Chapter XXVI.

Chapter XXVI.The Treatment of Diseases peculiar to Women.Sect.350.Besides all the preceding Diseases, to which Women are liable in common with Men, their Sex also exposes them to others peculiar to it, and which depend upon four principal Sources; which are their monthly Discharges, their Pregnancy, their Labours in Child-birth, and the Consequences of their Labours. It is not my present Design to treat professedly on each of the Diseases arising from these Causes, which would require a larger Volume than I have proposed; but I shall confine myself to certain general Directions on these four Heads.§ 351. Nature, who intended Women for the Increase, and the Nourishment of the human Race at the Breast, has subjected them to a periodical Efflux, or Discharge, of Blood: whichCircumstance constitutesthe Source, from whence the Infant is afterwards to receive his Nutrition and Growth.This Discharge generally commences, with us, between the Age of sixteen and eighteen. Young Maidens, before the Appearance of this Discharge, are frequently, and many for a long Time, in a State of Weakness, attended with various Complaints, which is termed theChlorosis, or Green Sickness, and Obstructions: and when their Appearance is extremely slow and backward, it occasions very grievous, and sometimes even mortal Diseases. Nevertheless it is too usual, though very improper, to ascribe all the Evils, to which they are subject at this Term of Life, solely to this Cause; while they really often result from a different Cause, of which the Obstructions themselves are sometimes only the Effect; and this is the natural, and, in some Degree, even necessary Feebleness of the Sex. The Fibres of Women which are intended to be relaxed, and to give Way, when they are unavoidably extended by the Growth of the Child, and its inclosing Membranes (which frequently arise to a very considerable Size) should necessarily be less stiff and rigid, less strong, and more lax and yielding than the Fibres of Men. Hence the Circulation of their Blood is more slow and languid than in Males; their Blood is less compact and dense, and more watery; their Fluids are more liable to stagnate in their different Bowels, and to form Infarctions and Obstructions.§ 352. The Disorders to which such a Constitution subjects them might, in some Measure, be prevented, by assisting that Languor or Feebleness of their natural Movements, by such an Increase of their Force, as Exercise might contribute to: But this Assistance, which in some Manner is more necessary for Females than Males, they are partly deprived of, by the general Education and Habitude of the Sex; as they are usually employed in managing Household Business, and such light sedentary Work, as afford them less Exercise and Motion, than the more active Occupations of Men. They stir about but little, whence their natural Tendency to Weakness increases from Habit, and thence becomes morbid and sickly. Their Blood circulates imperfectly; its Qualities become impaired; the Humours tend to a pretty general Stagnation; and none of the vital Functions are completely discharged.From such Causes and Circumstances they begin to sink into a State of Weakness, sometimes while they are very young, and many Years before this periodical Discharge could be expected. This State of Languor disposes them to be inactive; a little Exercise soon fatigues them, whence they take none at all. It might prove a Remedy, and even effect a Cure, at the Beginning of their Complaint; but as it is a Remedy, that is painful and disagreeable to them, they reject it, and thus increase their Disorders.Their Appetite declines with the other vital Functions, and gradually becomes still less; theusual salutary Kinds of Food never exciting it; instead of which they indulge themselves in whimsical Cravings, and often of the oddest and most improper Substances for Nutrition, which entirely impair the Stomach with its digestive Functions, and consequently Health itself.But sometimes after the Duration of this State for a few Years, the ordinary Time of their monthly Evacuations approaches, which however make not the least Appearance, for two Reasons. The first is, that their Health is too much impaired to accomplish this new Function, at a Time when all the others are so languid: and the second is, that under such Circumstances, the Evacuations themselves are unnecessary; since their final Purpose is to discharge (when the Sex arenot pregnant) that superfluous Blood, which they were intended to produce, and whose Retention would be unhealthy, when not applied to the Growth of the Fœtus, or Nourishment of the Child: and this Superfluity of Blood does not exist in Women, who have been long in a very low and languishing State.§ 353. Their Disorder however continues to increase, as every one daily must, which does not terminate. This Increase of it is attributed to the Suppression or Non-appearance of their monthly Efflux, which is often erroneous; since the Disorder is not always owing to that Suppression, which is often the Effect of their Distemperature. This is so true, that even when the Efflux happens, if their Weakness still continues,the Patients are far from being the better for it, but the reverse. Neither is it unusual to see young Lads, who have received from Nature, and from their Parents, a sort of feminine Constitution, Education and Habitude, infested with much the same Symptoms, as obstructed young Women.Country Girls, who are generally more accustomed to such hardy Work and Exercise as Country Men, are less subject to these Complaints, than Women who live in Cities.§ 354. Let People then be careful not to deceive themselves on this important Account; since all the Complaints of young Maidens are not owing to the Want of their Customs. Nevertheless it is certain there are some of them, who are really afflicted from this Cause. For Instance, when a strong young Virgin in full Health, who is nearly arrived to her full Growth, and who manifestly abounds with Blood, does not obtain this Discharge at the usual Time of Life, then indeed this superfluous Blood is the Fountain of very many Disorders, and greatly more violent ones than those, which result from the contrary Causes already mentioned.If the lazy inactive City Girls are more subject to the Obstructions, which either arise from the Weakness and Languor I have formerly taken Notice of, or which accompany it; Country Girls are more subject to Complaints from this latter Cause (too great a Retention of superfluous Blood) than Women who live in Cities: and it isthis last Cause that excites those singular Disorders, which appear so supernatural to the common People, that they ascribe them to Sorcery.§ 355. And even after these periodical Discharges have appeared, it is known that they have often been suppressed, without the least unhealthy Consequence resulting from that Suppression. They are often suppressed, in the Circumstances mentioned§ 351, by a Continuance of the Disease, which was first an Obstacle or Retardment to their Appearance; and in other Cases, they have been suppressed by other Causes, such as Cold, Moisture, violent Fear, any very strong Passion; by too chilly a Course of Diet, with Indigestion; or too hot and irritating Diet; by Drinks cooled with Ice, by Exercise too long continued, and by unusual Watching. The Symptoms, occasioned by such Suppressions, are sometimes more violent than those, which preceded the first Appearance of the Discharge.§ 356. The great Facility with which this Evacuation may be suppressed, diminished, or disordered, by the Causes already assigned; the terrible Evils which are the Consequences of such Interruptions and Irregularities of them, seem to me very cogent Reasons to engage the Sex to use all possible Care, in every Respect, to preserve the Regularity of them; by avoiding, during their Approach and Continuance, every Cause that may prevent or lessen them. Would they be thoroughly persuaded, not solely by my Advice, but by that of their Mothers, theirRelations, their Friends, and by their own Experience, of what great Importance it is to be very attentive to themselves, at those critical Times, I think there is not one Woman, who from the first, to the very last Appearance of them, would not conduct herself with the most scrupulous Regularity.Their Demeanour, in these Circumstances, very fundamentally interests their own Health, as well as that of their Children; and consequently their own Happiness, as well as that of their Husbands and Families.The younger and more delicate they are, Caution becomes the more necessary for them. I am very sensible a strong Country Girl is too negligent in regulating herself at those critical Seasons, and sometimes without any ill Consequence; but at another Time she may suffer severely for it: and I could produce a long List of many, who, by their Imprudence on such Occasions, have thrown themselves into the most terrible Condition.Besides the Caution with which Females should avoid these general Causes, just mentioned in the preceding Section, every Person ought to remember what has most particularly disagreed with her during that Term, and for ever constantly to reject it.§ 357. There are many Women whose Customs visit them without the slightest Impeachment of their Health: others are sensibly disordered on every Return of them; and to others again they are very tormenting, by the violentCholics, of a longer or a shorter Duration, which precede or accompany them. I have known some of these violent Attacks last but some Minutes, and others which continued a few Hours. Nay some indeed have persisted for many Days, attended with Vomiting, Fainting, with Convulsions from excessive Pain, with Vomiting of Blood, Bleedings from the Nose,&c.which, in short, have brought them to the very Jaws of Death. So very dangerous a Situation requires the closest Attention; though, as it results from several and frequently very opposite Causes, it is impossible within the present Plan, to direct the Treatment that may be proper for each Individual. Some Women have the Unhappiness to be subject to these Symptoms every Month, from the first Appearance, to the final Termination, of these Discharges; except proper Remedies and Regimen, and sometimes a happy Child-birth, remove them. Others complain but now and then, every second, third, or fourth Month; and there are some again, who having suffered very severely during the first Months, or Years, after their first Eruptions, suffer no more afterwards. A fourth Number, after having had their Customs for a long Time, without the least Complaint, find themselves afflicted with cruel Pains, at every Return of them; if by Imprudence, or some inevitable Fatality, they have incurred any Cause, that has suppressed, diminished, or delayed them. This Consideration ought to suggest a proper Caution even to such, as generally undergo theseDischarges, without Pain or Complaint: since all may be assured, that though they suffer no sensible Disorder at that Time, they are nevertheless more delicate, more impressible by extraneous Substances, more easily affected by the Passions of the Mind, and have also weaker Stomachs at these particular Periods.§ 358. These Discharges may also be sometimes too profuse in Quantity, in which Case the Patients become obnoxious to very grievous Maladies; into the Discussion of which however I shall not enter here, as they are much less frequent than those, arising from a Suppression of them. Besides which, in such Cases, Recourse may be had to the Directions I shall give hereafter, when I treat of that Loss of Blood, which may be expedient, during the Course of Gravidation or Pregnancy. See§ 365.§ 359. Finally, even when they are the most regular, after their Continuance for a pretty certain Number of Years (rarely exceeding thirty-five) they go off of their own Accord, and necessarily, between the Age of forty-five and fifty; sometimes even sooner, but seldom continuing longer: and thisCrisisof their ceasing is generally a very troublesome, and often a very dangerous, one for the Sex.§ 360. The Evils mentioned§ 352may be prevented, by avoiding the Causes producing them; and, 1, by obliging young Maidens to use considerable Exercise; especially as soon asthere is the least Reason to suspect the Approach of this Disorder, theChlorosis, or Green Sickness.2, By watching them carefully, that they eat nothing unwholesome or improper; as there are scarcely any natural Substances, even among such as are most improper for them, and the most distasteful, which have not sometimes been the Objects of their sickly, their unaccountable Cravings. Fat Aliments, Pastry, farinaceous or mealy, and sour and watery Foods are pernicious to them. Herb-Teas, which are frequently directed as a Medicine for them, are sufficient to throw them into the Disorder, by increasing that Relaxation of their Fibres, which is a principal Cause of it. If they must drink any such Infusions, as medicated Drinks, let them be taken cold: but the best Drink for them is Water, in which red hot Iron has been extinguished.3, They must avoid hot sharp Medicines, and such as are solely intended to force down their Terms, which are frequently attended with very pernicious Consequences, and never do any good: and they are still the more hurtful, as the Patient is the younger.4, If the Malady increases, it will be necessary to give them some Remedies; but these should not be Purges, nor consist of Diluters, and Decoctions of Herbs, of Salts, and a Heap of other useless and noxious Ingredients; but they should take Filings of Iron, which is the most certain Remedy in such Cases. These Filings Should beof true simple Iron, and not from Steel; and Care should be taken that it be not rusty, in which State it has very little Effect.At the Beginning of this Distemper, and to young Girls, it is sufficient to give twenty Grains daily, enjoining due Exercise and a suitable Diet. When it prevails in a severer Degree, and the Patient is not so young, a Quarter of an Ounce may be safely ventured on: Certain Bitters or Aromatics may be advantageously joined to the Filings, which are numbered in the Appendix,54,55,56, and constitute the most effectual Remedies in this Distemper, to be taken in the Form of Powder, of vinous Infusion, or of Electary.82When there is a just Indication to bring down the Discharge, the vinous InfusionNº. 55must be given, and generally succeeds: but I must again repeat it (as it should carefully be considered) that the Stoppage or Obstruction of this Discharge is frequently the Effect, not the Cause, of this Disease; and that there should be no Attempt to force it down, which in such a Case, may sometimes prove more hurtful than beneficial; since it would naturally return of its own Accord, on the Recovery, and with the Strength, of the Patient: as their Return should follow that of perfect Health, and neither can precede Health, nor introduce it. There aresome Cases particularly, in which it would be highly dangerous to use hot and active Medicines, such Cases for Instance, as are attended with some Degree of Fever, a frequent Coughing, a Hæmorrhage, or Bleeding, with great Leanness and considerable Thirst: all which Complaints should be removed, before any hot Medicines are given to force this Evacuation, which many very ignorantly imagine cures all other female Disorders; an Error, that has prematurely occasioned the Loss of many Womens' Lives.§ 361. While the Patient is under a Course of these Medicines, she should not take any of those I have forbidden in the preceding Sections; and the Efficacy of these should also be furthered with proper Exercise. That in a Carriage is very healthy; Dancing is so too, provided it be not extended to an Excess. In Case of a Relapse in these Disorders, the Patient is to be treated, as if it were an original Attack.§ 362. The other Sort of Obstructions described§ 354requires a very different Treatment. Bleeding, which is hurtful in the former Sort, and the Use, or rather Abuse, of which has thrown several young Women into irrecoverable Weaknesses, has often removed this latter Species, as it were, in a Moment. Bathing of the Feet, the PowdersNº. 20, and Whey have frequently succeeded: but at other Times it is necessary to accommodate the Remedies and the Method to each particular Case, and to judge of itfrom its own peculiar Circumstances and Appearances.§ 363. When these Evacuations naturally cease through Age (See§ 359) if they stop suddenly and all at once, and had formerly flowed very largely, Bleeding must, 1, necessarily be directed, and repeated every six, every four, or even every three Months.2, The usual Quantity of Food should be somewhat diminished, especially of Flesh, of Eggs and of strong Drink.3, Exercise should be increased.4, The Patient should frequently take, in a Morning fasting, the PowderNº. 24, which is very beneficial in such Cases; as it moderately increases the natural Excretions by Stool, Urine and Perspiration; and thence lessens that Quantity of Blood, which would otherwise superabound.Nevertheless, should this total Cessation of the monthly Discharge be preceded by, or attended with, any extraordinary Loss of Blood, which is frequently the Case, Bleeding is not so necessary; but the Regimen and Powder just directed are very much so; to which the PurgeNº. 23should now and then be joined, at moderate Intervals. The Use of astringent Medicines at this critical Time might dispose the Patient to a Cancer of the Womb.Many Women die about this Age, as it is but too easy a Matter to injure them then; aCircumstance that should make them very cautious and prudent in the Medicines they recur to. On the other Hand it also frequently happens, that their Constitutions alter for the better, after this critical Time of Life; their Fibres grow stronger; they find themselves sensibly more hearty and hardy; many former slight Infirmities disappear, and they enjoy a healthy and happy old Age. I have known several who threw away their Spectacles at the Age of fifty-two, or fifty-three, which they had used five or six Years before.The Regimen I have just directed, the PowderNº. 24, and the PotionNº. 32, agree very well in almost all inveterate Discharges (I speak of the female Peasantry) at whatever Time of Life.Of Disorders attending Gravidation, or the Term of going with Child.§ 364. Gravidation is generally a less ailing or unhealthy State in the Country, than in very populous Towns. Nevertheless Country Women are subject, as well as Citizens, to Pains of the Stomach, to vomiting in a Morning, to Head-ach and Tooth-ach; but these Complaints very commonly yield to Bleeding, which is almost the only Remedy necessary83for pregnant Women.§ 365. Sometimes after carrying too heavy Burthens; after too much or too violent Work; after receiving excessive Jolts, or having had a Fall, they are subject to violent Pains of the Loins, which extend down to their Thighs, and terminate quite at the Bottom of the Belly; and which commonly import, that they are in Danger of an Abortion, or Miscarrying.To prevent this Consequence, which is always dangerous, they should, 1, immediately go to Bed; and if they have not a Mattrass, they should lie upon a Bed stuffed with Straw, a Feather-bed being very improper in such Cases. They should repose, or keep themselves quite still in this Situation for several Days, not stirring, and speaking as little as possible.2, They should directly lose eight or nine Ounces of Blood from the Arm.3, They should not eat Flesh, Flesh-broth, nor Eggs; but live solely on Soups made of farinaceous or mealy Substances.4, They should take every two Hours half a Paper of the PowderNº. 20; and should drink nothing but the PtisanNº. 2.Some sanguine robust Women are very liable to miscarry at a certain Time, or Stage, of their Pregnancy. This may be obviated by their bleeding some Days before that Time approaches, and by their observing the Regimen I have advised. But this Method would avail very little for delicate Citizens, who miscarry from a very different Cause; and whose Abortions are to be prevented by a very different Treatment.Of Delivery, or Child-birth.§ 366. It has been observed that a greater Proportion of Women die in the Country in, or very speedily after, their Delivery, and that from the Scarcity of good Assistance, and the great Plenty of what is bad; and that a greater Proportion of those in Cities die after their Labours are effected, by a Continuance of their former bad Health.The Necessity there is for better instructed, better qualified Midwives, through a great Part ofSwisserland, is but too manifest an Unhappiness, which is attended with the most fatal Consequences, and which merits the utmost Attention of the Government.The Errors which are incurred, during actual Labour, are numberless, and too often indeed are also irremediable. It would require a wholeBook, expressly for that Purpose (and in some Countries there are such) to give all the Directions that are necessary, to prevent so many Fatalities: and it would be as necessary to form a sufficient Number of well-qualified Midwives to comprehend, and to observe them; which exceeds the Plan of the Work I have proposed. I shall only mark out one of the Causes, and the most injurious one on this Occasion: This is the Custom of giving hot irritating Things, whenever the Labour is very painful, or is slow; such as Castor, or its Tincture, Saffron, Sage, Rue, Savin, Oil of Amber, Wine, Venice Treacle, Wine burnt with Spices, Coffee, Brandy, Aniseed-Water, Walnut-Water, Fennel-Water, and other Drams or strong Liquors. All these Things are so many Poisons in this Respect, which, very far from promoting the Woman's Delivery, render it more difficult by inflaming the Womb (which cannot then so well contract itself) and the Parts, through which the Birth is to pass, in Consequence of which they swell, become more straitened, and cannot yield or be dilated. Sometimes these stimulating hot Medicines also bring on Hæmorrhages, which prove mortal in a few Hours.§ 367. A considerable Number, both of Mothers and Infants, might be preserved by the directly opposite Method. As soon as a Woman who was in very good Health, just before the Approach of her Labour, being robust and well made, finds her Travail come on, and that it ispainful and difficult; far from encouraging those premature Efforts, which are always destructive; and from furthering them by the pernicious Medicines I have just enumerated, the Patient should be bled in the Arm, which will prevent the Swelling and Inflammation; asswage the Pains; relax the Parts, and dispose every thing to a favourable Issue.During actual Labour no other Nourishment should be allowed, except a little Panada every three Hours, and as much Toast and Water, as the Woman chuses.Every fourth Hour a Glyster should be given, consisting of a Decoction of Mallows and a little Oil. In the Intervals between these Glysters she should be set over a kind of Stove, or in a pierced easy Chair, containing a Vessel in which there is some hot Water: the Passage should be gently rubbed with a little Butter; and Stapes wrung out of a Fomentation of simple hot Water, which is the most efficacious of any, should be applied over the Belly.The Midwives, by taking this Method, are not only certain of doing no Mischief, but they also allow Nature an Opportunity of doing Good: as a great many Labours, which seem difficult at time, terminate happily; and this safe and unprecipitate Manner of proceeding at least affords Time to call in further Assistance. Besides, the Consequences of such Deliveries are healthy and happy; when by pursuing the heating oppressing Practice, even though the Delivery be effected, bothMother and Infant have been so cruelly, though undesignedly, tormented, that both of them frequently perish.§ 368. I acknowledge these Means are insufficient, when the Child is unhappily situated in the Womb; or when there is an embarrassing Conformation in the Mother: though at least they prevent the Case from proving worse, and leave Time for calling in Men-Midwives, or other female ones, who may be better qualified.I beg leave again to remind the Midwives, that they should be very cautious of urging their Women to make any forced Efforts to forward the Birth, which are extremely injurious to them, and which may render a Delivery very dangerous and embarrassing, that might otherwise have been happily effected: and I insist the more freely on the Danger attending these unreasonable Efforts, and on the very great Importance of Patience, as the other very pernicious Practice is become next to universal amongst us.The Weakness, in which the labouring Woman appears, makes the By-standers fearful that she will not have Strength enough to be delivered; which they think abundantly justifies them in giving her Cordials; but this Way of Reasoning is very weak and chimerical. Their Strength, on such Occasions, is not so very speedily dissipated: the small light Pains sink them, but in Proportion as the Pains become stronger, their Strength arises; being never deficient, when there is no extraordinary and uncommon Symptom;and we may reasonably be assured, that in a healthy, well formed Woman, meer Weakness never prevents a Delivery.Of the Consequences of Labour, or Childbirth.§ 369. The most usual Consequences of Childbirth in the Country are, 1, An excessive Hæmorrhage.2, An Inflammationof the Womb. 3, A sudden Suppression of theLochia, or usual Discharges after Delivery. And, 4, the Fever and other Accidents, resulting from the Milk.Excessive Bleedings or Floodings, should be treated according to the Manner directed§ 365: and if they are very excessive, Folds of Linen, which have been wrung out of a Mixture of equal Parts of Water and Vinegar, should be applied to the Belly, the Loins, and the Thighs: these should be changed for fresh moist ones, as they dry; and should be omitted, as soon as the Bleeding abates.§ 370. The Inflammation of the Womb is discoverable by Pains in all the lower Parts of the Belly; by a Tension or Tightness of the whole; by a sensible Increase of Pain upon touching it; a kind of red Stain or Spot, that mounts to the Middle of the Belly, as high as the Navel; which Spot, as the Disease increases, turns black, and then is always a mortal Symptom; by a very extraordinary Degree of Weakness; an astonishing Change of Countenance; a lightDeliriumor Raving; a continual Fever with a weak and hardPulse; sometimes incessant Vomitings; a frequent Hiccup; a moderate Discharge of a reddish, stinking, sharp Water; frequent Urgings to go to Stool; a burning kind of Heat of Urine; and sometimes an entire Suppression of it.§ 371. This most dangerous and frequently mortal Disease should be treated like inflammatory ones. After Bleeding, frequent Glysters of warm Water must by no Means be omitted; some should also be injected into the Womb, and applied continually over the Belly. The Patient may also drink continually, either of simple Barley-Water, with a Quarter of an Ounce of Nitre in every Pot of it, or of Almond MilkNº. 4.§ 372. The total Suppression of theLochia, the Discharges after Labour, which proves a Cause of the most violent Disorders, should be treated exactly in the same Manner: but if unhappily hot Medicines have been given, in order to force them down, the Case will very generally prove a most hopeless one.§ 373. If the Milk-fever run very high, the Barley Ptisan directed§ 371, and Glysters, with a very light Diet, consisting only of Panada, or made of some other farinaceous Substances, and very thin, very generally remove it.§ 374. Delicate infirm Women, who have not all the requisite and necessary Attendance they want; and such as from Indigence are obliged to work too soon, are exposed to many Accidents, which frequently arise from a Wantof due Perspiration, and an insufficient Discharge of theLochia; and hence, the Separation of the Milk in their Breasts being disturbed, there are milky Congestions, or Knots as it were, which are always very painful and troublesome, and especially when they are formed more inwardly. They often happen on the Thighs, in which Case the PtisanNº. 58is to be drank, and the PulticesNº. 59must be applied. These two Remedies gradually dissipate and remove the Tumour, if that may be effected without Suppuration. But if that proves impossible, andPus, or Matter, is actually formed, a Surgeon must open the Abscess, and treat it like any other.§ 375. Should the Milk coagulate, or curdle as it were, in the Breast, it is of the utmost Importance immediately to attenuate or dissolve that Thickness, which would otherwise degenerate into a Hardness and prove aScirrhus; and from aScirrhusin Process of Time a Cancer, that most tormenting and cruel Distemper.This horrible Evil however may be prevented by an Application to these small Tumours, as soon as ever they appear, For this Purpose nothing is more effectual than the PrescriptionsNº. 57and60; but under such menacing Circumstances, it is always prudent to take the best Advice, as early as possible.From the Moment these hard Tumours become excessively and obstinately so, and yet without any Pain, we should abstain from every Application, all are injurious; and greasy, sharp,resinous and spirituous ones speedily change theScirrhusinto a Cancer. Whenever it becomes manifestly such, all Applications are also equally pernicious, except that ofNº. 60. Cancers have long been thought and found incurable; but within a few Years past some have been cured by the RemedyNº. 57; which nevertheless is not infallible, though it should always be tried.84§ 376. The Nipples of Women, who give Milk, are often fretted or excoriated, which proves very severely painful to them. One of the best Applications is the most simple Ointment, being a Mixture of Oil and Wax melted together; or the OintmentNº. 66. Should the Complaint prove very obstinate, the Nurse ought to be purged, which generally removes it.

Chapter XXVI.The Treatment of Diseases peculiar to Women.Sect.350.Besides all the preceding Diseases, to which Women are liable in common with Men, their Sex also exposes them to others peculiar to it, and which depend upon four principal Sources; which are their monthly Discharges, their Pregnancy, their Labours in Child-birth, and the Consequences of their Labours. It is not my present Design to treat professedly on each of the Diseases arising from these Causes, which would require a larger Volume than I have proposed; but I shall confine myself to certain general Directions on these four Heads.§ 351. Nature, who intended Women for the Increase, and the Nourishment of the human Race at the Breast, has subjected them to a periodical Efflux, or Discharge, of Blood: whichCircumstance constitutesthe Source, from whence the Infant is afterwards to receive his Nutrition and Growth.This Discharge generally commences, with us, between the Age of sixteen and eighteen. Young Maidens, before the Appearance of this Discharge, are frequently, and many for a long Time, in a State of Weakness, attended with various Complaints, which is termed theChlorosis, or Green Sickness, and Obstructions: and when their Appearance is extremely slow and backward, it occasions very grievous, and sometimes even mortal Diseases. Nevertheless it is too usual, though very improper, to ascribe all the Evils, to which they are subject at this Term of Life, solely to this Cause; while they really often result from a different Cause, of which the Obstructions themselves are sometimes only the Effect; and this is the natural, and, in some Degree, even necessary Feebleness of the Sex. The Fibres of Women which are intended to be relaxed, and to give Way, when they are unavoidably extended by the Growth of the Child, and its inclosing Membranes (which frequently arise to a very considerable Size) should necessarily be less stiff and rigid, less strong, and more lax and yielding than the Fibres of Men. Hence the Circulation of their Blood is more slow and languid than in Males; their Blood is less compact and dense, and more watery; their Fluids are more liable to stagnate in their different Bowels, and to form Infarctions and Obstructions.§ 352. The Disorders to which such a Constitution subjects them might, in some Measure, be prevented, by assisting that Languor or Feebleness of their natural Movements, by such an Increase of their Force, as Exercise might contribute to: But this Assistance, which in some Manner is more necessary for Females than Males, they are partly deprived of, by the general Education and Habitude of the Sex; as they are usually employed in managing Household Business, and such light sedentary Work, as afford them less Exercise and Motion, than the more active Occupations of Men. They stir about but little, whence their natural Tendency to Weakness increases from Habit, and thence becomes morbid and sickly. Their Blood circulates imperfectly; its Qualities become impaired; the Humours tend to a pretty general Stagnation; and none of the vital Functions are completely discharged.From such Causes and Circumstances they begin to sink into a State of Weakness, sometimes while they are very young, and many Years before this periodical Discharge could be expected. This State of Languor disposes them to be inactive; a little Exercise soon fatigues them, whence they take none at all. It might prove a Remedy, and even effect a Cure, at the Beginning of their Complaint; but as it is a Remedy, that is painful and disagreeable to them, they reject it, and thus increase their Disorders.Their Appetite declines with the other vital Functions, and gradually becomes still less; theusual salutary Kinds of Food never exciting it; instead of which they indulge themselves in whimsical Cravings, and often of the oddest and most improper Substances for Nutrition, which entirely impair the Stomach with its digestive Functions, and consequently Health itself.But sometimes after the Duration of this State for a few Years, the ordinary Time of their monthly Evacuations approaches, which however make not the least Appearance, for two Reasons. The first is, that their Health is too much impaired to accomplish this new Function, at a Time when all the others are so languid: and the second is, that under such Circumstances, the Evacuations themselves are unnecessary; since their final Purpose is to discharge (when the Sex arenot pregnant) that superfluous Blood, which they were intended to produce, and whose Retention would be unhealthy, when not applied to the Growth of the Fœtus, or Nourishment of the Child: and this Superfluity of Blood does not exist in Women, who have been long in a very low and languishing State.§ 353. Their Disorder however continues to increase, as every one daily must, which does not terminate. This Increase of it is attributed to the Suppression or Non-appearance of their monthly Efflux, which is often erroneous; since the Disorder is not always owing to that Suppression, which is often the Effect of their Distemperature. This is so true, that even when the Efflux happens, if their Weakness still continues,the Patients are far from being the better for it, but the reverse. Neither is it unusual to see young Lads, who have received from Nature, and from their Parents, a sort of feminine Constitution, Education and Habitude, infested with much the same Symptoms, as obstructed young Women.Country Girls, who are generally more accustomed to such hardy Work and Exercise as Country Men, are less subject to these Complaints, than Women who live in Cities.§ 354. Let People then be careful not to deceive themselves on this important Account; since all the Complaints of young Maidens are not owing to the Want of their Customs. Nevertheless it is certain there are some of them, who are really afflicted from this Cause. For Instance, when a strong young Virgin in full Health, who is nearly arrived to her full Growth, and who manifestly abounds with Blood, does not obtain this Discharge at the usual Time of Life, then indeed this superfluous Blood is the Fountain of very many Disorders, and greatly more violent ones than those, which result from the contrary Causes already mentioned.If the lazy inactive City Girls are more subject to the Obstructions, which either arise from the Weakness and Languor I have formerly taken Notice of, or which accompany it; Country Girls are more subject to Complaints from this latter Cause (too great a Retention of superfluous Blood) than Women who live in Cities: and it isthis last Cause that excites those singular Disorders, which appear so supernatural to the common People, that they ascribe them to Sorcery.§ 355. And even after these periodical Discharges have appeared, it is known that they have often been suppressed, without the least unhealthy Consequence resulting from that Suppression. They are often suppressed, in the Circumstances mentioned§ 351, by a Continuance of the Disease, which was first an Obstacle or Retardment to their Appearance; and in other Cases, they have been suppressed by other Causes, such as Cold, Moisture, violent Fear, any very strong Passion; by too chilly a Course of Diet, with Indigestion; or too hot and irritating Diet; by Drinks cooled with Ice, by Exercise too long continued, and by unusual Watching. The Symptoms, occasioned by such Suppressions, are sometimes more violent than those, which preceded the first Appearance of the Discharge.§ 356. The great Facility with which this Evacuation may be suppressed, diminished, or disordered, by the Causes already assigned; the terrible Evils which are the Consequences of such Interruptions and Irregularities of them, seem to me very cogent Reasons to engage the Sex to use all possible Care, in every Respect, to preserve the Regularity of them; by avoiding, during their Approach and Continuance, every Cause that may prevent or lessen them. Would they be thoroughly persuaded, not solely by my Advice, but by that of their Mothers, theirRelations, their Friends, and by their own Experience, of what great Importance it is to be very attentive to themselves, at those critical Times, I think there is not one Woman, who from the first, to the very last Appearance of them, would not conduct herself with the most scrupulous Regularity.Their Demeanour, in these Circumstances, very fundamentally interests their own Health, as well as that of their Children; and consequently their own Happiness, as well as that of their Husbands and Families.The younger and more delicate they are, Caution becomes the more necessary for them. I am very sensible a strong Country Girl is too negligent in regulating herself at those critical Seasons, and sometimes without any ill Consequence; but at another Time she may suffer severely for it: and I could produce a long List of many, who, by their Imprudence on such Occasions, have thrown themselves into the most terrible Condition.Besides the Caution with which Females should avoid these general Causes, just mentioned in the preceding Section, every Person ought to remember what has most particularly disagreed with her during that Term, and for ever constantly to reject it.§ 357. There are many Women whose Customs visit them without the slightest Impeachment of their Health: others are sensibly disordered on every Return of them; and to others again they are very tormenting, by the violentCholics, of a longer or a shorter Duration, which precede or accompany them. I have known some of these violent Attacks last but some Minutes, and others which continued a few Hours. Nay some indeed have persisted for many Days, attended with Vomiting, Fainting, with Convulsions from excessive Pain, with Vomiting of Blood, Bleedings from the Nose,&c.which, in short, have brought them to the very Jaws of Death. So very dangerous a Situation requires the closest Attention; though, as it results from several and frequently very opposite Causes, it is impossible within the present Plan, to direct the Treatment that may be proper for each Individual. Some Women have the Unhappiness to be subject to these Symptoms every Month, from the first Appearance, to the final Termination, of these Discharges; except proper Remedies and Regimen, and sometimes a happy Child-birth, remove them. Others complain but now and then, every second, third, or fourth Month; and there are some again, who having suffered very severely during the first Months, or Years, after their first Eruptions, suffer no more afterwards. A fourth Number, after having had their Customs for a long Time, without the least Complaint, find themselves afflicted with cruel Pains, at every Return of them; if by Imprudence, or some inevitable Fatality, they have incurred any Cause, that has suppressed, diminished, or delayed them. This Consideration ought to suggest a proper Caution even to such, as generally undergo theseDischarges, without Pain or Complaint: since all may be assured, that though they suffer no sensible Disorder at that Time, they are nevertheless more delicate, more impressible by extraneous Substances, more easily affected by the Passions of the Mind, and have also weaker Stomachs at these particular Periods.§ 358. These Discharges may also be sometimes too profuse in Quantity, in which Case the Patients become obnoxious to very grievous Maladies; into the Discussion of which however I shall not enter here, as they are much less frequent than those, arising from a Suppression of them. Besides which, in such Cases, Recourse may be had to the Directions I shall give hereafter, when I treat of that Loss of Blood, which may be expedient, during the Course of Gravidation or Pregnancy. See§ 365.§ 359. Finally, even when they are the most regular, after their Continuance for a pretty certain Number of Years (rarely exceeding thirty-five) they go off of their own Accord, and necessarily, between the Age of forty-five and fifty; sometimes even sooner, but seldom continuing longer: and thisCrisisof their ceasing is generally a very troublesome, and often a very dangerous, one for the Sex.§ 360. The Evils mentioned§ 352may be prevented, by avoiding the Causes producing them; and, 1, by obliging young Maidens to use considerable Exercise; especially as soon asthere is the least Reason to suspect the Approach of this Disorder, theChlorosis, or Green Sickness.2, By watching them carefully, that they eat nothing unwholesome or improper; as there are scarcely any natural Substances, even among such as are most improper for them, and the most distasteful, which have not sometimes been the Objects of their sickly, their unaccountable Cravings. Fat Aliments, Pastry, farinaceous or mealy, and sour and watery Foods are pernicious to them. Herb-Teas, which are frequently directed as a Medicine for them, are sufficient to throw them into the Disorder, by increasing that Relaxation of their Fibres, which is a principal Cause of it. If they must drink any such Infusions, as medicated Drinks, let them be taken cold: but the best Drink for them is Water, in which red hot Iron has been extinguished.3, They must avoid hot sharp Medicines, and such as are solely intended to force down their Terms, which are frequently attended with very pernicious Consequences, and never do any good: and they are still the more hurtful, as the Patient is the younger.4, If the Malady increases, it will be necessary to give them some Remedies; but these should not be Purges, nor consist of Diluters, and Decoctions of Herbs, of Salts, and a Heap of other useless and noxious Ingredients; but they should take Filings of Iron, which is the most certain Remedy in such Cases. These Filings Should beof true simple Iron, and not from Steel; and Care should be taken that it be not rusty, in which State it has very little Effect.At the Beginning of this Distemper, and to young Girls, it is sufficient to give twenty Grains daily, enjoining due Exercise and a suitable Diet. When it prevails in a severer Degree, and the Patient is not so young, a Quarter of an Ounce may be safely ventured on: Certain Bitters or Aromatics may be advantageously joined to the Filings, which are numbered in the Appendix,54,55,56, and constitute the most effectual Remedies in this Distemper, to be taken in the Form of Powder, of vinous Infusion, or of Electary.82When there is a just Indication to bring down the Discharge, the vinous InfusionNº. 55must be given, and generally succeeds: but I must again repeat it (as it should carefully be considered) that the Stoppage or Obstruction of this Discharge is frequently the Effect, not the Cause, of this Disease; and that there should be no Attempt to force it down, which in such a Case, may sometimes prove more hurtful than beneficial; since it would naturally return of its own Accord, on the Recovery, and with the Strength, of the Patient: as their Return should follow that of perfect Health, and neither can precede Health, nor introduce it. There aresome Cases particularly, in which it would be highly dangerous to use hot and active Medicines, such Cases for Instance, as are attended with some Degree of Fever, a frequent Coughing, a Hæmorrhage, or Bleeding, with great Leanness and considerable Thirst: all which Complaints should be removed, before any hot Medicines are given to force this Evacuation, which many very ignorantly imagine cures all other female Disorders; an Error, that has prematurely occasioned the Loss of many Womens' Lives.§ 361. While the Patient is under a Course of these Medicines, she should not take any of those I have forbidden in the preceding Sections; and the Efficacy of these should also be furthered with proper Exercise. That in a Carriage is very healthy; Dancing is so too, provided it be not extended to an Excess. In Case of a Relapse in these Disorders, the Patient is to be treated, as if it were an original Attack.§ 362. The other Sort of Obstructions described§ 354requires a very different Treatment. Bleeding, which is hurtful in the former Sort, and the Use, or rather Abuse, of which has thrown several young Women into irrecoverable Weaknesses, has often removed this latter Species, as it were, in a Moment. Bathing of the Feet, the PowdersNº. 20, and Whey have frequently succeeded: but at other Times it is necessary to accommodate the Remedies and the Method to each particular Case, and to judge of itfrom its own peculiar Circumstances and Appearances.§ 363. When these Evacuations naturally cease through Age (See§ 359) if they stop suddenly and all at once, and had formerly flowed very largely, Bleeding must, 1, necessarily be directed, and repeated every six, every four, or even every three Months.2, The usual Quantity of Food should be somewhat diminished, especially of Flesh, of Eggs and of strong Drink.3, Exercise should be increased.4, The Patient should frequently take, in a Morning fasting, the PowderNº. 24, which is very beneficial in such Cases; as it moderately increases the natural Excretions by Stool, Urine and Perspiration; and thence lessens that Quantity of Blood, which would otherwise superabound.Nevertheless, should this total Cessation of the monthly Discharge be preceded by, or attended with, any extraordinary Loss of Blood, which is frequently the Case, Bleeding is not so necessary; but the Regimen and Powder just directed are very much so; to which the PurgeNº. 23should now and then be joined, at moderate Intervals. The Use of astringent Medicines at this critical Time might dispose the Patient to a Cancer of the Womb.Many Women die about this Age, as it is but too easy a Matter to injure them then; aCircumstance that should make them very cautious and prudent in the Medicines they recur to. On the other Hand it also frequently happens, that their Constitutions alter for the better, after this critical Time of Life; their Fibres grow stronger; they find themselves sensibly more hearty and hardy; many former slight Infirmities disappear, and they enjoy a healthy and happy old Age. I have known several who threw away their Spectacles at the Age of fifty-two, or fifty-three, which they had used five or six Years before.The Regimen I have just directed, the PowderNº. 24, and the PotionNº. 32, agree very well in almost all inveterate Discharges (I speak of the female Peasantry) at whatever Time of Life.Of Disorders attending Gravidation, or the Term of going with Child.§ 364. Gravidation is generally a less ailing or unhealthy State in the Country, than in very populous Towns. Nevertheless Country Women are subject, as well as Citizens, to Pains of the Stomach, to vomiting in a Morning, to Head-ach and Tooth-ach; but these Complaints very commonly yield to Bleeding, which is almost the only Remedy necessary83for pregnant Women.§ 365. Sometimes after carrying too heavy Burthens; after too much or too violent Work; after receiving excessive Jolts, or having had a Fall, they are subject to violent Pains of the Loins, which extend down to their Thighs, and terminate quite at the Bottom of the Belly; and which commonly import, that they are in Danger of an Abortion, or Miscarrying.To prevent this Consequence, which is always dangerous, they should, 1, immediately go to Bed; and if they have not a Mattrass, they should lie upon a Bed stuffed with Straw, a Feather-bed being very improper in such Cases. They should repose, or keep themselves quite still in this Situation for several Days, not stirring, and speaking as little as possible.2, They should directly lose eight or nine Ounces of Blood from the Arm.3, They should not eat Flesh, Flesh-broth, nor Eggs; but live solely on Soups made of farinaceous or mealy Substances.4, They should take every two Hours half a Paper of the PowderNº. 20; and should drink nothing but the PtisanNº. 2.Some sanguine robust Women are very liable to miscarry at a certain Time, or Stage, of their Pregnancy. This may be obviated by their bleeding some Days before that Time approaches, and by their observing the Regimen I have advised. But this Method would avail very little for delicate Citizens, who miscarry from a very different Cause; and whose Abortions are to be prevented by a very different Treatment.Of Delivery, or Child-birth.§ 366. It has been observed that a greater Proportion of Women die in the Country in, or very speedily after, their Delivery, and that from the Scarcity of good Assistance, and the great Plenty of what is bad; and that a greater Proportion of those in Cities die after their Labours are effected, by a Continuance of their former bad Health.The Necessity there is for better instructed, better qualified Midwives, through a great Part ofSwisserland, is but too manifest an Unhappiness, which is attended with the most fatal Consequences, and which merits the utmost Attention of the Government.The Errors which are incurred, during actual Labour, are numberless, and too often indeed are also irremediable. It would require a wholeBook, expressly for that Purpose (and in some Countries there are such) to give all the Directions that are necessary, to prevent so many Fatalities: and it would be as necessary to form a sufficient Number of well-qualified Midwives to comprehend, and to observe them; which exceeds the Plan of the Work I have proposed. I shall only mark out one of the Causes, and the most injurious one on this Occasion: This is the Custom of giving hot irritating Things, whenever the Labour is very painful, or is slow; such as Castor, or its Tincture, Saffron, Sage, Rue, Savin, Oil of Amber, Wine, Venice Treacle, Wine burnt with Spices, Coffee, Brandy, Aniseed-Water, Walnut-Water, Fennel-Water, and other Drams or strong Liquors. All these Things are so many Poisons in this Respect, which, very far from promoting the Woman's Delivery, render it more difficult by inflaming the Womb (which cannot then so well contract itself) and the Parts, through which the Birth is to pass, in Consequence of which they swell, become more straitened, and cannot yield or be dilated. Sometimes these stimulating hot Medicines also bring on Hæmorrhages, which prove mortal in a few Hours.§ 367. A considerable Number, both of Mothers and Infants, might be preserved by the directly opposite Method. As soon as a Woman who was in very good Health, just before the Approach of her Labour, being robust and well made, finds her Travail come on, and that it ispainful and difficult; far from encouraging those premature Efforts, which are always destructive; and from furthering them by the pernicious Medicines I have just enumerated, the Patient should be bled in the Arm, which will prevent the Swelling and Inflammation; asswage the Pains; relax the Parts, and dispose every thing to a favourable Issue.During actual Labour no other Nourishment should be allowed, except a little Panada every three Hours, and as much Toast and Water, as the Woman chuses.Every fourth Hour a Glyster should be given, consisting of a Decoction of Mallows and a little Oil. In the Intervals between these Glysters she should be set over a kind of Stove, or in a pierced easy Chair, containing a Vessel in which there is some hot Water: the Passage should be gently rubbed with a little Butter; and Stapes wrung out of a Fomentation of simple hot Water, which is the most efficacious of any, should be applied over the Belly.The Midwives, by taking this Method, are not only certain of doing no Mischief, but they also allow Nature an Opportunity of doing Good: as a great many Labours, which seem difficult at time, terminate happily; and this safe and unprecipitate Manner of proceeding at least affords Time to call in further Assistance. Besides, the Consequences of such Deliveries are healthy and happy; when by pursuing the heating oppressing Practice, even though the Delivery be effected, bothMother and Infant have been so cruelly, though undesignedly, tormented, that both of them frequently perish.§ 368. I acknowledge these Means are insufficient, when the Child is unhappily situated in the Womb; or when there is an embarrassing Conformation in the Mother: though at least they prevent the Case from proving worse, and leave Time for calling in Men-Midwives, or other female ones, who may be better qualified.I beg leave again to remind the Midwives, that they should be very cautious of urging their Women to make any forced Efforts to forward the Birth, which are extremely injurious to them, and which may render a Delivery very dangerous and embarrassing, that might otherwise have been happily effected: and I insist the more freely on the Danger attending these unreasonable Efforts, and on the very great Importance of Patience, as the other very pernicious Practice is become next to universal amongst us.The Weakness, in which the labouring Woman appears, makes the By-standers fearful that she will not have Strength enough to be delivered; which they think abundantly justifies them in giving her Cordials; but this Way of Reasoning is very weak and chimerical. Their Strength, on such Occasions, is not so very speedily dissipated: the small light Pains sink them, but in Proportion as the Pains become stronger, their Strength arises; being never deficient, when there is no extraordinary and uncommon Symptom;and we may reasonably be assured, that in a healthy, well formed Woman, meer Weakness never prevents a Delivery.Of the Consequences of Labour, or Childbirth.§ 369. The most usual Consequences of Childbirth in the Country are, 1, An excessive Hæmorrhage.2, An Inflammationof the Womb. 3, A sudden Suppression of theLochia, or usual Discharges after Delivery. And, 4, the Fever and other Accidents, resulting from the Milk.Excessive Bleedings or Floodings, should be treated according to the Manner directed§ 365: and if they are very excessive, Folds of Linen, which have been wrung out of a Mixture of equal Parts of Water and Vinegar, should be applied to the Belly, the Loins, and the Thighs: these should be changed for fresh moist ones, as they dry; and should be omitted, as soon as the Bleeding abates.§ 370. The Inflammation of the Womb is discoverable by Pains in all the lower Parts of the Belly; by a Tension or Tightness of the whole; by a sensible Increase of Pain upon touching it; a kind of red Stain or Spot, that mounts to the Middle of the Belly, as high as the Navel; which Spot, as the Disease increases, turns black, and then is always a mortal Symptom; by a very extraordinary Degree of Weakness; an astonishing Change of Countenance; a lightDeliriumor Raving; a continual Fever with a weak and hardPulse; sometimes incessant Vomitings; a frequent Hiccup; a moderate Discharge of a reddish, stinking, sharp Water; frequent Urgings to go to Stool; a burning kind of Heat of Urine; and sometimes an entire Suppression of it.§ 371. This most dangerous and frequently mortal Disease should be treated like inflammatory ones. After Bleeding, frequent Glysters of warm Water must by no Means be omitted; some should also be injected into the Womb, and applied continually over the Belly. The Patient may also drink continually, either of simple Barley-Water, with a Quarter of an Ounce of Nitre in every Pot of it, or of Almond MilkNº. 4.§ 372. The total Suppression of theLochia, the Discharges after Labour, which proves a Cause of the most violent Disorders, should be treated exactly in the same Manner: but if unhappily hot Medicines have been given, in order to force them down, the Case will very generally prove a most hopeless one.§ 373. If the Milk-fever run very high, the Barley Ptisan directed§ 371, and Glysters, with a very light Diet, consisting only of Panada, or made of some other farinaceous Substances, and very thin, very generally remove it.§ 374. Delicate infirm Women, who have not all the requisite and necessary Attendance they want; and such as from Indigence are obliged to work too soon, are exposed to many Accidents, which frequently arise from a Wantof due Perspiration, and an insufficient Discharge of theLochia; and hence, the Separation of the Milk in their Breasts being disturbed, there are milky Congestions, or Knots as it were, which are always very painful and troublesome, and especially when they are formed more inwardly. They often happen on the Thighs, in which Case the PtisanNº. 58is to be drank, and the PulticesNº. 59must be applied. These two Remedies gradually dissipate and remove the Tumour, if that may be effected without Suppuration. But if that proves impossible, andPus, or Matter, is actually formed, a Surgeon must open the Abscess, and treat it like any other.§ 375. Should the Milk coagulate, or curdle as it were, in the Breast, it is of the utmost Importance immediately to attenuate or dissolve that Thickness, which would otherwise degenerate into a Hardness and prove aScirrhus; and from aScirrhusin Process of Time a Cancer, that most tormenting and cruel Distemper.This horrible Evil however may be prevented by an Application to these small Tumours, as soon as ever they appear, For this Purpose nothing is more effectual than the PrescriptionsNº. 57and60; but under such menacing Circumstances, it is always prudent to take the best Advice, as early as possible.From the Moment these hard Tumours become excessively and obstinately so, and yet without any Pain, we should abstain from every Application, all are injurious; and greasy, sharp,resinous and spirituous ones speedily change theScirrhusinto a Cancer. Whenever it becomes manifestly such, all Applications are also equally pernicious, except that ofNº. 60. Cancers have long been thought and found incurable; but within a few Years past some have been cured by the RemedyNº. 57; which nevertheless is not infallible, though it should always be tried.84§ 376. The Nipples of Women, who give Milk, are often fretted or excoriated, which proves very severely painful to them. One of the best Applications is the most simple Ointment, being a Mixture of Oil and Wax melted together; or the OintmentNº. 66. Should the Complaint prove very obstinate, the Nurse ought to be purged, which generally removes it.

The Treatment of Diseases peculiar to Women.Sect.350.Besides all the preceding Diseases, to which Women are liable in common with Men, their Sex also exposes them to others peculiar to it, and which depend upon four principal Sources; which are their monthly Discharges, their Pregnancy, their Labours in Child-birth, and the Consequences of their Labours. It is not my present Design to treat professedly on each of the Diseases arising from these Causes, which would require a larger Volume than I have proposed; but I shall confine myself to certain general Directions on these four Heads.§ 351. Nature, who intended Women for the Increase, and the Nourishment of the human Race at the Breast, has subjected them to a periodical Efflux, or Discharge, of Blood: whichCircumstance constitutesthe Source, from whence the Infant is afterwards to receive his Nutrition and Growth.This Discharge generally commences, with us, between the Age of sixteen and eighteen. Young Maidens, before the Appearance of this Discharge, are frequently, and many for a long Time, in a State of Weakness, attended with various Complaints, which is termed theChlorosis, or Green Sickness, and Obstructions: and when their Appearance is extremely slow and backward, it occasions very grievous, and sometimes even mortal Diseases. Nevertheless it is too usual, though very improper, to ascribe all the Evils, to which they are subject at this Term of Life, solely to this Cause; while they really often result from a different Cause, of which the Obstructions themselves are sometimes only the Effect; and this is the natural, and, in some Degree, even necessary Feebleness of the Sex. The Fibres of Women which are intended to be relaxed, and to give Way, when they are unavoidably extended by the Growth of the Child, and its inclosing Membranes (which frequently arise to a very considerable Size) should necessarily be less stiff and rigid, less strong, and more lax and yielding than the Fibres of Men. Hence the Circulation of their Blood is more slow and languid than in Males; their Blood is less compact and dense, and more watery; their Fluids are more liable to stagnate in their different Bowels, and to form Infarctions and Obstructions.§ 352. The Disorders to which such a Constitution subjects them might, in some Measure, be prevented, by assisting that Languor or Feebleness of their natural Movements, by such an Increase of their Force, as Exercise might contribute to: But this Assistance, which in some Manner is more necessary for Females than Males, they are partly deprived of, by the general Education and Habitude of the Sex; as they are usually employed in managing Household Business, and such light sedentary Work, as afford them less Exercise and Motion, than the more active Occupations of Men. They stir about but little, whence their natural Tendency to Weakness increases from Habit, and thence becomes morbid and sickly. Their Blood circulates imperfectly; its Qualities become impaired; the Humours tend to a pretty general Stagnation; and none of the vital Functions are completely discharged.From such Causes and Circumstances they begin to sink into a State of Weakness, sometimes while they are very young, and many Years before this periodical Discharge could be expected. This State of Languor disposes them to be inactive; a little Exercise soon fatigues them, whence they take none at all. It might prove a Remedy, and even effect a Cure, at the Beginning of their Complaint; but as it is a Remedy, that is painful and disagreeable to them, they reject it, and thus increase their Disorders.Their Appetite declines with the other vital Functions, and gradually becomes still less; theusual salutary Kinds of Food never exciting it; instead of which they indulge themselves in whimsical Cravings, and often of the oddest and most improper Substances for Nutrition, which entirely impair the Stomach with its digestive Functions, and consequently Health itself.But sometimes after the Duration of this State for a few Years, the ordinary Time of their monthly Evacuations approaches, which however make not the least Appearance, for two Reasons. The first is, that their Health is too much impaired to accomplish this new Function, at a Time when all the others are so languid: and the second is, that under such Circumstances, the Evacuations themselves are unnecessary; since their final Purpose is to discharge (when the Sex arenot pregnant) that superfluous Blood, which they were intended to produce, and whose Retention would be unhealthy, when not applied to the Growth of the Fœtus, or Nourishment of the Child: and this Superfluity of Blood does not exist in Women, who have been long in a very low and languishing State.§ 353. Their Disorder however continues to increase, as every one daily must, which does not terminate. This Increase of it is attributed to the Suppression or Non-appearance of their monthly Efflux, which is often erroneous; since the Disorder is not always owing to that Suppression, which is often the Effect of their Distemperature. This is so true, that even when the Efflux happens, if their Weakness still continues,the Patients are far from being the better for it, but the reverse. Neither is it unusual to see young Lads, who have received from Nature, and from their Parents, a sort of feminine Constitution, Education and Habitude, infested with much the same Symptoms, as obstructed young Women.Country Girls, who are generally more accustomed to such hardy Work and Exercise as Country Men, are less subject to these Complaints, than Women who live in Cities.§ 354. Let People then be careful not to deceive themselves on this important Account; since all the Complaints of young Maidens are not owing to the Want of their Customs. Nevertheless it is certain there are some of them, who are really afflicted from this Cause. For Instance, when a strong young Virgin in full Health, who is nearly arrived to her full Growth, and who manifestly abounds with Blood, does not obtain this Discharge at the usual Time of Life, then indeed this superfluous Blood is the Fountain of very many Disorders, and greatly more violent ones than those, which result from the contrary Causes already mentioned.If the lazy inactive City Girls are more subject to the Obstructions, which either arise from the Weakness and Languor I have formerly taken Notice of, or which accompany it; Country Girls are more subject to Complaints from this latter Cause (too great a Retention of superfluous Blood) than Women who live in Cities: and it isthis last Cause that excites those singular Disorders, which appear so supernatural to the common People, that they ascribe them to Sorcery.§ 355. And even after these periodical Discharges have appeared, it is known that they have often been suppressed, without the least unhealthy Consequence resulting from that Suppression. They are often suppressed, in the Circumstances mentioned§ 351, by a Continuance of the Disease, which was first an Obstacle or Retardment to their Appearance; and in other Cases, they have been suppressed by other Causes, such as Cold, Moisture, violent Fear, any very strong Passion; by too chilly a Course of Diet, with Indigestion; or too hot and irritating Diet; by Drinks cooled with Ice, by Exercise too long continued, and by unusual Watching. The Symptoms, occasioned by such Suppressions, are sometimes more violent than those, which preceded the first Appearance of the Discharge.§ 356. The great Facility with which this Evacuation may be suppressed, diminished, or disordered, by the Causes already assigned; the terrible Evils which are the Consequences of such Interruptions and Irregularities of them, seem to me very cogent Reasons to engage the Sex to use all possible Care, in every Respect, to preserve the Regularity of them; by avoiding, during their Approach and Continuance, every Cause that may prevent or lessen them. Would they be thoroughly persuaded, not solely by my Advice, but by that of their Mothers, theirRelations, their Friends, and by their own Experience, of what great Importance it is to be very attentive to themselves, at those critical Times, I think there is not one Woman, who from the first, to the very last Appearance of them, would not conduct herself with the most scrupulous Regularity.Their Demeanour, in these Circumstances, very fundamentally interests their own Health, as well as that of their Children; and consequently their own Happiness, as well as that of their Husbands and Families.The younger and more delicate they are, Caution becomes the more necessary for them. I am very sensible a strong Country Girl is too negligent in regulating herself at those critical Seasons, and sometimes without any ill Consequence; but at another Time she may suffer severely for it: and I could produce a long List of many, who, by their Imprudence on such Occasions, have thrown themselves into the most terrible Condition.Besides the Caution with which Females should avoid these general Causes, just mentioned in the preceding Section, every Person ought to remember what has most particularly disagreed with her during that Term, and for ever constantly to reject it.§ 357. There are many Women whose Customs visit them without the slightest Impeachment of their Health: others are sensibly disordered on every Return of them; and to others again they are very tormenting, by the violentCholics, of a longer or a shorter Duration, which precede or accompany them. I have known some of these violent Attacks last but some Minutes, and others which continued a few Hours. Nay some indeed have persisted for many Days, attended with Vomiting, Fainting, with Convulsions from excessive Pain, with Vomiting of Blood, Bleedings from the Nose,&c.which, in short, have brought them to the very Jaws of Death. So very dangerous a Situation requires the closest Attention; though, as it results from several and frequently very opposite Causes, it is impossible within the present Plan, to direct the Treatment that may be proper for each Individual. Some Women have the Unhappiness to be subject to these Symptoms every Month, from the first Appearance, to the final Termination, of these Discharges; except proper Remedies and Regimen, and sometimes a happy Child-birth, remove them. Others complain but now and then, every second, third, or fourth Month; and there are some again, who having suffered very severely during the first Months, or Years, after their first Eruptions, suffer no more afterwards. A fourth Number, after having had their Customs for a long Time, without the least Complaint, find themselves afflicted with cruel Pains, at every Return of them; if by Imprudence, or some inevitable Fatality, they have incurred any Cause, that has suppressed, diminished, or delayed them. This Consideration ought to suggest a proper Caution even to such, as generally undergo theseDischarges, without Pain or Complaint: since all may be assured, that though they suffer no sensible Disorder at that Time, they are nevertheless more delicate, more impressible by extraneous Substances, more easily affected by the Passions of the Mind, and have also weaker Stomachs at these particular Periods.§ 358. These Discharges may also be sometimes too profuse in Quantity, in which Case the Patients become obnoxious to very grievous Maladies; into the Discussion of which however I shall not enter here, as they are much less frequent than those, arising from a Suppression of them. Besides which, in such Cases, Recourse may be had to the Directions I shall give hereafter, when I treat of that Loss of Blood, which may be expedient, during the Course of Gravidation or Pregnancy. See§ 365.§ 359. Finally, even when they are the most regular, after their Continuance for a pretty certain Number of Years (rarely exceeding thirty-five) they go off of their own Accord, and necessarily, between the Age of forty-five and fifty; sometimes even sooner, but seldom continuing longer: and thisCrisisof their ceasing is generally a very troublesome, and often a very dangerous, one for the Sex.§ 360. The Evils mentioned§ 352may be prevented, by avoiding the Causes producing them; and, 1, by obliging young Maidens to use considerable Exercise; especially as soon asthere is the least Reason to suspect the Approach of this Disorder, theChlorosis, or Green Sickness.2, By watching them carefully, that they eat nothing unwholesome or improper; as there are scarcely any natural Substances, even among such as are most improper for them, and the most distasteful, which have not sometimes been the Objects of their sickly, their unaccountable Cravings. Fat Aliments, Pastry, farinaceous or mealy, and sour and watery Foods are pernicious to them. Herb-Teas, which are frequently directed as a Medicine for them, are sufficient to throw them into the Disorder, by increasing that Relaxation of their Fibres, which is a principal Cause of it. If they must drink any such Infusions, as medicated Drinks, let them be taken cold: but the best Drink for them is Water, in which red hot Iron has been extinguished.3, They must avoid hot sharp Medicines, and such as are solely intended to force down their Terms, which are frequently attended with very pernicious Consequences, and never do any good: and they are still the more hurtful, as the Patient is the younger.4, If the Malady increases, it will be necessary to give them some Remedies; but these should not be Purges, nor consist of Diluters, and Decoctions of Herbs, of Salts, and a Heap of other useless and noxious Ingredients; but they should take Filings of Iron, which is the most certain Remedy in such Cases. These Filings Should beof true simple Iron, and not from Steel; and Care should be taken that it be not rusty, in which State it has very little Effect.At the Beginning of this Distemper, and to young Girls, it is sufficient to give twenty Grains daily, enjoining due Exercise and a suitable Diet. When it prevails in a severer Degree, and the Patient is not so young, a Quarter of an Ounce may be safely ventured on: Certain Bitters or Aromatics may be advantageously joined to the Filings, which are numbered in the Appendix,54,55,56, and constitute the most effectual Remedies in this Distemper, to be taken in the Form of Powder, of vinous Infusion, or of Electary.82When there is a just Indication to bring down the Discharge, the vinous InfusionNº. 55must be given, and generally succeeds: but I must again repeat it (as it should carefully be considered) that the Stoppage or Obstruction of this Discharge is frequently the Effect, not the Cause, of this Disease; and that there should be no Attempt to force it down, which in such a Case, may sometimes prove more hurtful than beneficial; since it would naturally return of its own Accord, on the Recovery, and with the Strength, of the Patient: as their Return should follow that of perfect Health, and neither can precede Health, nor introduce it. There aresome Cases particularly, in which it would be highly dangerous to use hot and active Medicines, such Cases for Instance, as are attended with some Degree of Fever, a frequent Coughing, a Hæmorrhage, or Bleeding, with great Leanness and considerable Thirst: all which Complaints should be removed, before any hot Medicines are given to force this Evacuation, which many very ignorantly imagine cures all other female Disorders; an Error, that has prematurely occasioned the Loss of many Womens' Lives.§ 361. While the Patient is under a Course of these Medicines, she should not take any of those I have forbidden in the preceding Sections; and the Efficacy of these should also be furthered with proper Exercise. That in a Carriage is very healthy; Dancing is so too, provided it be not extended to an Excess. In Case of a Relapse in these Disorders, the Patient is to be treated, as if it were an original Attack.§ 362. The other Sort of Obstructions described§ 354requires a very different Treatment. Bleeding, which is hurtful in the former Sort, and the Use, or rather Abuse, of which has thrown several young Women into irrecoverable Weaknesses, has often removed this latter Species, as it were, in a Moment. Bathing of the Feet, the PowdersNº. 20, and Whey have frequently succeeded: but at other Times it is necessary to accommodate the Remedies and the Method to each particular Case, and to judge of itfrom its own peculiar Circumstances and Appearances.§ 363. When these Evacuations naturally cease through Age (See§ 359) if they stop suddenly and all at once, and had formerly flowed very largely, Bleeding must, 1, necessarily be directed, and repeated every six, every four, or even every three Months.2, The usual Quantity of Food should be somewhat diminished, especially of Flesh, of Eggs and of strong Drink.3, Exercise should be increased.4, The Patient should frequently take, in a Morning fasting, the PowderNº. 24, which is very beneficial in such Cases; as it moderately increases the natural Excretions by Stool, Urine and Perspiration; and thence lessens that Quantity of Blood, which would otherwise superabound.Nevertheless, should this total Cessation of the monthly Discharge be preceded by, or attended with, any extraordinary Loss of Blood, which is frequently the Case, Bleeding is not so necessary; but the Regimen and Powder just directed are very much so; to which the PurgeNº. 23should now and then be joined, at moderate Intervals. The Use of astringent Medicines at this critical Time might dispose the Patient to a Cancer of the Womb.Many Women die about this Age, as it is but too easy a Matter to injure them then; aCircumstance that should make them very cautious and prudent in the Medicines they recur to. On the other Hand it also frequently happens, that their Constitutions alter for the better, after this critical Time of Life; their Fibres grow stronger; they find themselves sensibly more hearty and hardy; many former slight Infirmities disappear, and they enjoy a healthy and happy old Age. I have known several who threw away their Spectacles at the Age of fifty-two, or fifty-three, which they had used five or six Years before.The Regimen I have just directed, the PowderNº. 24, and the PotionNº. 32, agree very well in almost all inveterate Discharges (I speak of the female Peasantry) at whatever Time of Life.

Sect.350.

Sect.350.

Besides all the preceding Diseases, to which Women are liable in common with Men, their Sex also exposes them to others peculiar to it, and which depend upon four principal Sources; which are their monthly Discharges, their Pregnancy, their Labours in Child-birth, and the Consequences of their Labours. It is not my present Design to treat professedly on each of the Diseases arising from these Causes, which would require a larger Volume than I have proposed; but I shall confine myself to certain general Directions on these four Heads.

§ 351. Nature, who intended Women for the Increase, and the Nourishment of the human Race at the Breast, has subjected them to a periodical Efflux, or Discharge, of Blood: whichCircumstance constitutesthe Source, from whence the Infant is afterwards to receive his Nutrition and Growth.

This Discharge generally commences, with us, between the Age of sixteen and eighteen. Young Maidens, before the Appearance of this Discharge, are frequently, and many for a long Time, in a State of Weakness, attended with various Complaints, which is termed theChlorosis, or Green Sickness, and Obstructions: and when their Appearance is extremely slow and backward, it occasions very grievous, and sometimes even mortal Diseases. Nevertheless it is too usual, though very improper, to ascribe all the Evils, to which they are subject at this Term of Life, solely to this Cause; while they really often result from a different Cause, of which the Obstructions themselves are sometimes only the Effect; and this is the natural, and, in some Degree, even necessary Feebleness of the Sex. The Fibres of Women which are intended to be relaxed, and to give Way, when they are unavoidably extended by the Growth of the Child, and its inclosing Membranes (which frequently arise to a very considerable Size) should necessarily be less stiff and rigid, less strong, and more lax and yielding than the Fibres of Men. Hence the Circulation of their Blood is more slow and languid than in Males; their Blood is less compact and dense, and more watery; their Fluids are more liable to stagnate in their different Bowels, and to form Infarctions and Obstructions.

§ 352. The Disorders to which such a Constitution subjects them might, in some Measure, be prevented, by assisting that Languor or Feebleness of their natural Movements, by such an Increase of their Force, as Exercise might contribute to: But this Assistance, which in some Manner is more necessary for Females than Males, they are partly deprived of, by the general Education and Habitude of the Sex; as they are usually employed in managing Household Business, and such light sedentary Work, as afford them less Exercise and Motion, than the more active Occupations of Men. They stir about but little, whence their natural Tendency to Weakness increases from Habit, and thence becomes morbid and sickly. Their Blood circulates imperfectly; its Qualities become impaired; the Humours tend to a pretty general Stagnation; and none of the vital Functions are completely discharged.

From such Causes and Circumstances they begin to sink into a State of Weakness, sometimes while they are very young, and many Years before this periodical Discharge could be expected. This State of Languor disposes them to be inactive; a little Exercise soon fatigues them, whence they take none at all. It might prove a Remedy, and even effect a Cure, at the Beginning of their Complaint; but as it is a Remedy, that is painful and disagreeable to them, they reject it, and thus increase their Disorders.

Their Appetite declines with the other vital Functions, and gradually becomes still less; theusual salutary Kinds of Food never exciting it; instead of which they indulge themselves in whimsical Cravings, and often of the oddest and most improper Substances for Nutrition, which entirely impair the Stomach with its digestive Functions, and consequently Health itself.

But sometimes after the Duration of this State for a few Years, the ordinary Time of their monthly Evacuations approaches, which however make not the least Appearance, for two Reasons. The first is, that their Health is too much impaired to accomplish this new Function, at a Time when all the others are so languid: and the second is, that under such Circumstances, the Evacuations themselves are unnecessary; since their final Purpose is to discharge (when the Sex arenot pregnant) that superfluous Blood, which they were intended to produce, and whose Retention would be unhealthy, when not applied to the Growth of the Fœtus, or Nourishment of the Child: and this Superfluity of Blood does not exist in Women, who have been long in a very low and languishing State.

§ 353. Their Disorder however continues to increase, as every one daily must, which does not terminate. This Increase of it is attributed to the Suppression or Non-appearance of their monthly Efflux, which is often erroneous; since the Disorder is not always owing to that Suppression, which is often the Effect of their Distemperature. This is so true, that even when the Efflux happens, if their Weakness still continues,the Patients are far from being the better for it, but the reverse. Neither is it unusual to see young Lads, who have received from Nature, and from their Parents, a sort of feminine Constitution, Education and Habitude, infested with much the same Symptoms, as obstructed young Women.

Country Girls, who are generally more accustomed to such hardy Work and Exercise as Country Men, are less subject to these Complaints, than Women who live in Cities.

§ 354. Let People then be careful not to deceive themselves on this important Account; since all the Complaints of young Maidens are not owing to the Want of their Customs. Nevertheless it is certain there are some of them, who are really afflicted from this Cause. For Instance, when a strong young Virgin in full Health, who is nearly arrived to her full Growth, and who manifestly abounds with Blood, does not obtain this Discharge at the usual Time of Life, then indeed this superfluous Blood is the Fountain of very many Disorders, and greatly more violent ones than those, which result from the contrary Causes already mentioned.

If the lazy inactive City Girls are more subject to the Obstructions, which either arise from the Weakness and Languor I have formerly taken Notice of, or which accompany it; Country Girls are more subject to Complaints from this latter Cause (too great a Retention of superfluous Blood) than Women who live in Cities: and it isthis last Cause that excites those singular Disorders, which appear so supernatural to the common People, that they ascribe them to Sorcery.

§ 355. And even after these periodical Discharges have appeared, it is known that they have often been suppressed, without the least unhealthy Consequence resulting from that Suppression. They are often suppressed, in the Circumstances mentioned§ 351, by a Continuance of the Disease, which was first an Obstacle or Retardment to their Appearance; and in other Cases, they have been suppressed by other Causes, such as Cold, Moisture, violent Fear, any very strong Passion; by too chilly a Course of Diet, with Indigestion; or too hot and irritating Diet; by Drinks cooled with Ice, by Exercise too long continued, and by unusual Watching. The Symptoms, occasioned by such Suppressions, are sometimes more violent than those, which preceded the first Appearance of the Discharge.

§ 356. The great Facility with which this Evacuation may be suppressed, diminished, or disordered, by the Causes already assigned; the terrible Evils which are the Consequences of such Interruptions and Irregularities of them, seem to me very cogent Reasons to engage the Sex to use all possible Care, in every Respect, to preserve the Regularity of them; by avoiding, during their Approach and Continuance, every Cause that may prevent or lessen them. Would they be thoroughly persuaded, not solely by my Advice, but by that of their Mothers, theirRelations, their Friends, and by their own Experience, of what great Importance it is to be very attentive to themselves, at those critical Times, I think there is not one Woman, who from the first, to the very last Appearance of them, would not conduct herself with the most scrupulous Regularity.

Their Demeanour, in these Circumstances, very fundamentally interests their own Health, as well as that of their Children; and consequently their own Happiness, as well as that of their Husbands and Families.

The younger and more delicate they are, Caution becomes the more necessary for them. I am very sensible a strong Country Girl is too negligent in regulating herself at those critical Seasons, and sometimes without any ill Consequence; but at another Time she may suffer severely for it: and I could produce a long List of many, who, by their Imprudence on such Occasions, have thrown themselves into the most terrible Condition.

Besides the Caution with which Females should avoid these general Causes, just mentioned in the preceding Section, every Person ought to remember what has most particularly disagreed with her during that Term, and for ever constantly to reject it.

§ 357. There are many Women whose Customs visit them without the slightest Impeachment of their Health: others are sensibly disordered on every Return of them; and to others again they are very tormenting, by the violentCholics, of a longer or a shorter Duration, which precede or accompany them. I have known some of these violent Attacks last but some Minutes, and others which continued a few Hours. Nay some indeed have persisted for many Days, attended with Vomiting, Fainting, with Convulsions from excessive Pain, with Vomiting of Blood, Bleedings from the Nose,&c.which, in short, have brought them to the very Jaws of Death. So very dangerous a Situation requires the closest Attention; though, as it results from several and frequently very opposite Causes, it is impossible within the present Plan, to direct the Treatment that may be proper for each Individual. Some Women have the Unhappiness to be subject to these Symptoms every Month, from the first Appearance, to the final Termination, of these Discharges; except proper Remedies and Regimen, and sometimes a happy Child-birth, remove them. Others complain but now and then, every second, third, or fourth Month; and there are some again, who having suffered very severely during the first Months, or Years, after their first Eruptions, suffer no more afterwards. A fourth Number, after having had their Customs for a long Time, without the least Complaint, find themselves afflicted with cruel Pains, at every Return of them; if by Imprudence, or some inevitable Fatality, they have incurred any Cause, that has suppressed, diminished, or delayed them. This Consideration ought to suggest a proper Caution even to such, as generally undergo theseDischarges, without Pain or Complaint: since all may be assured, that though they suffer no sensible Disorder at that Time, they are nevertheless more delicate, more impressible by extraneous Substances, more easily affected by the Passions of the Mind, and have also weaker Stomachs at these particular Periods.

§ 358. These Discharges may also be sometimes too profuse in Quantity, in which Case the Patients become obnoxious to very grievous Maladies; into the Discussion of which however I shall not enter here, as they are much less frequent than those, arising from a Suppression of them. Besides which, in such Cases, Recourse may be had to the Directions I shall give hereafter, when I treat of that Loss of Blood, which may be expedient, during the Course of Gravidation or Pregnancy. See§ 365.

§ 359. Finally, even when they are the most regular, after their Continuance for a pretty certain Number of Years (rarely exceeding thirty-five) they go off of their own Accord, and necessarily, between the Age of forty-five and fifty; sometimes even sooner, but seldom continuing longer: and thisCrisisof their ceasing is generally a very troublesome, and often a very dangerous, one for the Sex.

§ 360. The Evils mentioned§ 352may be prevented, by avoiding the Causes producing them; and, 1, by obliging young Maidens to use considerable Exercise; especially as soon asthere is the least Reason to suspect the Approach of this Disorder, theChlorosis, or Green Sickness.

2, By watching them carefully, that they eat nothing unwholesome or improper; as there are scarcely any natural Substances, even among such as are most improper for them, and the most distasteful, which have not sometimes been the Objects of their sickly, their unaccountable Cravings. Fat Aliments, Pastry, farinaceous or mealy, and sour and watery Foods are pernicious to them. Herb-Teas, which are frequently directed as a Medicine for them, are sufficient to throw them into the Disorder, by increasing that Relaxation of their Fibres, which is a principal Cause of it. If they must drink any such Infusions, as medicated Drinks, let them be taken cold: but the best Drink for them is Water, in which red hot Iron has been extinguished.

3, They must avoid hot sharp Medicines, and such as are solely intended to force down their Terms, which are frequently attended with very pernicious Consequences, and never do any good: and they are still the more hurtful, as the Patient is the younger.

4, If the Malady increases, it will be necessary to give them some Remedies; but these should not be Purges, nor consist of Diluters, and Decoctions of Herbs, of Salts, and a Heap of other useless and noxious Ingredients; but they should take Filings of Iron, which is the most certain Remedy in such Cases. These Filings Should beof true simple Iron, and not from Steel; and Care should be taken that it be not rusty, in which State it has very little Effect.

At the Beginning of this Distemper, and to young Girls, it is sufficient to give twenty Grains daily, enjoining due Exercise and a suitable Diet. When it prevails in a severer Degree, and the Patient is not so young, a Quarter of an Ounce may be safely ventured on: Certain Bitters or Aromatics may be advantageously joined to the Filings, which are numbered in the Appendix,54,55,56, and constitute the most effectual Remedies in this Distemper, to be taken in the Form of Powder, of vinous Infusion, or of Electary.82When there is a just Indication to bring down the Discharge, the vinous InfusionNº. 55must be given, and generally succeeds: but I must again repeat it (as it should carefully be considered) that the Stoppage or Obstruction of this Discharge is frequently the Effect, not the Cause, of this Disease; and that there should be no Attempt to force it down, which in such a Case, may sometimes prove more hurtful than beneficial; since it would naturally return of its own Accord, on the Recovery, and with the Strength, of the Patient: as their Return should follow that of perfect Health, and neither can precede Health, nor introduce it. There aresome Cases particularly, in which it would be highly dangerous to use hot and active Medicines, such Cases for Instance, as are attended with some Degree of Fever, a frequent Coughing, a Hæmorrhage, or Bleeding, with great Leanness and considerable Thirst: all which Complaints should be removed, before any hot Medicines are given to force this Evacuation, which many very ignorantly imagine cures all other female Disorders; an Error, that has prematurely occasioned the Loss of many Womens' Lives.

§ 361. While the Patient is under a Course of these Medicines, she should not take any of those I have forbidden in the preceding Sections; and the Efficacy of these should also be furthered with proper Exercise. That in a Carriage is very healthy; Dancing is so too, provided it be not extended to an Excess. In Case of a Relapse in these Disorders, the Patient is to be treated, as if it were an original Attack.

§ 362. The other Sort of Obstructions described§ 354requires a very different Treatment. Bleeding, which is hurtful in the former Sort, and the Use, or rather Abuse, of which has thrown several young Women into irrecoverable Weaknesses, has often removed this latter Species, as it were, in a Moment. Bathing of the Feet, the PowdersNº. 20, and Whey have frequently succeeded: but at other Times it is necessary to accommodate the Remedies and the Method to each particular Case, and to judge of itfrom its own peculiar Circumstances and Appearances.

§ 363. When these Evacuations naturally cease through Age (See§ 359) if they stop suddenly and all at once, and had formerly flowed very largely, Bleeding must, 1, necessarily be directed, and repeated every six, every four, or even every three Months.

2, The usual Quantity of Food should be somewhat diminished, especially of Flesh, of Eggs and of strong Drink.

3, Exercise should be increased.

4, The Patient should frequently take, in a Morning fasting, the PowderNº. 24, which is very beneficial in such Cases; as it moderately increases the natural Excretions by Stool, Urine and Perspiration; and thence lessens that Quantity of Blood, which would otherwise superabound.

Nevertheless, should this total Cessation of the monthly Discharge be preceded by, or attended with, any extraordinary Loss of Blood, which is frequently the Case, Bleeding is not so necessary; but the Regimen and Powder just directed are very much so; to which the PurgeNº. 23should now and then be joined, at moderate Intervals. The Use of astringent Medicines at this critical Time might dispose the Patient to a Cancer of the Womb.

Many Women die about this Age, as it is but too easy a Matter to injure them then; aCircumstance that should make them very cautious and prudent in the Medicines they recur to. On the other Hand it also frequently happens, that their Constitutions alter for the better, after this critical Time of Life; their Fibres grow stronger; they find themselves sensibly more hearty and hardy; many former slight Infirmities disappear, and they enjoy a healthy and happy old Age. I have known several who threw away their Spectacles at the Age of fifty-two, or fifty-three, which they had used five or six Years before.

The Regimen I have just directed, the PowderNº. 24, and the PotionNº. 32, agree very well in almost all inveterate Discharges (I speak of the female Peasantry) at whatever Time of Life.

Of Disorders attending Gravidation, or the Term of going with Child.§ 364. Gravidation is generally a less ailing or unhealthy State in the Country, than in very populous Towns. Nevertheless Country Women are subject, as well as Citizens, to Pains of the Stomach, to vomiting in a Morning, to Head-ach and Tooth-ach; but these Complaints very commonly yield to Bleeding, which is almost the only Remedy necessary83for pregnant Women.§ 365. Sometimes after carrying too heavy Burthens; after too much or too violent Work; after receiving excessive Jolts, or having had a Fall, they are subject to violent Pains of the Loins, which extend down to their Thighs, and terminate quite at the Bottom of the Belly; and which commonly import, that they are in Danger of an Abortion, or Miscarrying.To prevent this Consequence, which is always dangerous, they should, 1, immediately go to Bed; and if they have not a Mattrass, they should lie upon a Bed stuffed with Straw, a Feather-bed being very improper in such Cases. They should repose, or keep themselves quite still in this Situation for several Days, not stirring, and speaking as little as possible.2, They should directly lose eight or nine Ounces of Blood from the Arm.3, They should not eat Flesh, Flesh-broth, nor Eggs; but live solely on Soups made of farinaceous or mealy Substances.4, They should take every two Hours half a Paper of the PowderNº. 20; and should drink nothing but the PtisanNº. 2.Some sanguine robust Women are very liable to miscarry at a certain Time, or Stage, of their Pregnancy. This may be obviated by their bleeding some Days before that Time approaches, and by their observing the Regimen I have advised. But this Method would avail very little for delicate Citizens, who miscarry from a very different Cause; and whose Abortions are to be prevented by a very different Treatment.

§ 364. Gravidation is generally a less ailing or unhealthy State in the Country, than in very populous Towns. Nevertheless Country Women are subject, as well as Citizens, to Pains of the Stomach, to vomiting in a Morning, to Head-ach and Tooth-ach; but these Complaints very commonly yield to Bleeding, which is almost the only Remedy necessary83for pregnant Women.

§ 365. Sometimes after carrying too heavy Burthens; after too much or too violent Work; after receiving excessive Jolts, or having had a Fall, they are subject to violent Pains of the Loins, which extend down to their Thighs, and terminate quite at the Bottom of the Belly; and which commonly import, that they are in Danger of an Abortion, or Miscarrying.

To prevent this Consequence, which is always dangerous, they should, 1, immediately go to Bed; and if they have not a Mattrass, they should lie upon a Bed stuffed with Straw, a Feather-bed being very improper in such Cases. They should repose, or keep themselves quite still in this Situation for several Days, not stirring, and speaking as little as possible.

2, They should directly lose eight or nine Ounces of Blood from the Arm.

3, They should not eat Flesh, Flesh-broth, nor Eggs; but live solely on Soups made of farinaceous or mealy Substances.

4, They should take every two Hours half a Paper of the PowderNº. 20; and should drink nothing but the PtisanNº. 2.

Some sanguine robust Women are very liable to miscarry at a certain Time, or Stage, of their Pregnancy. This may be obviated by their bleeding some Days before that Time approaches, and by their observing the Regimen I have advised. But this Method would avail very little for delicate Citizens, who miscarry from a very different Cause; and whose Abortions are to be prevented by a very different Treatment.

Of Delivery, or Child-birth.§ 366. It has been observed that a greater Proportion of Women die in the Country in, or very speedily after, their Delivery, and that from the Scarcity of good Assistance, and the great Plenty of what is bad; and that a greater Proportion of those in Cities die after their Labours are effected, by a Continuance of their former bad Health.The Necessity there is for better instructed, better qualified Midwives, through a great Part ofSwisserland, is but too manifest an Unhappiness, which is attended with the most fatal Consequences, and which merits the utmost Attention of the Government.The Errors which are incurred, during actual Labour, are numberless, and too often indeed are also irremediable. It would require a wholeBook, expressly for that Purpose (and in some Countries there are such) to give all the Directions that are necessary, to prevent so many Fatalities: and it would be as necessary to form a sufficient Number of well-qualified Midwives to comprehend, and to observe them; which exceeds the Plan of the Work I have proposed. I shall only mark out one of the Causes, and the most injurious one on this Occasion: This is the Custom of giving hot irritating Things, whenever the Labour is very painful, or is slow; such as Castor, or its Tincture, Saffron, Sage, Rue, Savin, Oil of Amber, Wine, Venice Treacle, Wine burnt with Spices, Coffee, Brandy, Aniseed-Water, Walnut-Water, Fennel-Water, and other Drams or strong Liquors. All these Things are so many Poisons in this Respect, which, very far from promoting the Woman's Delivery, render it more difficult by inflaming the Womb (which cannot then so well contract itself) and the Parts, through which the Birth is to pass, in Consequence of which they swell, become more straitened, and cannot yield or be dilated. Sometimes these stimulating hot Medicines also bring on Hæmorrhages, which prove mortal in a few Hours.§ 367. A considerable Number, both of Mothers and Infants, might be preserved by the directly opposite Method. As soon as a Woman who was in very good Health, just before the Approach of her Labour, being robust and well made, finds her Travail come on, and that it ispainful and difficult; far from encouraging those premature Efforts, which are always destructive; and from furthering them by the pernicious Medicines I have just enumerated, the Patient should be bled in the Arm, which will prevent the Swelling and Inflammation; asswage the Pains; relax the Parts, and dispose every thing to a favourable Issue.During actual Labour no other Nourishment should be allowed, except a little Panada every three Hours, and as much Toast and Water, as the Woman chuses.Every fourth Hour a Glyster should be given, consisting of a Decoction of Mallows and a little Oil. In the Intervals between these Glysters she should be set over a kind of Stove, or in a pierced easy Chair, containing a Vessel in which there is some hot Water: the Passage should be gently rubbed with a little Butter; and Stapes wrung out of a Fomentation of simple hot Water, which is the most efficacious of any, should be applied over the Belly.The Midwives, by taking this Method, are not only certain of doing no Mischief, but they also allow Nature an Opportunity of doing Good: as a great many Labours, which seem difficult at time, terminate happily; and this safe and unprecipitate Manner of proceeding at least affords Time to call in further Assistance. Besides, the Consequences of such Deliveries are healthy and happy; when by pursuing the heating oppressing Practice, even though the Delivery be effected, bothMother and Infant have been so cruelly, though undesignedly, tormented, that both of them frequently perish.§ 368. I acknowledge these Means are insufficient, when the Child is unhappily situated in the Womb; or when there is an embarrassing Conformation in the Mother: though at least they prevent the Case from proving worse, and leave Time for calling in Men-Midwives, or other female ones, who may be better qualified.I beg leave again to remind the Midwives, that they should be very cautious of urging their Women to make any forced Efforts to forward the Birth, which are extremely injurious to them, and which may render a Delivery very dangerous and embarrassing, that might otherwise have been happily effected: and I insist the more freely on the Danger attending these unreasonable Efforts, and on the very great Importance of Patience, as the other very pernicious Practice is become next to universal amongst us.The Weakness, in which the labouring Woman appears, makes the By-standers fearful that she will not have Strength enough to be delivered; which they think abundantly justifies them in giving her Cordials; but this Way of Reasoning is very weak and chimerical. Their Strength, on such Occasions, is not so very speedily dissipated: the small light Pains sink them, but in Proportion as the Pains become stronger, their Strength arises; being never deficient, when there is no extraordinary and uncommon Symptom;and we may reasonably be assured, that in a healthy, well formed Woman, meer Weakness never prevents a Delivery.

§ 366. It has been observed that a greater Proportion of Women die in the Country in, or very speedily after, their Delivery, and that from the Scarcity of good Assistance, and the great Plenty of what is bad; and that a greater Proportion of those in Cities die after their Labours are effected, by a Continuance of their former bad Health.

The Necessity there is for better instructed, better qualified Midwives, through a great Part ofSwisserland, is but too manifest an Unhappiness, which is attended with the most fatal Consequences, and which merits the utmost Attention of the Government.

The Errors which are incurred, during actual Labour, are numberless, and too often indeed are also irremediable. It would require a wholeBook, expressly for that Purpose (and in some Countries there are such) to give all the Directions that are necessary, to prevent so many Fatalities: and it would be as necessary to form a sufficient Number of well-qualified Midwives to comprehend, and to observe them; which exceeds the Plan of the Work I have proposed. I shall only mark out one of the Causes, and the most injurious one on this Occasion: This is the Custom of giving hot irritating Things, whenever the Labour is very painful, or is slow; such as Castor, or its Tincture, Saffron, Sage, Rue, Savin, Oil of Amber, Wine, Venice Treacle, Wine burnt with Spices, Coffee, Brandy, Aniseed-Water, Walnut-Water, Fennel-Water, and other Drams or strong Liquors. All these Things are so many Poisons in this Respect, which, very far from promoting the Woman's Delivery, render it more difficult by inflaming the Womb (which cannot then so well contract itself) and the Parts, through which the Birth is to pass, in Consequence of which they swell, become more straitened, and cannot yield or be dilated. Sometimes these stimulating hot Medicines also bring on Hæmorrhages, which prove mortal in a few Hours.

§ 367. A considerable Number, both of Mothers and Infants, might be preserved by the directly opposite Method. As soon as a Woman who was in very good Health, just before the Approach of her Labour, being robust and well made, finds her Travail come on, and that it ispainful and difficult; far from encouraging those premature Efforts, which are always destructive; and from furthering them by the pernicious Medicines I have just enumerated, the Patient should be bled in the Arm, which will prevent the Swelling and Inflammation; asswage the Pains; relax the Parts, and dispose every thing to a favourable Issue.

During actual Labour no other Nourishment should be allowed, except a little Panada every three Hours, and as much Toast and Water, as the Woman chuses.

Every fourth Hour a Glyster should be given, consisting of a Decoction of Mallows and a little Oil. In the Intervals between these Glysters she should be set over a kind of Stove, or in a pierced easy Chair, containing a Vessel in which there is some hot Water: the Passage should be gently rubbed with a little Butter; and Stapes wrung out of a Fomentation of simple hot Water, which is the most efficacious of any, should be applied over the Belly.

The Midwives, by taking this Method, are not only certain of doing no Mischief, but they also allow Nature an Opportunity of doing Good: as a great many Labours, which seem difficult at time, terminate happily; and this safe and unprecipitate Manner of proceeding at least affords Time to call in further Assistance. Besides, the Consequences of such Deliveries are healthy and happy; when by pursuing the heating oppressing Practice, even though the Delivery be effected, bothMother and Infant have been so cruelly, though undesignedly, tormented, that both of them frequently perish.

§ 368. I acknowledge these Means are insufficient, when the Child is unhappily situated in the Womb; or when there is an embarrassing Conformation in the Mother: though at least they prevent the Case from proving worse, and leave Time for calling in Men-Midwives, or other female ones, who may be better qualified.

I beg leave again to remind the Midwives, that they should be very cautious of urging their Women to make any forced Efforts to forward the Birth, which are extremely injurious to them, and which may render a Delivery very dangerous and embarrassing, that might otherwise have been happily effected: and I insist the more freely on the Danger attending these unreasonable Efforts, and on the very great Importance of Patience, as the other very pernicious Practice is become next to universal amongst us.

The Weakness, in which the labouring Woman appears, makes the By-standers fearful that she will not have Strength enough to be delivered; which they think abundantly justifies them in giving her Cordials; but this Way of Reasoning is very weak and chimerical. Their Strength, on such Occasions, is not so very speedily dissipated: the small light Pains sink them, but in Proportion as the Pains become stronger, their Strength arises; being never deficient, when there is no extraordinary and uncommon Symptom;and we may reasonably be assured, that in a healthy, well formed Woman, meer Weakness never prevents a Delivery.

Of the Consequences of Labour, or Childbirth.§ 369. The most usual Consequences of Childbirth in the Country are, 1, An excessive Hæmorrhage.2, An Inflammationof the Womb. 3, A sudden Suppression of theLochia, or usual Discharges after Delivery. And, 4, the Fever and other Accidents, resulting from the Milk.Excessive Bleedings or Floodings, should be treated according to the Manner directed§ 365: and if they are very excessive, Folds of Linen, which have been wrung out of a Mixture of equal Parts of Water and Vinegar, should be applied to the Belly, the Loins, and the Thighs: these should be changed for fresh moist ones, as they dry; and should be omitted, as soon as the Bleeding abates.§ 370. The Inflammation of the Womb is discoverable by Pains in all the lower Parts of the Belly; by a Tension or Tightness of the whole; by a sensible Increase of Pain upon touching it; a kind of red Stain or Spot, that mounts to the Middle of the Belly, as high as the Navel; which Spot, as the Disease increases, turns black, and then is always a mortal Symptom; by a very extraordinary Degree of Weakness; an astonishing Change of Countenance; a lightDeliriumor Raving; a continual Fever with a weak and hardPulse; sometimes incessant Vomitings; a frequent Hiccup; a moderate Discharge of a reddish, stinking, sharp Water; frequent Urgings to go to Stool; a burning kind of Heat of Urine; and sometimes an entire Suppression of it.§ 371. This most dangerous and frequently mortal Disease should be treated like inflammatory ones. After Bleeding, frequent Glysters of warm Water must by no Means be omitted; some should also be injected into the Womb, and applied continually over the Belly. The Patient may also drink continually, either of simple Barley-Water, with a Quarter of an Ounce of Nitre in every Pot of it, or of Almond MilkNº. 4.§ 372. The total Suppression of theLochia, the Discharges after Labour, which proves a Cause of the most violent Disorders, should be treated exactly in the same Manner: but if unhappily hot Medicines have been given, in order to force them down, the Case will very generally prove a most hopeless one.§ 373. If the Milk-fever run very high, the Barley Ptisan directed§ 371, and Glysters, with a very light Diet, consisting only of Panada, or made of some other farinaceous Substances, and very thin, very generally remove it.§ 374. Delicate infirm Women, who have not all the requisite and necessary Attendance they want; and such as from Indigence are obliged to work too soon, are exposed to many Accidents, which frequently arise from a Wantof due Perspiration, and an insufficient Discharge of theLochia; and hence, the Separation of the Milk in their Breasts being disturbed, there are milky Congestions, or Knots as it were, which are always very painful and troublesome, and especially when they are formed more inwardly. They often happen on the Thighs, in which Case the PtisanNº. 58is to be drank, and the PulticesNº. 59must be applied. These two Remedies gradually dissipate and remove the Tumour, if that may be effected without Suppuration. But if that proves impossible, andPus, or Matter, is actually formed, a Surgeon must open the Abscess, and treat it like any other.§ 375. Should the Milk coagulate, or curdle as it were, in the Breast, it is of the utmost Importance immediately to attenuate or dissolve that Thickness, which would otherwise degenerate into a Hardness and prove aScirrhus; and from aScirrhusin Process of Time a Cancer, that most tormenting and cruel Distemper.This horrible Evil however may be prevented by an Application to these small Tumours, as soon as ever they appear, For this Purpose nothing is more effectual than the PrescriptionsNº. 57and60; but under such menacing Circumstances, it is always prudent to take the best Advice, as early as possible.From the Moment these hard Tumours become excessively and obstinately so, and yet without any Pain, we should abstain from every Application, all are injurious; and greasy, sharp,resinous and spirituous ones speedily change theScirrhusinto a Cancer. Whenever it becomes manifestly such, all Applications are also equally pernicious, except that ofNº. 60. Cancers have long been thought and found incurable; but within a few Years past some have been cured by the RemedyNº. 57; which nevertheless is not infallible, though it should always be tried.84§ 376. The Nipples of Women, who give Milk, are often fretted or excoriated, which proves very severely painful to them. One of the best Applications is the most simple Ointment, being a Mixture of Oil and Wax melted together; or the OintmentNº. 66. Should the Complaint prove very obstinate, the Nurse ought to be purged, which generally removes it.

§ 369. The most usual Consequences of Childbirth in the Country are, 1, An excessive Hæmorrhage.2, An Inflammationof the Womb. 3, A sudden Suppression of theLochia, or usual Discharges after Delivery. And, 4, the Fever and other Accidents, resulting from the Milk.

Excessive Bleedings or Floodings, should be treated according to the Manner directed§ 365: and if they are very excessive, Folds of Linen, which have been wrung out of a Mixture of equal Parts of Water and Vinegar, should be applied to the Belly, the Loins, and the Thighs: these should be changed for fresh moist ones, as they dry; and should be omitted, as soon as the Bleeding abates.

§ 370. The Inflammation of the Womb is discoverable by Pains in all the lower Parts of the Belly; by a Tension or Tightness of the whole; by a sensible Increase of Pain upon touching it; a kind of red Stain or Spot, that mounts to the Middle of the Belly, as high as the Navel; which Spot, as the Disease increases, turns black, and then is always a mortal Symptom; by a very extraordinary Degree of Weakness; an astonishing Change of Countenance; a lightDeliriumor Raving; a continual Fever with a weak and hardPulse; sometimes incessant Vomitings; a frequent Hiccup; a moderate Discharge of a reddish, stinking, sharp Water; frequent Urgings to go to Stool; a burning kind of Heat of Urine; and sometimes an entire Suppression of it.

§ 371. This most dangerous and frequently mortal Disease should be treated like inflammatory ones. After Bleeding, frequent Glysters of warm Water must by no Means be omitted; some should also be injected into the Womb, and applied continually over the Belly. The Patient may also drink continually, either of simple Barley-Water, with a Quarter of an Ounce of Nitre in every Pot of it, or of Almond MilkNº. 4.

§ 372. The total Suppression of theLochia, the Discharges after Labour, which proves a Cause of the most violent Disorders, should be treated exactly in the same Manner: but if unhappily hot Medicines have been given, in order to force them down, the Case will very generally prove a most hopeless one.

§ 373. If the Milk-fever run very high, the Barley Ptisan directed§ 371, and Glysters, with a very light Diet, consisting only of Panada, or made of some other farinaceous Substances, and very thin, very generally remove it.

§ 374. Delicate infirm Women, who have not all the requisite and necessary Attendance they want; and such as from Indigence are obliged to work too soon, are exposed to many Accidents, which frequently arise from a Wantof due Perspiration, and an insufficient Discharge of theLochia; and hence, the Separation of the Milk in their Breasts being disturbed, there are milky Congestions, or Knots as it were, which are always very painful and troublesome, and especially when they are formed more inwardly. They often happen on the Thighs, in which Case the PtisanNº. 58is to be drank, and the PulticesNº. 59must be applied. These two Remedies gradually dissipate and remove the Tumour, if that may be effected without Suppuration. But if that proves impossible, andPus, or Matter, is actually formed, a Surgeon must open the Abscess, and treat it like any other.

§ 375. Should the Milk coagulate, or curdle as it were, in the Breast, it is of the utmost Importance immediately to attenuate or dissolve that Thickness, which would otherwise degenerate into a Hardness and prove aScirrhus; and from aScirrhusin Process of Time a Cancer, that most tormenting and cruel Distemper.

This horrible Evil however may be prevented by an Application to these small Tumours, as soon as ever they appear, For this Purpose nothing is more effectual than the PrescriptionsNº. 57and60; but under such menacing Circumstances, it is always prudent to take the best Advice, as early as possible.

From the Moment these hard Tumours become excessively and obstinately so, and yet without any Pain, we should abstain from every Application, all are injurious; and greasy, sharp,resinous and spirituous ones speedily change theScirrhusinto a Cancer. Whenever it becomes manifestly such, all Applications are also equally pernicious, except that ofNº. 60. Cancers have long been thought and found incurable; but within a few Years past some have been cured by the RemedyNº. 57; which nevertheless is not infallible, though it should always be tried.84

§ 376. The Nipples of Women, who give Milk, are often fretted or excoriated, which proves very severely painful to them. One of the best Applications is the most simple Ointment, being a Mixture of Oil and Wax melted together; or the OintmentNº. 66. Should the Complaint prove very obstinate, the Nurse ought to be purged, which generally removes it.

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