Feet, as we have even now said; after which he must fetch the after-burthen, which in these cases cleaves but little, being careful not to leave so much as a clod in the Womb, lest it still continue the Flooding,

which being done, it will soon after stop with all the accidents, if too much time was not spent before the operation.

Many Women and Children have perished for want of this operation in this ill accident; and ma∣ny others have escaped death, (which else most cer∣tanly had followed) by being timely succored.

Guillimen in Chap. 13 of his 2d Book of hap∣py Deliveries, makes mention of six or seven Histo∣ries to confirm this verity, in some of which we may find the Women and their Children bloody victims of it, for not having been in the like case delivered, which others, by a seasonable delivery, escaped: and the better to confirm it by my own experience, I will recite you one amongst the rest, very remark∣able, of the remembrance of which I am so sensible, that the Ink I write with at present to publish it to the World for their propfit, seems to me to be Blood, because in this sad and fatal occasion, I saw part of my self expire.

About three years since one of my Sisters, not yet one and twenty years of age, being about eight months and a half gone with her fifth Child, and then very well in health, was so unfortunate as to hurt her self (though at first small in appearance) by falling on her Knees, her Belly a little touching the ground by the fall, after which she passed a day or two without perceiving any great alteration, which made her neglect to repose her self, being very necessary for her; but the third day, or thereabouts, after her hurt, about eleven in the morning, she was suddenly surprised with strong and frequent pains in the Belly, which were imme∣diatly followed with Floodings; this made her

presently send for her Midwife, who no better un∣derstanding her Office, told her she must have pa∣patience, till the Womb had dilated it self by the pains, before she could be delivered, assuring her further that she had no reason to be afraid, and that she should be quickly freed from the danger, be∣cause her Child came right: she made her thus hope in vain three or four hours, until, the Flooding still continuing violently, the pains began to cease, and the poor Woman fell into frequent faintings, and then the Midwife desired a Chiurgeon to advise with in this case: they immediately sent to my house for me, but unfortunately missing of me, they sent for him, whom they judged the ablest of all the Chirurgeons that practised Midwifery in Paris, and immediatly conducted him to my Sisters, where he arrived about four in the afternoon, and having seen her,* 1.15 contented him∣self with only saying, she was a dead woman, and that nothing was to be done to her, but to give her all the Sacraments, and that ab∣solutely she could not be de∣livered; which likewise the Midwife joyntly con∣cluded, who believed that the opinion of a Man so authentickly esteemed of all, must be infallible. Assoon as he had delivered this Prognostick, he immediately returned home, and would by no means stay any longer, but left this young Woman in that deplorable condition with∣out any succour, whose life he had certainly saved

with her Childs, if he at that time had delivered her, which was very easie to be done, as will plain∣ly appear by the sequel of the History. After the advice of a person of so great reputation, together with that of the Midwife, since Monsieur N.* 1.16 could do nothing, there was no other remedy for so great a danger, but to hope in God alone, who was Almighty. They therefore endeavoured to comfort my poor Sister as well as they could, who longed for nothing more then to see me, to know whether I would pass the same sentence, and whether her danger, which still augmented more and more, was without remedy (for her Blood flowed away continually in great a∣bundance) At length I returned home, where they had been long before to tell me this bad news, though by misfortune could not find me (as I said before) which as soon as I understood, I immediately ha∣stened to her with all possible speed, where I saw as∣soon as I came in, so pittiful a spectacle, that all the passions of my Soul were at the instant agitated with many and different commotions; having after∣wards a little recovered my senses, I drew near to my Sisters Bed, where they had just given her the last Sacraments, and she conjured me very often to give that succour, which she said she only expect∣ed from me. After that I had understood from the Midwife all that had passed, and the opinion of the Chirurgeon, that had seen her above two hours before (for it was then six a clock) I perceived the Blood

to flood continually in great abundance and with∣out intermission, of which she had already lost above* 1.17 three quarts: and which was very remarkable, above twelve small Porengers, in the two hours after the Chirurgeon was returned, as it seemed to me by the number of Napkins and other Clothes, which were all muck wet with it; which Blood had stayed in her body and saved her life, if she had been then delivered: I saw likewise that she grew every moment weaker and weaker, which convinced me that she was then in more danger than she would have been if they had not let slipt the opportunity of delivering her two or three hours before, as it was possible and easie; because she had then almost all her strength, which she afterwards lost with the rest of her Blood, which all along flooded away; and desirous to know whether they could have delivered her, I found, by trying her body, that the inward ori∣fice of the Womb was dilated in such sort that I could easily introduce two or three fingers, and ha∣ving marked it, I made the Midwife try again to see whether the orifice was so disposed when the Chi∣rurgeon said that she could not be delivered, and whether she was of his opinion. She told me it was so, and that it had been alwayes in the same condi∣tion from the time of his departure. Assoon as she had made me this declaration, I easily perceived his ignorance, and where the shoe wring'd him.

Wherefore I told her, that I woundred much they were both of that opinion, seeing that in truth it seemed quite contrary to me, because it was at that time most certainly very easie for him to have

delivered her, if he had pleased, as it stil was, & what indeed I would have done at that very moment, if it had been possible for me to have had power enough over my Spirit, which wavered a long while about the resolution I was constrained to take, after I had lost the hopes of all other help. That which hin∣dered me, was not so much the Prognostick, that so famous a Chirurgeon had made, in perswading all the Assistants, that she could not be delivered, (though it might seem rash to oppose the sayings of such as are esteemed Oracles) neither was it the little strength the Patient had then left: but it was chiefly the relation of the Person, being my Sister, whom I tenderly loved, which troubled my spirits with such different passions, to see her before me ready to expire through the prodigious loss of blood, which proceeded from the same spring as mine own, that it was impossible for me at that mo∣ment to resolve, and obliged me to send again to the Chirurgeon (who was long since returned home) to entreat him to come back again to the House, that (my self demonstrating to him the facility I found for the operation, and making him understand and confess that in those cases there is no hope, unless it be undertaken as soon as may be) I might perswade him to deliver her, rather than to abandon the Mo∣ther, so to the dispair of her life, as he had done, and to suffer the Infant to perish with her unbap∣tized; which had been prevented if he had done what Art required, which is at least (when both cannot be saved) to save the Child, if possible, without prejudice to the Mother, which was very easie, as you shall presently understand: But no prayers nor sollicitations could ever prevail with him

to return, excusing himself that it was impossible for him to do any thing in the case. When this was related to me, I sent yet again to another Chi∣rurgeon, one of my Companions, being a little more obliging and serviceable, whom, if he had come time enough, I would have convinced of the ne∣cessity of the operation, and made him acknow∣ledge the facility of it: but by misfortune he was abroad. During all these goings and comings, there was an hour and half spent, which time she flooded without intermission, and her weakness grew more and more: wherefore seeing my self without hopes of getting the persons I sent for, I resolved to de∣liver her presently, which before was beyond my power, for the reasons recited, and indeed was now a little too late for the Mother; for, if I could have commanded my passions to have done it at the instant I arrived, there would then have been great bopes to have saved her, as well as I did the Child: After I had thus prepared my self for it, that is, having directed two of my fingers into the inner orifice of the Womb, being open enough to admit them into it, I did in a little while after in∣troduce a third, and by degrees the ends of all the five of my right hand, with which I dilated the orifice sufficiently to admit it quite in, as it is very easie in the like cases, because the abundance of Blood moistens and relaxeth extreamly (as is already mentioned) the whole Womb, into which having so gently entred my hand, I found the Child came right, and the Waters not yet broken; wherefore I presently broke the membranes with my nails and fingers, and then turning the Child, I took it by the feet, and brought it forth very easily, after the

manner I shall teach in the forementioned 14th Chapter of the 2d Book, all which I finished in less time than a hundred could be counted, and do con∣scientiously protest never to have delivered a Wo∣man sooner in all my life, of those whose Children came against Nature, nor easier, and with less vio∣lence to the Mother, who did not in the least com∣plain during the Operation, although she had her senses very well, and exactly knew all I did to her, and found her self very much comforted as soon as ever she was delivered, and immediately after the flooding began to cease: As to the Child I brought it alive, and it was presently baptized by a Priest that was in the Chamber. The poor Patient, and all the company present (which were in great num∣ber) found then manifestly that the Chirurgion and Midwife, who said she could not be delivered, had but little reason to assure any such thing.

The Operation was finished time enough for the Childs baptism, which (praised be God) it received; but too late to save the Mothers life, who (having before lost all her Blood) dyed an hour after she was so delivered, by the same weakness that she of∣ten fell into before she was delivered. The flooding indeed ceased presently, but she had not Blood enough left to enable her to resist those frequent faintings, which she might have done, as may pro∣bably be conjectured, if the Chirurgion that first saw her had delivered her three long hours before, as without doubt he might as ea∣sily have done as I; in which time she lost above twenty* 1.18 small porengers of Blood, of which four or five possibly might have been

sufficient to have saved her life, she being a young Woman of a very good constitution, having no in∣convenience or sickness when she was surprised with this fatal accident, which befel her (as aforesaid) about eleven in the morning, and she was delivered about seven at night; and because she had lost so much Blood before the Operation, it proved un∣profitable, she dying an hour after, having her perfect senses to the moment she expired, which was about eight the same night.

I will upon this lamentable Subject (to the end more care may be taken in the like cases) examine by way of digression, what might be the motive of this proceeding of the Chirurgeon, and of some others of the same humour. It must necessarily be agreed, that it was for one or more of these three causes, why either he would not, or could not lay this Woman when he saw her two hours before me, which (as I noted before) might easily have been done: It was either through Ignorance, Malice, or Policy: To imagine it his Ignorance, I cannot perswade my self, because he hath too great Reputation for that, although many persons that understand the Art ve∣ry well, easily agree with me, that he is of the number of those, of whom may justly be said, Minuit praesentia famam. That it was through Malice, who can imagine a man of so detestable a resolution could be found! but if it were neither Ig∣norance nor Malice, it is easy to guess it a damnable Policy, qualified by some with the name of Prudence;* 1.19 this false Prudence they

ordinarily use, that are in great reputation, ever endeavouring to their utmost to shun dangerous Cures, lest they that understand not the Art, should quit the good opinion they had of them, when it happens that the Patient dies under their hands, al∣though they were carefully and duly delivered. This was just our misfortune; for this Chiurgeon, who was very much esteemed by many Women of quality whom he delivered, avoided, all he could, dangerous labours, subject to ill success, as this was; and the rather then, because there was in my Sisters Chamber a Lady of quality, Wife to one of the chief Captains of the Guards, who dwelt in the same house, and whom he ordinarily delivered; which was the cause, that, believing the issue of the Operation doubtful, he chose rather to preserve the esteem of his ancient practice, amongst such as un∣derstood not the business well enough to be judge of his proceedings, than to do in this case his Chri∣stian duty; to which one ought alwayes to have more regard, than to all these Interests of vain Re∣putation, which usually corrupts the Conscience. They that make use of this Policy are often accesso∣ry to the death of poor Women who call for their assistance, and of their Children also.

I was willing to recite every circumstance of this Tragedy, that one may know in the like case the necessity of a speedy delivery. I have since that had many in the same case, to whom (by the assist∣ance of God) I warranted the lives of the Women, and saved the Children; of which I had in my self more satisfaction, than I could have gained by all the honour the World could procure me by so wicked a policy; which neither Chirurgeon nor

Midwife of an upright Conscience will ever use.

Now since in all floodings, there ever follows weakness and faintings, we must endeavour to pre∣serve that little strength the Patient hath left, and augment it if possible; that so they may have suffi∣cient to endure the operation, and to escape after∣wards: to which purpose there ought to be given her, from time to time, good strengthening Broths, Gelly's, and a little good Wine: she must alwayes smel to Rose-vinegar, and have a warm toast dipt in Wine and Cinamon, applied to the region of her Heart; which will do her more good than solid food: for, as Hippocrates saith in the eleventh A∣phorism of his second Book, Facilius est potu refici, quam cibo, one is sooner nourished by drink than meat; because the liquid aliments are much sooner distributed than the solid: And to prevent the Blood from flooding in great abun∣dance till she can be delivered,* 1.20 a Vein in her Arm may be opened, to turn a little the course backwards; and apply all along her Reins, Nap∣kins wet in Water and Vinegar. But if the flooding proceds from the separation of the after-burthen from the Womb, as my Sisters was, all these things are to little pur∣pose; and the best expedient is to deliver the Wo∣man assoon as may be, though she were but three or four months gone with Child, or less; because all ought as well to be brought away, whatever is with∣in the Womb, whether it be Fals-conception, Mole, or Child, without leaving any thing behind, which when it is quite cleared, closing and contracting it self, stops the flooding, for the reasons above alledg∣ed,

and all accidents which were caused by it; wher∣by the Woman afterwards recovers, if there be but sufficient strength remaining after delivery, as cer∣tainly will be, if not delayed too long.

CHAP. XXI. Of the weight, bearing down, or relaxation of the Matrix, which hinders a Woman with Child in her walking, and the freedom of coition.

MAny Women with Child find an extraordi∣nary weight at the bottom of their Bellies; which comes, because the Womb, by the weight it contains in its capacity, bears down upon the neck, and sometimes so low that they cannot walk with∣out pain and stradling; at which time also they cannot use copulation but with great inconvenience.

The bearing down of the Womb, is when it on∣ly falls into the Vagina, without coming in the least without the Privities, for then it is called the falling-out, or Praecipitation; which is a more troublesom and dangerous Disease, and doth not usually befal Women with Child, because the extent and bigness of the Womb hinders it, that it cannot fall out, but only bears down. The Precipitation is discerned by the view; and the bearing down easily, by puting up a Finger into the Vagina; for there the Womb will be soon met with, and its inner Orifice, which is very near the Privities, especially when the Woman stands upright.

This bearing down, is often caused by the relaxa∣tion of the ligaments of the Womb, and chiefly the large ones, which ought to fasten it on each side to∣wards the loins, to prevent it; which relaxation comes either from the weight of the burthen it bears and contains within, which constrains these liga∣ments to be extended more than ordinary; or from some fall, which by much shaking of it produceth the same effect, and so much the easier, by how much the burthen is greater; and likewise from some great pains or bad labour which preceeded the present pregnancy: or very often it is caused, or at least facilitated by abundance of humours, which moistening the ligaments, relax them in that man∣ner, to which the phlegmatick are very subject, who usually are much troubled with the Whites.

Besides the hinderance which the bearing down of the Womb causeth to the Womans walking and use of coition (as we have above mentioned) it caus∣eth likewise by its weight, principally towards the latter end of her reckoning, a numness in her Hips, sleepiness in her Thighs, as also difficulty of Urine, and going to stool: because by bearing down it presseth down the Bladder and the great Gut, be∣tween both which it is scituated. The Patient may be much easier cured of this bearing-down, after she is brought to bed, than whilst she is with Child; for being freed from its burthen, its ligaments will be the easier fortified: besides she may then use peffaries to keep it in its place, which cannot so well be done when she is with Child.

From what cause soever this bearing-down pro∣ceeds, the best remedy for a big-bellied Woman is to keep her bed, because the weight of it doth more

and more relax the ligaments when she is up: And if she have neither the means nor convenience so to take her rest, at least let her, if her belly be big enough, as it is towards the later end of her reckon∣ing, wear a Swaith very broad and fit for the pur∣pose, that by this means the burthen being a little supported, the ligaments may not be so much stretch∣ed and lengthened; and if she have a difficulty in making water, let her when she would do it, help her self by lifting up with both hands her Belly before, which will be a great ease, and hinder the neck of the Bladder from being so much compressed: but if the humours cause this relaxation of the ligaments of the Womb, she must keep her self to a drying dyet, her food being rather rosted than boiled, and must refrain from copulation. The Woman must not be straight laced, because that also forceth down the Matrix: and above all, when she is in labour, care must be taken that neither by means of the throwes, which strongly force down the Womb, nor by the birth of the Child, nor the violent ex∣traction of the burthen, she gets a precipitation in∣stead of a bearing down; which is soon done, as is seen often, when the method I teach in the 16th chapter of the second Book (where I treat of this Labour) is not well observed.

CHAP. XXII. Of the Dropsie of the Womb, and the oedemi∣tous Tumours of the Lips of the Privities.

THere are many phlegmatick Women, who certainly believe themselves with Child, void nothing but water, which was collected together in their Womb, and called the Dropsie of the Womb. It hath often happened that such a Disease hath deceived the Midwives as well as the Patient, who having a long time hoped, and been made to hope for a Child, at length instead of it, finds no∣thing but clear waters; as it once did to that Wood∣merchant (I mentioned in the 13th chapter of this first Book) who at the end of nine or ten months, of such a false Belly, voided a quantity of these waters, which was all that was contained and inclosed in the Womb. Guillemeau in the first chapter of his first Book of Labours, makes mention of the like History, of one named Madam du Pescher, who voided a pailfull of it, certainly believing her self to be with Child: And Fernelius in the 15th chap∣ter of his 6th Book of Pathologie, recites a case much more wonderful concerning these Dropsies. He tells us that he saw a Woman who at the times of her purgations cast forth, by the neck of the Womb, so great a quantity of water, very hot and yellowish, that she filled six or seven Basins, and voided so much of it that her Belly grew quite flat, after which her Courses came immediatly in order; and that the following months the like quantity was a∣gain

amassed, which afterwards came away as be∣fore, and that this Woman (which is most notori∣ous) being cured of this indisposition, became with Child, and was brought to bed of a living Child.

These Waters are either bred in the Womb, or brought thither from some other part, as in the dropsie of the Belly it passeth by transudation through the porous substance of the membranes of the Womb. They are bred in the Womb, when it is too cold, or too much debilitated by an ill and violent Labour preceeding; or, because the filth, as Whites, or other superfluities which it was ac∣customed to discharge it self of, hath a long time been suppressed. When the Waters contained in the capacity of the Womb have been sent thither from elsewhere, they are then never wrapt in a par∣ticular membrane, but only retained by the exact closure of its Orifice, and flows away as soon as it begins to open: but when they are bred in the Womb (which is for the most part after copulati∣on, if the Seed be either too cold, waterish, or cor∣rupted) they are then sometimes contained within membranes, which hinders the Patient from a speedy discharging of it, she going with it as long almost as with a Child: and this is the Dropsie which per∣swades them sometimes they are with Child.

'Tis easie to avoid being deceived by taking the Dropsie of the Womb for a Child, if one takes but good notice of all the signs mentioned, in treating of a true Conception, which concur not in this disease. The Patient hath indeed her Belly swell'd, and her Courses stopt in this case as well as if she were with Child, but there are many things which will dis∣cover to us the difference; for in the Dropsie, her

Breasts are flabby soft and fallen, she will have no Milk in them, nor find her self quicken at the ordi∣nary time, but only as it were a bubbling of agitat∣ed Waters; she will have a greater pain and weight in her Belly, which is likewise more equally in its circumference extended, than if there were a Child; she will also have the Lips of the Womb, her Thighs and Legs swell'd & aedematous; and a worse colour in her Face, than when she is with Child. Now as this Dropsie may come alone, so likewise may often happen together with a true Conception, these Wa∣ters being then contained without the membranes of the Child in the capacity of the Womb; for though there may be much Water within these membranes, it is not properly the Dropsie of the Womb, because there must ever naturally be some, in the midst of which the Faetus is contained: Notwithstanding, sometimes there is such a quantity of them, which doth so prodigiously swell the Womans Belly, that one would believe she had two or three Children, when she hath but only one, which is much weak∣ned by it, because the greatest part of its nourish∣ment is resolved into these Waters, which almost extinguisheth and suffocates that little natural heat which is there. Some Women have evacuated three or four quarts above two months before they were brought to bed; when this happens, they are then contained in the Womb without the Mem∣branes; for else the Child would be necessitated to be born presently after these Evacuations,* 1.21 if it were the Waters (that ought natu∣rally to be contained in the membranes) that came away.

The best Remedy for this kind of Dropsy, the Woman being vvith Child, is to vvait vvith patience the hour of her delivery, observing the mean time a drying dyet: but vvhen it is only Water contain∣ed in the Womb, she must use Diureticks to cause the Womb to open to evacuate them; and her Courses must be endeavoured to be provoked, ha∣ving alwayes a care to destroy by convenient Pur∣ges, the cause of the generation of such superflui∣ties.

The Womb is sometimes so full of these humours, that it dischargeth some on the outward parts, and principally upon those vvhich are near, as the lips of the Privities, vvhich often are thereby so swelled, that they become quite blown up; and sometimes in some Women are so big and swelled, that they cannot close their Thighs together for them, vvhich hinders their vvalking, unless vvith pain and great inconvenience. This Swelling is then livid, and al∣most transparant, even as a Hydrocele; because of the quantity of clear Water vvhich filled it: and because it may be painful and inconvenient to the Woman during her labour, by reason they straiten the passages, it vvill be necessary to remedy it before; vvhich, for the greater certainty, must be done by the operation of the hand, making many scarrifica∣tions vvith a Lancet all along the lips, vvhereby the humours will sweat out and distil forth by little and little; after vvhich Compresses dipt in Aromatick and Astringent Wine, must be put upon it to pre∣vent Relapses, by fortifying the parts, causing the Patient to observe all the vvhile a good dyet fit for the Dropsie. Some vvould apply Leeches, to avoid the pain of the Lancet: but they are not so proper,

because the small orifices they make, assoon as they are taken off, immediately close again, which hap∣pens not so soon to the Scarrifications, made as big or little as one will, and may be kept open by oynt∣ments applied to them, as long as may be thought fit or necessary.

CHAP. XXIII. Of the Venereal Disease in Women with Child.

IT is not very hard to imagine, how a breeding-Woman, that hath the Pox, can communicate it to a Child in her belly, because this contagious dis∣ease corrupting all the mass of the Mothers blood, it is necessary the Infant, which hath then no other su∣stenance, should be infected with it, converting this bad blood into its own substance, the acrimony of which Blood easily causeth in an Infants tender bo∣dy those malignant ulcers, which all such, whose Mo∣thers are contaminated with it, usually bring with them at their birth.

The Pox which in its essence is of the same species, and is only distinguished by degrees according as it is greater or less, communicating it self by the means of the Mothers blood, will make more or less impres∣sion on the Infants body according to its strength or weakness; and if the big-bellied Woman have Ulcers very near the Womb, as in the neck and neighbouring parts, by this proximity the venom will be very easily conveyed to it.

I do not design here to enquire into the bottom

of this Venereal Disease, nor to write particularly of the cure of it: but intend only to shew vvhether the Woman may undergo the Cure vvhilst with Child, or ought therefore to defer it till after they are brought to bed. That this may be the better determined, we must make some distinction; for, when the Woman is towards the end of her Ac∣count, it ought to be deferred till after she is brought to bed, when both she and the Child, if infected, may be taken in hand; because the labour coming on, when the Woman is in the midst of her Cure, she may run the hazard of her life: and besides, if the Child should be then still-born, one would be apt to think it was killed by the violence of the Medicaments, and blame the Chirurgeon of rashness.

When the Pox is but in the first degree, and hath caused no great accidents, one ought then likewise to remit the eradicating Cure till after Childbed, and be contented only with the palliating by a con∣venient dyet and gentle purgers from time to time, to prevent the evils encreasing: but if the Woman when young with Child, hath the Pox in the highest degree, accompanied with very great and continual accidents, which threaten danger, if her Cure be protracted till after Delivery; because in so long a time these accidents augmenting more and more, it would be impossible but her Fruit should be cor∣rupted, and very hard if she did not miscarry: that the greatest of these two evils be avoided, she ha∣ving strength enough, ought to be taken in hand; for, to imagine the worst, that the Remedies make her miscarry, it is no more than the greatness of the Disease would otherwise certainly do. Let her then

be taken in hand, without suffering the accidents longer to augment, vvhich by continuance render themselves much more dangerous both to her and her Child, being careful to give her the gentlest Remedies, and with more preparation and circum∣spection, so that the Evacuation procured to her by Salivation, be rather by little at a time, and the longer, than too great and sudden; and above all, that it be rather by anointing the upper parts only with* 1.22 Mercurial Oyntments, and not by Per∣fumes, which sooner endanger miscarrying, by opening the Womb; besides, that they sooner cause the Fruit to perish if it had life. For the same reason also, no Mercurial Medicine must be taken in at the mouth: vvherefore fricti∣ons of the upper parts are to be preferred, endea∣vouring alwayes, as much as may be, to be Masters of the Evacuation, and to hinder it from causing a Loosness; for that is more dangerous than Sali∣vation, because of the continual forcing downward in going to stool, by which the Womb receives great commotion, and is extreamly agitated.

I know very well that many will not easily be perswaded, but that either it is impossible to cure a Woman of the Pox whilst she is with Child, or that she and her Child cannot undergo the Reme∣dies without inevitable danger of death: however, the experience I have had of it my self, makes me to be of another opinion, which I am vvilling to com∣municate for an example in the like case. In the Year 1660, when I practised Midwifery in the Hostel de Dieu at Paris, a young Wench, not above twenty years old, came thither to lie-in of her se∣cond

Child, that had had the Pox before ever she conceived the first time, and after miscarried of a dead Child, rotten with the Pox; therefore being big this second time, and perceiving the accidents of ber disease to augment more and more, she con∣cluded there was no hopes this great Belly would succeed any better than the first, because she had all over her Body, especially upon both her Breasts, very many malignant Ulcers, which encreased day by day, and fearing it might turn to a Cancer be∣fore her Reckoning was compleat, being but three months gone, she resolved to submit to a thorough-Cure then, and to hazard her life in that condi∣tion to save her Child's, having no other hopes to effect it, nor being able her self to resist the grow∣ing disease. She acquainted three or four Chirur∣geons both vvith her disease and design, not at all concealing her great-belly; who for that cause would not undertake her, (although she was fully resolved upon it, and promised to pay them vvell) telling her that their Conscience would not suffer them to do it in the condition she was in, and that it would be better she would patiently submit to it aswell as she could till she was brought to bed, and then they vvould very vvillingly undertake her: But when she found none would undertake her, unless she concealed her great-belly, vvhich was not hard to be done being but three months gone, and believing there was no better an expedient; She met with an∣other (to whom she mentioned nothing of her great Belly) that put her into the ordinary course, as if there had been no Conception; and, besides the common Remedies used in this disease, he gave her a Salivation by five or six reiterated Frictions of the

Oyntment, vvhich followed her very plentifully five vvhole vveeks, so that she vvas vvell and per∣fectly cured, without leaving the least ill accident behind of her disease. When she was almost reco∣vered, and that all had succeeded wel, she told her Chirurgeon she was four months & a half gone with Child, (for she was three months when she came to him, where she lodged six weeks intire, without having it in the least perceived) which at first he could hardly believe, but perceiving her Belly ra∣ther grown bigger than lesser during the Evacuation the Physick had made, he was immediately assured of the truth of it: She informed him that the rea∣son why she had concealed her great-Belly, was, the refusal four Chirurgions (to whom she had confest it) made to take her in hand. From the time she was cured she suffered not the least in∣convenience during all the remainder of her time, except a little want, because all the money she had was given the Chirurgeon for her Cure, which made her come to the Hostel de Dieu to lie-in, where I delivered her of a Child at the full time, as big, fat and healthy, as if the Mother never had had the least touch of that disease in her whole body; and which was very remarkable, the Burthen (which is a part very susceptable of the least impression of a Woman's corrupt humours) was as neat, fair and ruddy as could be imagined.

This example, which is very true, may convince us, that a big-bellied Woman may be taken in hand for the Pox; and more safely, if the Precautions noted above be carefully observed: For it is with∣out contradiction, that if this Woman had not been cured, she had this second time been brought to bed

of a rotten Child, as before. Relating once this History to a Chirurgion, a Friend of mine; he told me, that himself twice, in two different persons, had the same success, who were very well cured, and their Children likewise well born at the full time, without having the least impression of the venom in any part of their Body. Varandaeus confirms to us this truth in the second Chapter of his second Book of Womens Diseases, where he precisely tells us, that he had seen big-bellied Women who had had this disease eradicated by anointings with Mer∣cury and Salivation prescribed by Empericks; which may convince us that this Cure will easily have a better success, when governed and managed by a knowing and methodical person.

In a word, 'tis easie to be perswaded that they can endure it, although with Child, because many very often have continual Feavers for twelve or fifteen dayes, and other acute distempers, for which they have been necessited to be nine or* 1.23 ten times blooded, and yet not∣withstanding have oft∣times gone through with their Children to their full account, and been delivered of them as well as if they never had had any ill accident.

CHAP. XXIV. Of Abortion, and its Causes.

WHen a Woman casts forth in the beginning what she had retained by conception in the Womb, 'tis called an Effluxion, or a sliding away of the Seeds, because they have not yet acquired any solid substance; if they miscarry of a false-concepti∣on, which is ordinarily from the later end of the first to the end of the second month, it is called an Ex∣pulsion; but when the Infant is already formed, and begins to live, if it comes before the time or∣dained and prescribed by Nature, it is an abortion: which may happen from the second to the beginning of the seventh month, for afterwards it is accounted a Birth, because the Infant being strong enough, and having all its perfections, may then live, which is impossible, if he comes before. These things thus understood, we then say, that an Abortion is an issuing forth of the Child, yet imperfect, out of the Womb contrary to Nature, before the term limited; which is the cause, that for the most part it is dead, or if sometimes alive, it dies in a short time af∣ter.

We may in general assert, that every acute Dis∣ease easily makes a Woman miscarry; because they destroy her fruit, which being dead, never stayes long in the Womb; and also puts the Woman in great hazard of her life, as saith Hippocrates in the 30th Aphorism of his 5th Book, Mulierem gravidam morbo quopiam acuto corripi, lethale. The particu∣lar

causes of Abortion, are all the accidents mention∣ed in the preceding chapters; as violent and frequent vomitings; because there is not only want of suffi∣cient nourishment for Mother and Child, when the food is so continually vomited up, but also great reachings and endeavours, by which the Womb be∣ing often compressed, and as it were shaken, is at last constrained to discharge it self before its time. Pains of the Reins, great Cholicks and Gripes may like∣wise cause the same accident, as the Strangury also; for there are then made strong compressions of the Belly every moment to expel the Urine. Great Coughs by their frequent agitation, suddenly thrust∣ing the Diaphragma with force downwards, give also violent shocks to the Womb. Great Loos∣nesses endanger a Woman to miscarry, according to the 34th Aphorism of the 5th Book; and sooner if a Tenesmus follows, which is great needings, whereby the right Gut seeks to expel the sharp hu∣mours that irritate and provoke it. This makes us take notice of the 27th of the 7th Book, Mulieri utero gerenti, si tensio supervenerit, facit abortum: for in this case the Womb, which is scituated upon the Rectum, receives a great commotion by its conti∣nual needings. If a Womans Courses flow immo∣deratly, it is impossible her Fruit can be in health, as it is in the 60th Aphorism of the 5th Book; for be∣sides, that the Infant is not sufficiently nourished, the Womb also by being too much moistened, is easily relaxed and opened. Letting Blood immode∣rately doth the same for the same reason, especially if the Child be great, according to the 31th Chap∣ter of the same Book.

But one of the worst accidents which cause A∣bortion,

is that Flooding, which proceeds from the separation of the After-birth from the Womb, of which we treated in the 20th Chapter of this first Book.

The Dropsie of the Womb hinders the Child from growing to perfection, for the great abundance of Water extinguisheth the natural heat which is already at that time much debilitated; and the Pox in the Mother infects the Child, and often Kills it in her Belly, as we have demonstrated in the pre∣ceeding Chapter; and whatever very much agi∣tates and shakes the big-bellied Womans body, is capable of making her miscarry; as great labour, strong contorsions, or violent motions, of what manner soever, in falling, leaping, dancing, and running or riding, going in a Coach or Waggon, crying aloud, or laughing heartily, or any blow received on the Belly; because that by such agita∣tions and commotions, the ligaments of the Womb are relaxed, yea and sometimes broken, as also the After-birth and Membranes of the Faetus are loos∣ned. A great noise suddenly and unexpectedly heard may make some Women miscarry; as the noise of a Cannon, and chiefly Thunderclaps; and yet more easily, if to this noise be added the fear they usually have of such things, which happens ra∣ther to the young than elderly Women; because their bodies being more tender and transpirable, the air, which is strongly forced by that noise, being in∣troduced into all her pores, offers a great violence by its impulsion on the Womb, and on the Child within it; which the elder being more robust, thicker and closer, resist with more ease. Great watchings, causing a dissipation of the Womans

strength, and much fasting for want of food, hin∣ders the Infant from acquiring its perfection; fetid and stinking smells do much contribute to abortion, and amongst others the smell of Charcoal, as ap∣pears by the History recited in the 10th Chapter of this Book.

The indispositions of the Womb produce the same effect, as when it is callous, or so small, or so much compressed by the Epiploon, that it cannot be ex∣tended, as it ought to be, sufficient to contain the Child and Burthen with ease together, with the Waters, which may likewise happen, if the Wo∣man be too strait laced, or keeps in her Belly with strong and stiff Busks for to be well shap'd; or by this subtilty to conceal a great-belly, as some do; frequent copulation, especially towards the end of her reckoning, may effect the same thing, because then, the Womb being very full, bears much down∣wards, and its inward orifice being very near, is subjected to violence.

If a Woman miscarries, without any of these accidents, and that one desires to know the cause of it, Hippocrates explains it in his 46th Aphorism of the 5th Book, where he saith, Quae veró medio∣criter corpulentae abortum faciunt secundo mense, aut tertio, fine occasione manifesta, iis acetabula uteri mucoris sunt plena, nec prae pondere faetum continere possunt sed abrumpuntur: any Woman indifferent∣ly corpulent, that miscarries the second or third month, without manifest or apparent cause, it is, because the Cotyl••dons of the Womb (which are the inward closures of its vessels) are full of viscous filth, by reason of which they cannot retain the weight of the Faetus, which is loosened from it. To

this accident phlegmatick Women are very subject, and those who have the Whites exceedingly, which by their continual affluence, moisten, and make the Womb within so slippery that the After-burthen cannot adhere to it, which also relaxeth it and its inward orifice, that the least occasion causeth abor∣tion.

But if the passions of the body cause so much hurt to a big-bellied Woman, those of the mind do no Iess, and specially Choler, which agitates, inflames, disperses and troubles all the Spirits, and mass of Blood, by which the Child suffers extreamly, be∣cause of the tenderness of its body; but above all, sudden fear, and the relation of bad news, are ca∣pable to make the Women miscarry at that instant; (as it happened to the Mother of that Cousin of mine, whom I mentioned in the 10th Chapter of this first Book) which likewise the other passions may cause, according as they are more or less vio∣lent, but not so easily. There are yet other causes of miscarrying which may be said to proceed from the Infant, as when they are monstrous, because they do not then follow the rule of Nature; as like∣wise when they have an unnatural scituation, which makes them torment themselves because of their in∣commodity, and they oblige the Womb to expel them, not being able to endure the pains they cause, which it yet does, when it is so great that it cannot contain it to the full time, nor the Mother furnish it with sufficient nourishment.

If we find one or more of the above specified ac∣cidents, and that the Woman withall hath a great heaviness in her Belly, so that it falls like a ball on her side when she turns, and that there proceeds

out of her Womb stinking and cadaverous humors, it is a sign she will soon miscarry of a dead Child: moreover, her Breasts will confirm it, if having been hard and full in the beginning, they become after∣wards empty and flabby, as is specified in the 37th Aphorism of the 5th Book; and the 38th of the same Book, saith, That if one of a big-bellied Womans Breasts, who hath two Children, begins to flag, it is a sign she will miscarry of the Child of that side; and of both, if both flag in the same manner.

It is most certain, a Woman is in more danger of her life when she miscarries, than at her full time; because (as we have said before) abortion is wholly contrary to Nature, and very often accompanied with flooding: and in more danger of miscarrying alwayes, if she miscarries of the first; and some apprehend then an impossibility of ever having Children after, to which, young married people are very subject, because of the violent emotion and perturbation of the whole body, excited by ardent and frequent copulations: but notwithstanding, they may preserve their fruit, when their greater vigour is over, and their loves a little mode∣rated.

We have taught in each of the foregoing Chap∣ters, how to prevent all the accidents before reci∣ted, any of which is sufficient to make her miscarry; and the easier, if many are complicated: where∣fore to avoid a troublesome and needless repetiti∣on, you may have recourse to the Remedies there taught, by which both Women and Children may escape the danger of death.

They that are subject to abortion, ought above all to take their ease, and keep in bed if they can,

observing a good diet, and refraining copulation as∣soon as she believes her self to be with Child; avoid∣ing the use of all Diureticks and Aperitives, which are very pernicious; as also violent passions of the mind, because they are very prejudicial. She ought likewise to be loose in her dress, that she may breath the freer, and not strait laced, and rackt, as most of them are ordinarily with their Busks under their cloths, to make their bodies strait; and amongst other things, they had need take heed of slipping and falling in their walking, to which big-bellied Women are very subject, because the bigness of their Bellies hinders them from seeing their way: they will therefore do well to wear low-heeld shoos with large soals, to prevent hurting themselves, as too many daily do. I admire in this case the superstiti∣on of many Midwives, and some Authors, who order a Woman with Child, to take, assoon as she hath hurt her Belly with a fall, some Crimson Silk, small minced in the yolk of an Egg, or the grains of* 1.24 Scarlet, and treddles of several Eggs put into the yolk of one; as if that entring the stomach, were able to fortifie the Womb and the Child in it, and to keep it there, for which there is no appearance of reason or truth: but quiet rest indeed contributes much to it, which for this reason is usually directed for nine dayes; although such a one hath need of 15 dayes, or more, for her hurt or commotion; and to others, five or six is sufficient; during which time may be applied hot to the Belly, Compresses steeped in Aromatick and Astringent Wine. But because there are many Women so infatuated with this superstitious cu∣stom, that they would not believe themselves out

of danger, if they took not that Crimson Silk, or the Treddles of the Eggs (which is a pure conceit) one may give it to those that desire it to content them, because these Remedies, though useless, can yet do no hurt. It is now time to make an end of this first Book, in which I have only mentioned the most ordinary distempers, which have some particu∣lar indications in their cure, during the Womans being with Child; of which I have not treated very exactly, because it may be supposed that one may elsewhere have a more perfect knowledge of them, with all their circumstances: let us now pass to the second Book, to treat of Deliveries, not only the natural, but likewise all that are contrary to nature, it being the principal motive that induced me to write, and to teach as well as I can, the best and most methodical deportment in it.

The End of the first Book.

Notes

• * 1.1

  Incapacity.
• * 1.2

  In his A∣natomy not yet printed
• * 1.3

  Lovingly.
• * 1.4

  Great, or right Gut.
• † 1.5

  shooting.
• * 1.6

  A kind of large Incision-knife.
• * 1.7

  Chirurgeons onely practise Midwifery in France.
• * 1.8

  The great Gut.
• * 1.9

  Untimely or unseasonable.
• * 1.10

  This excludes not Art to assist Nature, if not a∣ble to perform its duty in due sea∣son.
• * 1.11

  To be understood by Medicines, as appears by the word [miscarry] follo∣wing.
• * 1.12

  Implies Me∣dicines, as be∣fore.
• * 1.13

  An Hospital so called, in Paris.
• * 1.14

  The fleshy part of the burthen.
• * 1.15

  It were to be wish'd rather than hoped for, that Practi∣tioners in this and other the like dangerous cases (where∣of they have no certain know∣ledge) would consult, and not destroy one or more, by undertaking what they can∣not well perform, or discou∣rage Patients from sending for other help and advice; putting Life in ballance with their Reputation.
• * 1.16

  The great mischiefs which happen by the Prognosticks of such who have the luck, though they want the merit to be esteemed.
• * 1.17

  French quarts are English pottles.
• * 1.18

  each Porenger contains about four ounces.
• * 1.19

  A good Warning not to rely too much upon the ad∣vice of such famous Pra∣ctitioners, or Midwives, that prefer their Reputa∣tions above their Consci∣ences.
• * 1.20

  Rather Liga∣tures above the elbows, because too much Blood is already lost.
• * 1.21

  That being the right time of La∣bour.
• * 1.22

  As Unguentum Neapolitanum.
• * 1.23

  Such frequent bleeding Women with Child in so short a space, is not ap∣proved in England.
• * 1.24

  Kermes.