The midwives book, or, The whole art of midwifry discovered.: Directing childbearing women how to behave themselves in their conception, breeding, bearing, and nursing of children in six books, viz. ... / By Mrs. Jane Sharp practitioner in the art of midwifry above thirty years.

CHAP. IX.

Of the Posture the child holdeth in the Womb, and after what fashion it lieth there.

HEre Physicians are at a stand and are ne∣ver like to agree about it, not two in twenty that can set their horses together; the speculation is very curious, insomuch that the Prophet David ascribes this knowledge as more peculiar to God, Psalm 139. My reins are

thine, thou hast covered me in my mothers womb: I will give thanks unto thee for I am fearfully and wonderfully made: marvellous are thy works, and that my soul knoweth right well; my bones are not hid from thee, though I be made secretly and fashioned beneath in the earth; thine eyes did see my substance, yet being unperfect, and in thy Book were all my members written, which day by day were fashioned, whenas yet there was none of them.

Yet Anatomists have narrowly enquired in∣to this secret Cabinet of nature, and Hip∣pocrates that great Physician tells us in his Book De natura Pueri, that the infant lieth in the womb with his head, his hands, and his knees bending downward, towards his feet: so that he is bended round together, his hands lying upon both his knees, the thumbs of his hands, & his eyes meeting each with other, & so saith Bartholinus the younger of the two. Likewise Columbus's opinion is, that the child lieth round in the womb with the right arm bended, and the fingers of the right hand ly∣ing under the ear of it, above the neck, the head bowed so low that the chin meets and toucheth the breast, and the left arm bowed lying above the breast and the face, and the right elbow bended serves to underprop the left arm lying upon it; the legs are lying up∣wards,

and the right leg is lifted so high that the infants thigh toucheth its belly, the knees touch the Navel, and the heel toucheth the left buttock, and the foot is turned backward and hides the privy members; as for the left thigh, that toucheth the belly, and the left leg is lifted up to the breast; the stomach lyeth inward. But the expert Spigelius hath the fa∣shion of a child near the birth, whose figure I have here laid down, and I believe it is very proper, for, as well as I am able to judge by the figure, it is the very same with that of a child that I had once the chance to see when I was performing my office of Midwifry.

Here insert the Figure of the Child near its Birth.

[illustration] anatomical depiction of the child near its birth

The Figure Explained:

Being a Dissection of the WOMB, with the usual manner how the CHILD lies therein near the time of its Birth.

BB. The inner parts of the Chorion extended and branched out.

C. The Amnios extended.

DD. The Membrane of the Womb extended and branched.

E. The Fleshy substance call'd the Cake or Placenta, which nourishes the Infant, it is full of Vessels.

F. The Vessels appoint••d for th•• 〈…〉〈…〉

[illustration]

This is a general observation, that the Male Child most commonly lyeth on the right side in the womb, and the Female on the left side; but Hippocrates layeth it down as the most universal way, to have his hands, knees, and head bending down toward the feet, his nose betwixt his knees, his hands upon both knees, and his face between them, each eye touching each thumb; but he is wrapt as he lieth in two mantles or garments, as I said,

for a boy hath no more; that which imme∣diately covers him and lieth next to his skin, is called Amnios the skirt or Lamb-skin, it is wonderful soft and thin, and is loose on all sides, only it grows so fast to the Cake, that it can hardly be parted from it; the use of it farther is to receive the Childs sweat and U∣rine, which moisteneth the mouth of the Ma∣trix also and makes the birth more easie, but the outward coat called Chorion, is very strong and sinewy, and encloseth the child round a∣bout, and like a soft pillow or bed bears up all the veins and Arteries of the Navel, which would have been in danger, to have been carried so far, without some soft bolster to sus∣tain them.

These coats growing fast together seem to be but one coat, or one to be the beginning of the other, and this altogether taken is called the after-burden or Secundine, for when the Child is grown strong enough to come out of the womb, and the time of his birth is at hand, he breaks through these coverings, and the coverings come forth after the child is born: yet sometimes a piece of the Amnios covers the childs face and head when he is born and women call it the caule, and hold it to be a Sign of some great happiness that will befall the child in the following part of his

life, but some think it is neither here nor there, one born without this caule may be as happy as he that is born with it. There be∣long to the child whilest it lieth in the womb some things that are proper for it, some to cloath it, and are only for that time that it lieth in that place, and afterwards of no known use, though some have tried to make use of them in Physick and Chirurgery, but commonly they cast it away. Some things a∣gain serve to nourish and feed it in the womb, and those are the Navel-vessels which are four in number, two arteries, one vein, and that vessel which is called Ʋrachos, which carrieth away the childs water in the womb to that skin that is prepared to hold that water so long as the child staies in the womb and it is called Allantois. The vein I speak of comes from the Infants Liver, and when it is passed the navel, it brancheth into two branches; and these again divide and subdivide, the skin called Chorion supporting the branches of it, and these are joined to the Veins of the mo∣thers womb, and serve to suck and to carry the mothers blood from thence to feed the in∣fant with, whilest it stays there.

This Vein is for that end that the infant may be fed from the first time of conception untill it be born, and then its use is over as to

the first intention, when the child comes to feed it self, for then it hath no need to suck blood from the mother as it did before.

The Arteries are two on each side, and these spring from the branches of the great artery of the mother that comes from the small Guts and these serve to carry vital blood to feed the Infant with, when it is first well pre∣pared and concocted by the mother.

The next part for servile use, is a Nervous production called Ʋrachos, and it comes from the bottom of the bladder of the child to its Navel, and it serves, as the name also implies, to carry the childs Urine to the Allantois or skin that must retain it. But Anatomists are not all of one mind about it, for some say there is no such thing to be found in the after-burden of women, but in beasts it is. Let their ignorance or disputes be what they will to no purpose, I shall satisfie all by true ex∣perience, which cannot be contradicted; he that reads the Anatomy Lecture of Montpelion in France, Bartholomew Cabrolius a skilful Chi∣rurgion professeth that he saw a maid whose Urine came forth at her Navel, the ordinary passage of her water being obstructed: and Dr. John Fernelius tells the same story, of a man who was thirty years old, who had a stopping in the neck of his bladder so that for

many months continually his water came forth by his Navel, yet he found no hurt at all by it but was very well in health, and Fer∣nelius saith, the reason was, because his Na∣vel-string was not well tied, and the passage of the Ʋrachos gave way because it was not well dried. And there is another example that Valchier Coiler lays down of a German maid of Noremberge, she was thirty four years of age. These distempers are not frequent, because she must be a very unskilful Midwife that knows not how to tie and cut the Na∣vel string, yet these accidents are sufficient in such a dark matter to prove that there is such a thing as a Ʋrachos or Urine-carrier from the Navel in both sexes, men as well as women.

These four vessels, as I said, namely one Vein, two Arteries, and the Ʋrachos, join to∣gether near the Navel, and they are tyed by a skin they have from the Chorion or outward coat of the Secundine, and so they seem to be a Chord or Gut without any feeling, this is that that all People call the Navel-string, if wo∣man or man doubt of the truth of this relati∣on, let him only take the childs Navel-string when it is cut off, and untwist it, and open it and so they shall be able to satisfie themselves. These Vessels are so joined for to strengthen

them that they will not be broken, nor yet are they entangled together; when the child is born into the world then these Vessels as they hang without from the Navel serve for no o∣ther use but to be knit fast and to make a strong band to cover the Navel-hole. Yet experience hath found a way to make a Phy∣sical use of them, that what is spar'd from ty∣ing and to be cut off, may not be thrown a∣way; as for the Secundine and the parts of it, the parts of it are held to be four. I shall shew you a little more concerning the description and use of them. The first part is that which is commonly called a Sugar cake in Latine Placenta, and indeed it is very like a cake in the form of it, it is tied both to the Navel and to the strong outward, sinewy Coat of the Child in the womb called Chorion; and this is that which makes the greater part of the after burden or Secundine; the flesh hereof is soft and of a red colour, much like the spleen or milt, tending somewhat to black, there are abundance of small Veins and Arteries in it, and it should be probable that the chief use it serves for, is to cloath and keep the infant in the womb. Columbus a very good Anatomist, yet was much deceived when he affirms the Chorion or strongest and outward membrane that wraps the Child in the womb to be no

skin. It is undoubtedly known, that the Cho∣rion and Amnios do compass the child round, above, beneath, and on all sides, but the Al∣lantois that contains the childs Urine doth not so. Columbus he mistook this skin for the Pla∣centa or cake, but Hippocrates gives this name Secundine as general to the whole, in that book he hath written of womens diseases: for the Chorion is a skin very white, and thick, light and slippery, and it is laced, and adorn∣ed, and branched with a great many small Veins and Arteries, and we must not think that it serves only for a covering of the child in the womb, for it serves farther to receive and to bind fast the roots of the Veins, and Arteries or Navel-Vessels which I spake of before.

The Allantois or skin to contain the childs Urine in the womb is denied by many that there is any such Vessel to be found in mans body, I must confess reason must help us to discern it, for we can hardly see it or find it. It is said that in Holland men are wont to be present at their wives labours as well as women, and that few of the women use stools, but they sit in their Husbands laps when they are delivered; and they say there is such a a thing. Galen maintains, that there is as much reason and experience for it in men as in

beasts, good women as well as my self have done, may look for it, and find it too if they please, a very fine, white, soft, exceeding thin skin, and it lieth just under the cake or Placen∣ta, and there it is tied to the Ʋrachos from which it takes in the Urine, and its office is to keep the Urine apart from the sweat, that the saltness of the Urine may not hurt the tender Infant, which it must needs do, were it not kept up in a place by its self. The Amnios is the last and inmost skin, and it is wonderful fine, soft, white, transparent, fed and inter∣woven with many Veins and Arteries; this skin not only infolds the Infant, but also holds the sweat that comes from it whilest it lieth in the womb.