,the ,province of ,midwives in the ,practice of their ,art1 by ,william ,clark1 ,m4 ,d4 #afih-;ca4 #aghj4 ,,the ,,province ,,of ,,midwives ,,in ,,the ,practice of their ,,art3 ,instructing them in the timely ,knowledge of such ,difficulties as require the ,assistance of ,,men1 ,for the ,preservation of ,,mother and ,,child4 ,very necessary for the ,perusal of ,,all the ,,sex interested in the ,subject1 ,and interspersed with some ,new and ,useful ,,observations4 ,by ,,william ,,clark1 ,m4 ,d4 ,and of the ,college of ,,physicians4 ,molliter ,aufer ,onus4 ,,ovid4 ,,fasti4 ,printed for ,william ,frederick1 in ,,bath2 and sold by ,m4 ,cooper1 in ,pater-,noster-,row1 ,,london4 ,,mdccli4 ,,advertisement ,,to ,,the ,,reader4 ,the following small ,tract will appear contemptible to those who judge of the ,worth of ,books by their ,bulk2 but the ,author believes such as are practis'd in ,midwifry will acknowledge both the ,want and ,usefulness of an ,essay of this ,kind4 ,the ,division of the ,chapters1 naturally arising from the various ,circumstances which are treated of1 will rather assist than burden the ,memory1 and admit of a ready ,recourse to the short ,instructions1 in the ,knowledge and ,practice absolutely necessary1 given under each ,head4 ,the ,reader will the more readily excuse any ,defect in the ,stile1 when he considers the ,necessity of a strict ,expression on the ,subject and the ,difficulty a ,man lies under1 who writes not to the learned and experienced1 but chiefly for the ,sake of ,persons ignorant in ,anatomy and ,philosophy1 on a ,subject which for the most ,part excludes ,information by ,sight4 ,on such a ,subject it will not be imagined ,vanity or ,applause can incline a ,man to write a ,pamphlet1 rather than a ,volume2 when the ,author is not conscious of having omitted the ,instruction to be found in any ,book extant1 within the ,limits of his ,design2 and hopes ,experience will teach its ,value both to ,midwives and ,matrons2 and that the ,perusal will not at all injure1 if it does not improve1 the most knowing and experienced4 99 99 99 99 99 ,the ,,reader is desir'd to correct the following ,,errors with the ,pen4 ,page #i1 ,line #af1 read ,pains about the ,back1 ,navel1 c4--,p4 #cc1 l4 #ab4 omit the ,period after the ,word ,pain2 and make a ,semicolon1 instead of the ,comma1 after touch'd it4 ,,chapter ,i4 ,the ,,design4 ,the ,case of ,child-bearing ,women is very lamentable1 in the ,country especially1 by ,reason of the ,ignorance and ,unskilfulness of ,midwives2 for by their ,negligence and perverse ,management1 many ,mothers and ,children are destroyed1 to the great ,misfortune of particular ,families1 as well as of the ,publick1 at a ,time when it suffers by the ,loss of useful ,hands1 from too many other ,causes4 ,it were therefore to be wished1 that all ,midwives were so far appris'd of their ,duty1 as to be able to distinguish between ,cases within their ,abilities1 and such ,difficulties as may occasion the ,loss of the ,mother1 or ,child1 or both1 for ,want of necessary ,assistance4 ,they who intend to practice ,midwifry in ,,paris1 are oblig'd to attend anatomical ,lectures and ,dissections1 that their ,judgments may be inform'd1 by the ,knowledge of the ,structure of the ,body1 for an ,undertaking so hazardous in ignorant ,hands4 ,london1 at present1 affords equal ,advantages of ,information2 for the anatomical ,wax-work1 with suitable ,lectures1 might furnish as good a ,qualification1 with less ,offence than real ,dissections2 and there are not wanting those who professedly instruct both ,sexes by mechanical ,demonstrations4 ,and for the future1 it is to be hoped1 there will be no ,necessity for ,men to have ,recourse to ,,paris for ,observation1 since we have ,infirmaries at ,home for the ,accommodation of ,women in ,child-bed2 and tho' they are expos'd naked to the ,eye in the ,hotel de ,dieu1 it must be confess'd1 that the fundamental ,rules of the ,art are not built on what the ,eye of the ,observer can possibly discover in the most expert ,operators2 but depend on ,circumstances conceal'd from ,sight1 within the ,body of the ,patient4 ,but whatever ,advantages ,,london and ,,westminster afford for the ,instruction of ,midwives1 the ,country is entirely destitute of them2 and the best ,books on the ,subject1 adorn'd with elegant ,figures1 can give but a very imperfect ,notion of the ,parts they represent1 to any who have not attended ,dissections1 or seen more natural ,resemblances than ,cuts4 ,the ,figures in ,books1 exhibit the ,bones of the ,pelvis1 a ,variety of ,situations of the ,infant1 and ,uterus1 the ,placenta and umbilical ,vessels and ,membranes1 c4 whereas it would be no less serviceable to those1 who assist ,women in ,travel1 to be acquainted with the ,viscera1 liable to suffer by a difficult ,labour2 for the ,liver1 ,spleen1 ,sweetbread and ,kidneys1 if not the principal ,contents of the ,chest1 may be so injured by the ill ,position of the ,child1 ,compression of the ,parts1 and rash ,assistance1 as to prove fatal1 more or lets immediately2 occasioning ,inflammations1 ,suppurations1 ,mortifications1 ,schirrhu's1 ,cancers1 or ,consumptions4 ,the best ,writers of ,midwifry1 such as ,mauriceau1 ,deventer1 ,de la ,motte1 ,heister and others1 explain the ,causes of difficult ,births1 and the proper ,methods of ,assistance2 but instead of improving most ,country ,midwives1 fill them with ,conceits of what1 it is impossible1 they should understand1 and thereby occasion the ,loss of great ,numbers of ,women and ,children4 ,in order therefore that ,midwives may acquit themselves with ,reputation1 and that ,child-bearing ,women may be the better ,judges for themselves1 or the charitable ,part of the ,sex1 who are past these ,dangers1 the better able to assist their ,friends and ,neighbours1 ,i shall endeavour to shew how far they may act with ,safety under the ,disadvantage of ,country ,practice1 and describe those ,symptoms1 which for the most ,part accompany hard ,labours1 very probably beyond their ,abilities2 when they will justly incur the ,censure of ,inhumanity and ,rashness to depend upon their own ,skill4 ,,chapter ,,ii4 ,in this ,chapter ,i have avoided the ,use of ,terms of ,art1 or explain'd them1 in ,regard to those for whom ,i chiefly write1 as far as my ,regard to ,decency admits2 but if any ,word should occur not easily understood by any of my ,readers1 almost any ,english ,dictionary will explain its ,meaning2 and it cannot be expected that any ,book can instruct those who cannot read1 tho' ,i am sorry to say too many such assume the ,office of ,midwives4 ,as ,curiosity may reasonably induce many of the ,sex concern'd in the ,subject of these ,sheets1 to be inform'd of somewhat of the ,provision supreme ,wisdom has made for the ,existence of ,children in the ,womb1 ,i shall briefly mention the most obvious ,instruments relating to their ,breeding and ,birth1 without puzzling my ,readers with minute anatomical ,descriptions4 ,the ,vagina1 or ,passage1 lies between the ,neck of the ,bladder and the large or strait ,gut2 it is connected at the inward extreme to the ,womb1 and called the outward ,orifice at its beginning4 ,the ,womb lies between the ,bladder and ,strait ,gut1 and is connected to both2 during the ,time of ,breeding it increases in its ,dimensions1 and rising higher in the ,body1 by ,reason of the ,weight and ,substance of it1 with its ,contents1 at the ,fund1 or remote ,end of it1 may be liable to swag too much forward or backward1 or incline more or less to either ,side1 especially in such1 as by their ,occasions of ,industry in ,life are obliged to a ,variety of indirect ,situations2 by which ,means the inward ,orifice is perverted from a direct ,site with ,respect to the ,passage1 and obstructs an easy ,exclusion of the ,infant in ,travel4 ,the ,placenta or ,after-birth1 adhering to the ,fund of the ,womb1 receives the ,mother's ,blood1 by the ,umbilical-,vessels1 or ,navel-,string1 conveys it to the ,child for its ,nourishment1 and retransmits what is superfluous2 maintaining by the ,intercourse of ,arteries and ,veins1 the ,circulation of the ,blood between ,mother and ,child4 ,the ,membranes closely connected to the ,placenta1 and the ,fund of the ,womb1 between both which they seem to take their ,rise1 contain the ,humours in which the ,infant swims1 the better to preserve it from ,injuries1 by its ,pressure against unyielding ,parts1 and the ,humours before1 and after the ,breaking of the ,membranes1 commonly call'd the ,breaking of the ,waters1 in the ,birth1 very much facilitate it1 by opening the inward ,orifice of the ,womb1 and lubricating the ,passage for the ,child3 ,these ,membranes come away with the ,placenta1 under the ,name of the ,after-birth1 or ,secundines1 indifferently4 ,the ,pelvis or ,bason1 wherein the ,uterus or ,womb is seated1 is form'd by the forward ,bones1 commonly call'd the ,share-,bone1 the ,hip-,bones and their ,continuation on each ,side1 and the lower ,part of the ,back-,bone1 all which are so contiguous to each other1 as to form this ,cavity1 generally much larger in ,women than ,men1 cloathed with ,muscles1 between which the ,vagina is inserted4 ,the right ,formation of the ,pelvis1 is of the greatest ,consequence in ,favour of an easy ,birth2 when the ,bones forming it1 forward and backward1 and on each ,side1 both above and below1 don't too much approach each other1 and prevent the ,exclusion of the ,child between1 by a free ,admission4 ,,chapter ,,iii4 ,the ,symptoms preceeding ,natural ,labours4 ,i shall pass over the ,symptoms of ,pregnancy1 and the ,distinctions of true and false ,conceptions1 as ,things of which ,midwives can seldom be expected to be proper ,judges1 and proceed to their ,business1 ,natural ,labours2 comprehending1 under this ,name1 all such ,cases1 which require no further ,assistance than ,midwives1 in a general ,way1 may easily give2 or in their ,absence a ,nurse1 or any sensible ,woman1 who has attended ,deliveries4 ,after the ,woman has gone her due ,time of ,nine ,months1 the most usual ,term2 the ,signs preceeding ,labour are ,pains about the ,back1 ,navel and ,loins2 a considerable ,falling of the ,tumour of the ,belly1 by the ,burden's sinking lower2 and incommoding the ,woman in walking2 a more frequent ,inclination to make ,water3 ,these ,symptoms increase in ,proportion as the ,birth approaches2 but as the most certain ,knowledge of natural ,births1 can only be obtained by ,touching the ,woman in ,labour1 after having premised some ,things concerning her proper ,situation2 ,i shall direct how it ought to be done4 ,,chapter ,,iv4 ,of ,,situation4 ,many in the ,country choose to be on their ,legs or ,knees1 supported by a ,woman on each ,side1 or lean on a ,chair or ,bed1 and pass well enough through the present ,scene of their ,miseries3 ,but ,i would preferably advise a ,posture between lying and sitting1 on a ,pallet or common ,bed1 the ,head and ,shoulders being rais'd by ,bolsters or ,pillows1 the ,feathers beat back from the ,bed's ,feet1 to support the hollow of the ,loins1 and prevent the ,pressure of any ,thing against the ,bottom of the ,back ,bone1 to obstruct the ,passage of the ,child4 ,this ,situation is most commodious1 during ,labour1 for a ,woman to assist her ,pains with the greater ,freedom of ,respiration1 and the least ,fatigue and ,expence of ,spirits2 especially if the labouring ,woman lay hold of a folded ,napkin1 held stiffly for that ,purpose1 drawing her ,feet upwards towards her ,seat1 separating her ,knees1 and fixing her ,feet against something that will not easily give ,way4 ,if the ,person in ,labour will not be in ,bed1 the ,end may be answered by her sitting in another's ,lap1 with the ,bottom of her ,back-,bone situate between the other's ,knees1 with her own separated and supported1 and ,feet fixed as aforesaid1 to favour her bearing down4 ',tis inconsistent with the ,design of my ,writing to describe all the convenient ,situations1 necessary in ,cases of ,difficulty1 yet when the ,operator has rectified all ,obstructions to the ,birth1 the same ,situation of the ,body upon a ,slope1 from the ,head downwards is most suitable1 even altho'1 for ,conveniency1 she should be deliver'd lying on one ,side4 ,i shall1 on this ,occasion1 observe1 what ,i have found ,advantageous in my own ,experience1 as well as consonant to the ,advice of the best ,writers on the ,subject3 ,that the ,delivery on the ,back1 by the ,assistance of one placed on each ,side1 supporting her by the ,hams1 with her ,knees separated1 and raising her ,back ,bone a little from the ,bed during the ,activity of ,pains1 and the ,midwife's ,assistance of either ,sex1 is vastly preferable to the ,delivery on one ,side1 to which ,i impute the ,loss of many ,children brought by ,turning1 as well as a more tedious ,labour in other ,cases2 because this ,posture1 in some ,degree1 contracts the ,passage1 and only admits the proper ,separation of one ,knee4 ,,chapter ,v4 ,concerning ,,touching4 ,this ought to be put in ,practice1 as soon as1 from the ,symptoms given in the ,third ,chapter1 it is reasonable to expect the ,birth approaching2 and a ,child-bearing ,person would be very much her own ,enemy to refuse the only ,means of giving a true ,information of her ,case1 and the ,knowledge how to do her the most effectual ,service4 ,the ,midwife1 having her ,nails well pared1 and very smooth1 and her ,fingers anointed with ,oil or ,lard1 must introduce the two fore ,fingers of either ,hand into the ,passage or ,neck of the ,womb1 as far as its inward ,orifice1 directing them with a gentle and easy ,motion1 somewhat upwards1 as it were with a ,tendency through the ,passage towards the ,navel2 in this ,search she will find the internal ,orifice1 joining the ,passage or ,neck of the ,womb more or less open1 relaxed1 and thinner than usual2 and cautiously protruding her ,fingers farther1 she may possibly touch the ,crown of the ,child's ,head2 she will easily1 by the ,sutures1 or ,opening between the ,bones of the ,skull1 distinguish the ,crown3 ,keeping her ,fingers in this ,situation1 during the ,beginning1 and ,continuance of strong ,pains1 she will observe the ,waters contain'd in the ,membranes including the ,child1 and ,after-birth forming within the inward ,orifice1 as if something like a ,bladder blown1 or distended with ,water1 presented to the ,touch1 dilating the ,orifice with each ,throw2 these ,appearances presage a speedy and easy ,birth4 ,,chapter ,,vi4 ,of a natural ,birth1 and the ,office of the ,midwife4 ,as the ,birth approaches1 the ,woman grows hotter and red in the ,face2 the ,pains bear more strongly down2 the internal ,orifice opens2 the ,vagina or ,passage1 at its ,entrance1 becomes more swell'd1 as the ,child's ,head advances2 and the ,membranes are more and more tensely stretched2 before the ,birth1 the ,person is often seized with a ,vomiting1 and universal ,tremor1 without the ,coldness of an ,ague2 and very often a ,humour1 discolour'd with ,blood1 immediately preceeds the ,breach of the ,membranes2 when these ,symptoms1 or several of them1 become urgent1 'tis ,time to put the ,woman in a proper ,situation1 as describ'd in the preceeding ,chapter3 ,the ,midwife ought by no ,means to break the ,membranes1 but encourage the ,woman now to make the best of her ,pains1 by strongly bearing down1 as if going to ,stool2 the ,midwife with her ,fingers well anointed1 putting them gently within the internal ,orifice1 may cautiously1 by separating them1 assist its opening1 and ,removing it more behind the ,child's ,head1 thereby gradually promote its more easy ,transmission1 and at the same ,time prevent1 if necessary1 the ,womb from being too far protruded3 ,after the ,waters are broke1 as it is called1 and the ,head of the ,child comes into the ,passage1 the ,midwife may lay hold on each ,side of it1 taking ,care not to bruise it by rough ,handling1 and drawing it1 by ,waving her ,hands1 if necessary1 to loosen it1 when fixed1 rather than in a strait ,line1 assist the ,birth2 and if obstructed by the ,shoulders in the ,passage1 inserting a ,finger under each ,arm-,pit1 extricate them by the like ,action4 ',tis true1 it happens1 tho' unobserv'd by ,writers1 as far as ,i remember1 that many ,women have no ,waters breaking away1 either before or after the ,birth2 whether absorbed or not1 in ,time of ,labour1 ,i shall not at present determine2 this is called1 by the ,country ,people1 a dry ,labour1 and often attended with ,difficulty2 however1 if the ,crown appear forward1 the ,issue may nevertheless be favourable4 ,the ,child being born1 the next ,business is to tie the ,navel-string with a waxed ,thread1 so doubled1 as not to endanger cutting1 about two ,inches from the ,child's ,body1 making another ,ligature near the ,body of the ,mother1 so far distant from the former1 as may be convenient for ,cutting between both ,ligatures1 and separating the ,infant from its ,after-birth4 ,midwives are too apt to leave a greater ,length1 which can be of no ,service1 but has been thought1 on the contrary1 by our ,countryman ,,chapman1 to occasion ,navel ,ruptures4 ,after the ,separation of the ,navel-string1 the ,care to get the ,after-birth succeeds2 this will often come by the ,assistance of ,nature1 with a gentle ,motion of the ,hand gradually drawing and loosening it1 by the ,navel-string3 ,but if it adheres to the ,fund of the ,womb1 which is frequently the ,case1 whether from the ,waters being come away before the ,birth or otherwise2 it must cautiously be separated1 and extracted by the ,hand1 to prevent the most mischievous and fatal ,consequences4 ,the ,assistant holding the ,navel-string with one ,hand1 must with great ,caution introduce the other into the ,womb1 avoiding all ,violence to any ,part in the ,way1 'till she reaches the ,after-birth1 some ,part of which probably1 being loosened1 will be found more forward than the rest2 which taking between her ,thumb and ,fore-,fingers1 she must1 by an easy ,motion of her other ,fingers1 between the ,womb and ,after-birth1 gradually separate the ,parts adhering all round1 'till finding the whole free1 before the ,palm of the ,hand and ,fingers1 she brings it intirely away2 for should any ,part remain1 the poor ,woman's ,labour would still continue1 and occasion dangerous ,floodings1 requiring the immediate ,assistance of an able ,hand1 to rescue the ,patient from the immediate ,hazard of ,death4 ,sometimes when the ,womb has discharged its ,waters1 and the ,child1 by ,reason of a ,defect of ,pains1 or otherwise1 remains long very forward near the ,birth1 the ,womb so contracts about the ,after-birth1 as to make the ,separation of it very difficult2 in which case ,assistance is requisite1 from one well acquainted with the ,structure of the ,body2 and the longer this is delay'd1 the more ,danger there will be of all the bad ,consequences of the ,retention1 and ,corruption of the ,after-birth in the ,body4 ,it requires great ,care to prevent the ,protrusion of the ,womb in some ,women of a large ,pelvis1 or ,opening between the ,bones2 or if the ,after-birth remains closely fixed1 the ,womb1 in a very open ,pelvis1 may be thrust by the ,violence of the ,pains2 or drawn out of the ,body by an unskilful ,hand1 which is commonly very soon fatal to the poor ,woman2 and ,i believe happens much oftner than is apprehended1 tho' industriously conceal'd1 by guilty ,midwives1 under the ,colour of the poor ,woman's dying in ,child-bed1 from some other ,cause4 ,,deventer says1 he saw a sad ,spectacle at the ,,hague1 the ,head of the ,child excluded to the ,shoulders quite without the ,passage1 when ,three-fourth ,parts of the ,head were conceal'd within the ,womb1 the ,crown appearing within its inward ,orifice4 ,see ,chir4 ,op4 ,part ii4 ,page #cb4 ,a much worse ,case happen'd in my ,neighbourhood1 ,sept4 #bc1 #agdi4 ,i was call'd to a ,woman1 whose ,child1 on the #bast came unexpectedly1 without the least ,assistance1 in the ,presence of an old ,midwife of large ,practice2 she puzzled an ,hour1 as ,i was inform'd1 to bring away the ,after-birth1 which closely adhered to the ,fund of the ,womb2 while the unfortunate ,woman lay senseless1 saving the ,memory of being long expos'd to the ,cold1 when she came to herself2 after which she continued in violent ,labour-like ,pains2 upon ,scrutiny1 ,i found a large ,substance in the ,pelvis1 of the ,size of a ,child's ,head1 considerably resisting my ,touch2 ,i observ'd on ,trial1 a ,part of the ,woman's ,body every ,way interposed between my ,fingers and this ,substance1 by her ,sensibility of my ,touch2 therefore contenting myself with giving her some palliative ,medicines1 and telling the ,persons present1 a ,mole1 as ,i thought1 or ,child still remain'd to come away1 ,i for that ,time1 took my ,leave3 ,on the #bdth1 she was said to be much better2 on the #bith1 ,i was again call'd to this poor ,woman1 and inform'd1 that upon her first going to ,stool1 since ,i had before seen her1 which happen'd the same ,day1 the large ,substance before-mention'd1 came intirely out of her ,body2 to which it join'd by a thinner ,substance1 of some length3 ,i now perceived it was no less than the ,womb turned inside out1 suspended by its ,ligaments1 and joining to the ,vagina1 but very much swell'd by the ,obstruction of the circulating ,humours2 ,and an old ,gentlewoman1 who was present when the ,child was born1 inform'd me1 she saw the ,midwife draw this ,body from the ,woman1 by the ,navel-string1 and indeed1 the ,impression of her ,nails1 in separating the ,after-birth1 remain'd still visible at the ,bottom of the ,womb1 and the ,midwife having long expos'd the ,patient1 put this inverted ,womb again into her ,body4 ,the ,condition of the ,part1 after so long ,delay1 did not admit the ,possibility of rightly reinstating it2 ,i therefore return'd it1 as well as ,i could1 into the ,pelvis1 and introduc'd a ,pessary to retain it2 and as this ,person had already contracted a ,hectick1 ,i charg'd her1 as she valu'd her ,life1 to confine herself strictly to a cooling ,milk1 or vegetable ,diet2 she has since had large ,discharges of a bloody ,corruption1 with ,portions of a fleshy ,confidence from the ,parts affected4 ,in ,april1 #agea1 she told me the ,discharge coming from her had long been much abated in ,quantity1 and what remain'd was the ,whites2 that she had an inward ,fever1 and the ,piles1 for which ,i gave her my ,advice2 her ,complexion was chang'd from the most florid to a languishing ,paleness4 ,my ,brother1 much better known in this ,country1 and longer practis'd in ,midwifry1 has been concern'd in furnishing ,medicines for the ,person1 whose ,history ,i have given1 altho' by ,means of his ,absence1 he did not attend her on the most emergent ,occasions4 ,i have since been call'd to the ,assistance of the old ,midwife1 who attended1 and she frankly told me1 she had another ,woman under the like ,circumstance1 who died the same ,day4 ,having related such ,things as occur in the most favourable ,circumstances of ,travil1 about which all ,midwives ought to be well inform'd1 and those ,injuries to which ,women are sometimes liable1 notwithstanding the most promising ,appearances3 ,in the next ,place ,i proceed to shew1 what are the ,symptoms preceeding difficult ,labours1 which by timely ,assistance1 may be secured from the most dangerous1 if not fatal ,consequences1 and are of great ,moment to be known by ,midwives1 as well as ,matrons and ,child-bearing ,women1 to enable them to judge when it is absolutely necessary to recommend calling that ,aid1 which is beyond their ,capacity to give4 ,,chapter ,,vii4 ,the ,difficulty from the ,membranes4 ,an unforeseen ,difficulty may occur1 when ,appearances are otherwise favourable1 from the ,strength of the ,membranes1 obstructing the ,birth1 and requiring great ,caution to prevent2 for in this ,case1 the ,operator must break the ,membranes1 in order to promote the ,birth2 and as the ,waters1 they contain1 are a ,means to open the internal ,orifice1 lubricate the ,passage1 and facilitate the ,birth2 the breaking the ,membranes too soon1 will render the ,labour more tedious2 and should it be too long delay'd1 the ,patient's ,misery would be prolonged2 wherefore the ,midwife must not break them1 before the ,orifice is sufficiently open to admit the ,head1 when she may tear them with her ,nails1 but by no ,means pull them1 for as they adhere to the ,after-birth1 she might by that ,means separate it1 and bring on a ,flooding4 ,,chapter ,,viii4 ,difficulties occasion'd by the ,navel-,string4 ,the ,navel-string1 by a ,variety of ,convolutions1 sometimes obstructs the ,birth1 for being shortned1 by its ,contortions about the ,neck1 or any ,part of the ,body1 the ,labour will become unnatural1 by ,reason tho' the ,pains are strong1 the ,navel-string1 by its shortness1 will pull the ,child back with each ,pain2 and here an unskilful ,management may break the ,string1 and occasion a dangerous ,flooding2 but as the ,woman's ,pains will prove ineffectual1 notwithstanding their ,strength and ,force1 the ,midwife will1 by this ,means1 find the ,case out of her ,province2 ,i mean1 where the ,navel-string is very much abbreviated4 ,if the ,navel-string comes forward before the ,child's ,head1 it will seldom remain1 when put backward by the ,hand2 therefore1 if the ,midwife has any ,regard for the ,life of the ,child1 she ought to call for ,assistance1 before the ,birth is further advanc'd1 or it will be extremely difficult1 if not impossible1 to save the ,infant2 and she would probably be foil'd for want of sufficient ,strength1 had she ,skill to save it4 ,,chapter ,,ix4 ,difficulties from the ,placenta or ,secundines4 ,the ,placenta or ,after-birth1 being from any violent ,shock or ,accident1 more or less1 separated from its ,seat1 during any ,time of ,breeding1 will produce a ,flooding1 in ,proportion to its ,quantity1 dangerous1 which is sometimes so violent1 as to occasion ,death in an ,hour's ,time2 and nothing but instant ,delivery can prevent it4 ,when the ,case is not so desparate1 as all the ,blood in the ,mother's ,body1 necessary to support her own and ,infant's ,life1 may be drain'd away1 the ,consequence may be equally fatal in a more lingering ,way4 ,the #bfth ,feb4 #agdh1 ,i was sent for to a ,woman at ,,mountain-,,deverel1 within about ,five ,weeks of her ,time1 in a violent ,flooding2 her ,midwife gave her an ,opiate1 which she thought check'd her ,flooding1 excepting that once a ,week1 it became very violent1 for about three ,weeks past2 when ,i came1 the ,neighbours told me she had lost a ,pail full of ,blood2 the poor ,woman was so weak1 that her ,pulse were scarcely perceptible1 and her ,voice but a ,whisper2 ,i was unwilling to meddle1 for fear she should die under my ,hands1 but yielded to the ,importunity of her ,friends3 ,it was with great ,difficulty ,i introduced the ,tops of my two ,fore-fingers and ,thumbs into the internal ,orifice1 which ,i gradually dilated1 'till ,i could pass my ,hand1 when by turning1 ,i brought away a dead ,child1 depriv'd of its ,nutriment by the great ,loss of its maternal ,blood2 but had considerable ,trouble in getting the ,after-birth1 by ,reason of its ,adhesion3 ,after ,delivery1 the ,flooding immediately very much abated1 the poor ,woman reviv'd to ,admiration1 and ,i left her the next ,day1 as well as could be expected in so low a ,circumstance1 tho' dubious of her ,recovery3 ,i heard she died five or six ,weeks after2 but ,i am well satisfied1 had she had an earlier ,recourse for ,assistance1 she might have recover'd4 ,in these ,cases1 ,midwives are too apt to trust to their own ,judgments1 instead of calling for better ,assistance2 and tho' they have ,recourse to external ,applications1 ,ligatures1 and ,opiates1 these ,things1 injudiciously practis'd1 are frequently more detrimental than beneficial3 ,for ,instance1 should the ,arteries be compress'd by too tight a ,ligature of the ,arms and ,legs1 the ,flooding would become more violent4 ,when ignorant ,midwives1 by rashly pulling the ,navel-string1 break it1 or by the ,adhesion of the ,after-birth1 find it out of their ,power to bring it away1 they are apt to persuade ,people1 it will come without further ,help1 which seldom happens2 on the ,contrary it most frequently occasions ,death1 more or less suddenly1 or ,hecticks and ,consumptions1 when left to corrupt in the ,body3 ,the ,uterus sometimes so strongly contracts about1 and embraces it1 that it may be impossible1 after a few ,hours ,delay1 to procure it1 as ,i found in a ,case that occur'd to me at ,,colehorn1 the #cjth ,sept4 #agdh1 tho' little more than four ,hours passed1 from the ,time the ,midwife broke the ,string close to the ,placenta1 for the ,part of the ,uterus next the ,placenta was so contracted1 as barely to admit the ,tops of my two ,fore-fingers2 ,i endeavour'd1 with all possible ,caution1 to make a larger ,aperture1 but in the ill ,situation of the ,uterus1 at the ,extent of my ,reach1 all my ,attempts were in ,vain2 this ,woman rested well the succeeding ,night1 and had no extraordinary ,complaints when ,i left her in the ,morning1 first prescribing what ,i thought most suitable to her ,condition3 ,i afterwards heard she died with a ,frenzy1 succeeding a ,suppression of the usual ,purgations2 where the ,corruption of the ,placenta takes ,place1 the ,case is1 at least1 more ,chronical1 and the ,secundines1 gradually wasting1 come away ,piece-meal1 the ,patient labouring under a ,hectick from the ,contagion of putrid ,humours1 mixing with the circulating ,fluids4 ,i have at other ,times1 after a longer ,delay1 been more successful2 the #bhth ,december1 the same ,year1 ,i was call'd1 by ,order of the late ,lord ,,weymouth1 to the ,assistance of a poor ,woman at ,,hornisham1 whose ,after-birth had been retain'd three ,days2 she had contracted a ,fever from its ,putrefaction1 which was so great1 that scarcely any ,body could bear the ,room1 and had lost a great deal of ,blood by ,flooding2 the poor ,woman soon recover'd after her ,delivery1 in the ,use of a little ,medicine1 from his ,lordship's ,house3 ,i have seldom found the ,business difficult1 when speedily call'd in the like ,cases4 ,,chapter ,x4 ,difficulties attending the ,contraction1 or ,ill-site of the ,inward ,orifice4 ,in the ,fifth ,chapter ,i have told1 how the ,midwife may judge1 by touching1 of an easy ,birth2 carefully introducing her two ,fore-fingers into the ,passage1 to find the internal ,orifice of the ,womb in the ,beginning of ,labour2 now1 in doing this1 if the ,orifice1 she is in ,search for1 does not readily occur1 she has great ,reason to apprehend ,difficulty2 and if not well acquainted with the ,parts she handles1 by rude ,usage1 piercing through any ,part of the ,vagina1 which presents to the ,touch1 may do ,mischief4 ,such an ,injury was done to one of ,box1 where ,i was called ,sept4 #ba1 #agdh4 ,this ,woman had been in ,labour several ,days2 the ,midwife having1 the last ,time1 been with her eighteen ,hours1 the ,pole of the ,child's ,head lay upon the ,share-bone1 which was rectifyed by one ,limb of the ,extractor and brought into the ,passage2 the other ,limb being joined1 the ,infant was soon born2 but what before surprized me1 was to find a ,passage1 for my ,fingers1 considerably remote from the internal ,orifice1 with great ,complaints of a smarting ,pain when ,i touch'd it2 a ,suppuration follow'd1 but the ,woman soon recover'd1 after the frequent ,use of an emollient and discutient ,fomentation4 ,when the ,orifice presents rightly1 and is easily found1 it is next of ,consequence to observe1 whether the ,pains relax1 open and enlarge it2 for should it remain thick and contracted1 instead of relaxing and growing thinner1 if the ,infant comes rightly directed1 the ,woman's ,pains are not genuine but spurious2 it will then be proper to give an emollient and carminative ,glyster1 and probably the false ,pains will be reliev'd1 and the true succeed2 or some ,time may intervene1 before her true ,labour1 especially if the full ,time of ,breeding should not be expired4 ,if the ,midwife cannot reach the internal ,orifice1 and the ,child's ,head lays high1 the ,orifice may possibly lay high1 backwards or forwards1 or more or less so1 inclining ,sideways2 the ,reason of which may be apprehended1 from the brief ,account of the ,womb1 and the ,pelvis1 in the ,second ,chapter4 ,in this ,case it may be with great ,difficulty1 the ,assistant can reach the nearest ,margin of the internal ,orifice1 tho' well instructed and experienced1 and it will often require the ,hand of an expert ,artist1 early in ,labour to rectify it1 or turn the ,child1 when ,travil is advanced2 or if too long neglected may occasion the ,death of one1 or both ,mother and ,child4 ,,chapter ,,xi4 ,difficulties attending a wrong ,position of the ,child's ,head4 ,if in the ,progress of ,travil1 the ,midwife perceives any ,part of the ,head1 besides the ,crown1 discoverable by its ,sutures1 presenting1 and it appear broad1 and very hard to the ,touch3 ,if the ,waters may be felt descending in a long ,form through the internal ,orifice1 somewhat like a ,piece of a ,gut distended with ,water3 ,these ,appearances presage the utmost ,difficulty and ,danger1 commonly owing to the small ,distance between the forward and back ,bones2 an ill ,situation of the internal ,orifice2 the comparative ,largeness of the ,child's ,head2 or the ill ,site of the ,womb2 whereby the ,head may be pressed against the ,bones forward or backward1 or somewhat inclined to either ,side1 in a wrong ,direction for the ,passage4 ,these ,causes1 singly or concurring1 render the ,case much beyond the ,skill1 and very often the ,strength1 of a ,midwife to redress4 ,when unqualified ,midwives observe the ,head present to the inward ,orifice1 they are too apt to promise good ,success1 and behave with the utmost ,confidence1 wherein they are often egregiously mistaken2 for there cannot be a more difficult ,birth1 than frequently happens1 when any other ,part1 instead of the ,crown1 offers2 and the ,misfortune is1 the longer ,recourse to proper ,assistance is delay'd1 the greater the ,difficulty becomes every ,moment2 and the poor ,woman may think herself happy1 if she escapes with her ,life1 the ,danger of a most fatiguing and tedious ,labour1 succeeded1 perhaps1 by such a ,relaxation of the ,vagina or ,passage1 as will occasion great ,uneasiness in going1 or being in an upright ,posture1 without the immediate ,help of ,medicines1 both externally and internally2 or wearing a ,pessary for its ,support1 during ,life4 ,whereas 'tis certain1 that if the ,mother's ,pains1 strongly bearing down1 the ,muscles of the ,belly contracting and becoming sensibly hard to the ,touch1 don't manifestly promote the ,birth1 it must needs be owing to some ,obstruction beyond the ,midwife's ,skill2 who in this ,circumstance is apt to complain1 the ,pains are not sufficiently strong1 'till the poor ,woman is ready to expire1 from the ,loss of her ,strength1 by her long ,suffering under them2 and told she must patiently wait ,god's ,time1 who in ,case he miraculously interpos'd1 wants not the ,midwife's ,assistance3 ,and what still adds to this deplorable ,calamity1 'tis likely she is put upon exerting her utmost ,strength1 assisted by ,cordials2 when encouraging her ,labour and provoking her ,pains1 'till the ,obstructions in the ,way of the ,birth are remov'd1 contribute still further to the ,danger attending4 ,i don't deny but that in some ,cases1 a tedious ,labour may be owing to a ,defect of sufficiently strong ,pains2 but as this often proceeds from ,circumstances obstructing the ,birth1 true ,labour naturally takes ,place1 when they are remov'd2 and1 by a right ,management of the ,hand1 is more effectually promoted1 without ,cordials or forcing ,medicines1 where the ,pains are deficient4 ,under this ,sort of unnatural ,birth1 may very well be enumerated1 the ,face presenting towards the ,mother's ,belly1 or the ,side of the ,head coming ,foremost1 for its ,passage must be extreamly difficult in these ,postures2 as well as when the ,face comes forward2 for then by ,reason of the great ,tumour1 about the ,head1 ,face1 ,eyes1 and ,mouth1 from ,lodging between the ,bones1 the ,infant expiring in the ,birth1 has been often taken for a ,monster4 ,i have often been so happy1 when the ,head has long remain'd1 wedg'd between the ,bones1 as to bring the ,child alive1 by the ,forceps1 in a few ,minutes1 if seasonably call'd1 when the ,woman in ,travil has been in the utmost ,danger of ,death4 ,the #eth of ,may1 #agea1 ,i met with as bad a ,case1 as most of this ,kind at ,,wiggleton3 ,this ,woman1 by the ,midwife's ,account1 seem'd to be in ,labour at ,times near a ,month1 and for a ,week last1 almost in continual ,pain1 with her first ,child3 as ,i was call'd late to her ,assistance1 ,i could not judge1 by early ,appearances1 of the ,situation of the ,uterus1 or ,infant2 this is most commonly only in the ,power of the ,midwife to observe2 her ,waters had gradually drain'd away above a ,week1 and there still remain'd some ,part of the ,membranes depending like a ,gut in the ,vagina1 the ,head offer'd1 firmly wedg'd in the ,pelvis2 the ,part most obvious to the ,touch1 by its ,softness and fleshy ,consistence1 seem'd to be the ,cheek3 ,the poor ,woman's ,pains1 for some ,hours1 were ineffectual for want of ,strength1 her ,spirits being exhausted1 by a ,labour so fatiguing2 there was no ,possibility of turning the ,child2 ,i endeavour'd1 with some ,success1 to promote the ,birth1 by bearing strongly against the inferior ,part of the ,os-sacrum1 but her ,weakness1 depriving me of the small ,benefit of her ,pains1 ,i had for a ,time2 there was an absolute ,necessity for a speedy ,delivery1 for the ,mother's ,sake3 ',twas with some ,difficulty ,i overcame her ,prejudice1 and those ,present against the ,use of any ,instrument1 tho' at length they yielded2 when introducing a ,limb of the ,extractor on each ,side of the ,head1 and ,co-operating with a small ,pain1 encouraging the ,woman to bear down as strongly as she could1 ,i immediately brought a ,daughter1 with a monstrous long ,head alive4 ,i ,,have1 however1 met with some ,cases1 which ,i could relieve by no better ,method1 than lessening the ,head2 but considering for whose ,benefit ,i am chiefly ,writing1 and how dangerous the ,use of ,instruments may be in injudicious ,hands1 ,i rather choose to advise ,women not to meddle with them1 than pretend to relate the ,method of using them4 ,,chapter ,,xii4 ,difficulties from other ill ,positions of the ,infant4 ,the ,arm or ,shoulder presenting1 is so well known to be attended with ,difficulty1 that few ,women will attempt such ,deliveries1 unless they are so very ignorant1 as to imagine they can bring the ,child by pulling at an ,arm4 ,as our ,miscarriages1 or rather ,misfortunes1 in ,practice1 may no less contribute to the ,information of others1 by ,caution1 than our ,success1 by ,example2 ,i shall not scruple to give a candid ,relation of the most fatal ,occurrence1 which ever fell to my ,lot4 ,the #abth ,september1 #agdh1 ,i was called to a ,woman at ,,troubridge1 her ,matrix lay forward in a prominent ,abdomen hanging very low1 the ,os-uteri ,internum lay very much backward1 both ,hands presented to it1 this ,woman had been very ill the preceeding ,week1 and in extreme ,misery the last ,twenty-four ,hours2 with a great deal of ,trouble1 ,i got and drew towards me one ,foot1 with the ,heel turn'd towards the ,mother's ,belly2 in drawing the ,infant so far as the ,arm-pits1 ,i found the ,face of the ,child did not turn so readily as ,i expected towards the ,mother's ,back2 as soon as ,i had brought the ,feet some ,distance without the ,vagina1 while ,i endeavour'd to extract the ,child by hold of its ,thighs1 the ,midwife1 unknown to me1 officiously laying hold of the ,infant's ,feet1 exerted her ,strength at the same ,time with mine2 ,i intended to leave the ,arms according to ,,deventer1 as a ,security to the more safe ,transmission of the ,head2 and while our united ,strength was exerted1 ,i found the ,neck gave way1 with something of an audible ,crack2 and with some ,surprize1 looking about me1 saw the ,midwife labouring at the ,child's ,feet1 and check'd her1 as acting very rashly1 without my ,direction2 thus we had really separated the ,spine of the ,neck1 and the ,head only adhering to the ,body by the ,skin1 was with little or no ,force separated from it3 ,in passing my ,hand1 after a tye on the ,navel-string1 ,i found the ,head fell back into the prominent ,part of the ,abdomen1 insomuch that ,i could only reach the separated ,part of the ,neck1 and ,i endeavour'd1 in vain1 to get hold of the ,head by the ,crotchet3 ,while ,i was thus employ'd1 a ,flooding came on1 by the ,separation of the ,placenta1 which quick'ned my ,endeavours1 from the ,apprehensions of her sudden ,death1 if she was not immediately deliver'd2 but the poor ,woman1 much spent with ,fatigue and ,loss of ,blood1 begg'd ,i would desist1 preferring ,death to ,life2 in which being join'd by the ,people present1 and not a little exhausted of ,spirit and ,strength myself1 ,i was1 much against my ,will1 obliged to leave her to her ,fate4 ,here ,i would observe1 it appear'd the ,body was that of a large ,boy1 and tho' ,i find ,,giffard and others made no ,scruple of leaving the ,arms of a small ,child1 ,i must join with them in advising not to bring a large one1 without first procuring the ,arms2 tho' ,i will not say1 whether the ,method of delivering on one ,side instead of the ,back1 the lower ,part somewhat raised from the ,bed1 at the same ,time encouraging ,labour with ,hopes of immediate ,delivery1 recommended by ,,deventer1 may not occasion the ,danger of leaving the ,arms4 ,there are ,variety of other wrong ,situations1 and ,cases of ,difficulty1 which ,i could illustrate by ,examples in my own ,practice1 and may be found in the ,observations of ,,mauriceau ,,de-,,la-,,motte1 ,,giffard and others1 for the ,information of such as practise ,midwifry1 that have no ,relation to the ,information of ,midwives1 either in their own ,practice1 or ,occasions of ,assistance4 ,,chapter ,,xiii4 ,of ,,twins4 ,the ,case of ,twins may1 in many ,country ,places1 be esteemed beyond the ,skill of ,women practicing ,midwifry2 but as they are not alike ignorant1 and this ,delivery1 with a right ,management1 is attended with no great ,difficulty1 ,i shall describe it as plainly as ,i can4 ,if a ,child comes naturally by the ,force of the ,mother's ,pains1 and the ,after-birth does not easily follow1 the ,midwife1 by passing her ,hand to separate its ,adhesion as directed in the sixth ,chapter1 will readily find whether another ,child still remains to be born1 by the ,appearance of other ,membranes1 including ,waters1 c4 ,and as where more than one is to be born1 they are generally proportionably smaller1 and tho' the first ,child comes naturally1 the second may not1 she need not wait for the ,birth of the other1 by the meer ,force of ,nature1 for this would greatly hazard the ,life of the ,child1 and sometimes of the ,mother1 by a ,flooding2 but ought to break the ,membranes1 and search for the ,feet1 carefully preventing their being intangled with the ,navel-string2 and having got both in her ,hand1 draw them into the ,passage2 if the ,child's ,toes point to the ,mother's ,back1 there will be no ,danger of the ,chin or ,nose being hung on the ,bones before1 and she may draw the ,feet forth with the rest of the ,body1 without delaying to bring down the ,arms1 encouraging the ,mother to assist in the mean ,time1 by bearing down with or without ,pains4 ,in ,case the ,child's ,toes should point to the ,mother's ,belly1 the ,midwife1 in drawing the ,child forth from the ,hips forward1 must gradually turn the ,belly of the ,child towards the ,mother's ,back1 by the ,assistance of the other ,hand in the proceeding4 ,if the ,woman be straiter1 or the ,child larger1 than ordinary1 when she has brought the ,infant into the ,passage somewhat short of the ,arm-pits1 she must1 by introducing her ,fingers1 first over one ,shoulder1 cautiously bring down one ,arm1 and then in like ,manner the other1 and drawing the ,child forward1 she must make ,use of both ,hands to extricate the ,head2 the ,fingers of one ,hand between the ,mother's ,back and ,child's ,jaws1 bearing and drawing them from the ,back-bone1 and with the ,fingers of the other ,hand over the ,shoulders1 and the flat against the ,child's ,back1 draw it forth1 the ,mother as aforesaid assisting all the while4 ,writers advise putting two ,fingers into the ,child's ,mouth2 but as great ,injury has often been done that ,way1 it is much safer to bring the ,child by bearing with the ,fingers against its ,jaws4 ,if an ,arm should be broke in bringing down1 let it be spliced with thin ,paste-board1 and bound at its full ,extent to preserve its right ,shape4 ,in fetching an ,infant by turning1 'tis necessary to draw its ,feet into the ,passage1 with the ,toes situate towards the ,infant's ,belly1 for it may be extreamly difficult1 if not impossible1 to draw it backwards1 contrary to the natural ,bent of its ,thighs and ,back2 and a ,limb may sometimes as easily be pull'd off1 as the ,child brought to the ,birth this ,way2 the ,midwife must therefore make ,use of the right1 or left ,hand in doing it1 which happens to be most convenient1 to the natural bending of the ,infant's ,body4 ,i ,,think it cannot be safe for a ,woman to turn a ,child upon ether ,occasions requiring it2 their ,strength1 as well as ,skill being frequently inferior to the ,task2 besides1 there may be great ,danger of injuring the ,vitals of the ,mother in other ,cases1 especially after the ,operation is unseasonably delay'd4 ,as each ,child has a ,navel-string1 as well as ,after-birth belonging to it 7tho' both ,placenta's are sometimes so joined as easily to be distinguished7 the ,care respecting the ,navel-string1 already related in the ,sixth ,chapter1 must of ,course be taken for the ,first-born1 and its ,secundines left1 'till after the ,birth of the ,second1 when both1 if necessary1 must be separated and brought away1 as there advis'd1 with ,regard to one alone1 and the ,navel-string of the last ,infant tied after the same ,manner as in the ,birth of one ,infant4 ,,chapter ,,xiv4 ,of a ,dead ,child4 ,a ,dead ,child is often born with abundantly more ,difficulty than a living one1 for the last by its ,struggles considerably promotes its own ,birth2 whereas1 the first lies immoveably in the same ,posture1 without changing ,situation by its own ,activity4 ,when the ,death of the ,child proceeds from any accidental ,injury1 the breeding ,woman commonly knows it1 by the ,perception of a ,weight within her1 in the ,part where it lies1 instead of its usual ,motions1 which from that ,time cease1 and occasion1 not without ,reason1 a ,solicitude for the best ,assistance4 ,one of my ,neighbours1 whom ,i lately deliver'd1 had the ,misfortune to fall flat on her ,face1 between the #gth and #hth ,month of her ,pregnancy2 from which ,time to that of her ,labour1 above three ,weeks after1 she had a continual ,sensation of a ,weight within her1 without any of the ,child's ,motions1 as before this ,accident1 although it was not succeeded by a ,flooding1 as is common upon a partial or total ,separation of the ,placenta3 ,she had frequently been attacked with ,pains resembling ,travil1 for above two ,weeks before it came on effectually2 in this ,case after ,i had brought the ,child by turning1 ,i found the ,secundines extremely offensive1 by ,reason of their ,putrefaction4 ,from ,causes less manifest1 'tis a ,thing more precarious to judge of the ,infant's ,death2 the ,woman in ,travil has not perceived the ,motion of the ,child for some ,days1 while it was yet living2 a cadacerous ,smell is not infallible2 the coming away of the ,child's ,excrement1 may proceed from the ,compression of its ,abdomen in the ,birth1 especially when the ,buttocks present2 these ,appearances therefore can only be a ,foundation at best for probable ,conjecture2 nothing short of the ,peeling of the ,cuticle or ,scarf-,skin of the ,child upon ,touching it1 can be a certain ,token of its ,death4 ,,chapter ,,xv4 ,the necessary ,care of a ,mother and ,child4 ,after ,delivery1 tis too universal a ,practice to palliate the ,after-pains by ,opiates1 which if given beyond the ,proportion1 necessary to take off the ,spasms attending1 are mischievous1 tending to obstruct the natural ,cleansings1 so absolutely necessary to succeed2 and as these ,pains cease of ,course for the most ,part in two or three ,days1 it were much better to have recourse to ,sperma ,ceti dissolv'd with the ,yolk of an ,egg in a ,draught of ,caudle1 or a ,linctus of ,sallad ,oil and ,sugar1 if ,oil of ,sweet ,almonds cannot be had fresh1 as often as the ,pains are violent4 ,particular ,occasions may indeed require other ,methods1 but then 'tis best to be well advis'd1 whether ,opiates1 or other ,medicines are necessary4 ,during their ,purgations1 the ,woman1 in ,child-bed1 ought to be kept warm1 from all ,danger of taking cold1 to a ,degree of sensible ,perspiration1 and if she has no ,stool by the third ,day1 which commonly brings1 with the ,milk1 a feverish ,heat1 a ,kitchen ,glyster ought to be given and repeated in costive ,habits1 as there is ,occasion4 ,i ,,shall conclude with some ,things of the ,care of ,infants newly born2 a ,subject the more interesting1 as our ,natives are known greatly to decrease from the free ,use of ,spirituous ,liquors2 which ,loss might in some ,degree be repaired by a better ,care of their ,offspring1 who are not only expos'd to suffer by the ,ignorance of ,midwives1 but must undergo a second ,martyrdom from swadling and cramming4 ,their fond ,nurses greatly contribute to the general ,cause of all their ,distempers1 ,indigestion1 frequently feeding them 'till they return it by the ,mouth1 which under these ,circumstances1 unless supply'd by a ,looseness1 is the only ,means of their ,preservation from more immediate ,death4 ,this ,overcharge of their ,stomachs1 producing ,crudities1 gives them the most excruciating ,pains in their ,bowels2 occasioning very often ,fevers and ,convulsions1 and yet their ,cries are customarily appeas'd by more ,food1 furnishing an ,encrease of sharp ,crudities in their ,bowels2 and 'tis well if ,syrup of ,poppies1 ,godfrey's ,cordial1 or some other ,opiate1 be not given to stifle their ,complaints1 but in ,effect to encrease the ,mischief1 by confining the ,acrimony of an ,overload within them4 ,infants are born with their ,stomachs and ,intestines charged with the ,recrements of the ,humours in which they swim1 before ,birth1 and the glandular ,secretions within them1 which will naturally purge away with the first ,milk they draw from the ,mother's ,breast2 and they would sleep1 were they not too soon fed1 'till this ,provision of ,nature is ready for them1 as ,dr4 ,,cadogan found from ,experience in his own ,family2 but as the ,humour of ,feeding them sooner generally obtains1 and the ,mother too often is not the ,nurse2 ,half a ,drachm of ,castile ,soap diffolv'd in a ,spoonful or two of thin ,caudle1 and sweetened with ,honey1 would cleanse the ,child1 and prevent many ,distempers1 owing to a ,retention of ,impurities within them before the ,birth1 if given soon after4 ',tis well worth remarking1 that the ,food the ,nurse takes communicates its ,nature to the ,milk1 so that the ,child may be intoxicated by her giving ,suck too soon after strong ,drink or ,spirituous ,liquors1 by which ,means many are destroy'd2 it is likewise well known1 if the ,nurse takes a ,purge1 her ,milk will purge the ,child4 ,this informs us1 that when the ,child is troubled with ,gripes1 attended with green1 sour-smelling ,stools1 the ,mother1 or ,nurse1 by being confin'd to an ,animal ,diet1 will1 in a great ,degree1 prevent the ,gripes1 ,looseness1 or ,convulsions1 occasion'd by the ,acidities of the ,child's ,stomach and ,bowels1 from the contrary ,qualities communicated to her ,milk4 ,on the ,contrary1 a vegetable ,diet will greatly relieve the same ,complaints1 attended with strong smelling ,stools1 and a ,tendency to the ,putrefaction of the ,humours1 and the ,child's ,spoon-meat1 when any ,thing is given besides the ,mother's ,milk1 may be regulated accordingly3 ,in the mean ,time1 in both ,cases1 these ,indigestions ought to be purged off with a few ,grains of ,rhubarb1 or double the ,quantity infus'd at ,night in a ,spoonful of common ,drink1 strain'd and sweetened with ,honey4 ,this1 with a suitable and commodious ,dress1 leaving them ,freedom for all their ,motions1 taking ,care not to fill them with ,crudities1 by over-charging their ,stomachs1 would preserve the ,health of young ,children1 they would then sleep away most of their ,time1 without those continual ,cries of ,misery1 calling on the ,compassion of all about them1 whereby abundance of ,trouble to their ,nurses1 and the continual ,occasion of ,medicines1 to sweeten and purge away the ,effects of ,indigestion1 would be prevented4 ,,finis4 ,,transcriber',s ,,note ,original spelling and grammar were generally retained4 ,the following two corrections were made in conformance with the spirit of the list of errata on page vi4 ,page #i1 l4 #af4 8,pains about the ,navel and ,loins0 was changed to 8,pains about the ,back1 ,navel and ,loins04 ,page #cc1 l4 #ab4 ,changed 8great ,complaints of a smarting ,pain2 when ,i touch'd it a ,suppuration0 to 8great ,complaints of a smarting ,pain when ,i touch'd it2 a ,suppuration04 ,this correction is not quite what the erratum on page vi recommends--but the recommendation is not quite correct4 ,page #ba4 ,changed 8which happpen'd the same ,day0 to 8which happen'd the same ,day04 ,page #di4 ,changed 8and its ,secondines left0 to 8and its ,secundines left04