ARISTOTLE’S WORKS.
ARISTOTLE’S WORKS.
ARISTOTLE’S WORKS.
ARISTOTLE’S WORKS.
THE MIDWIFE.GUIDE TO CHILD-BEARING WOMEN.
In this Chapter I am to treat of the womb, which the Latins call matrix. Its parts are two; the mouth of the womb, and the bottom of it. The mouth is an orifice at the entrance into it, which may be shut together like a purse. When a woman is not pregnant, it is a little oblong, and of substance very thick and close; but when she is pregnant it is shortened, and its thickness diminisheth proportionably to its distension: and therefore it is a mistake of anatomists, who affirm that its substance waxeth thicker a little before a woman’s labour; for any one’s reason will inform him, that the more distended it is, thethinner it must be; and the nearer a woman is to the time of her delivery, the shorter her womb must be extended.
The Author of Nature has placed the womb in the belly, that the heat might always be maintained by the warmth of the parts surrounding it: it is therefore seated in the middle of the hypogastrium (or lower part of the belly,) between the bladder and the rectum (or right gut) by which also it is defended from any hurt through the hardness of the bones: and it is placed in the lower part of the belly for the conveniency of a birth being thrust out at the full time.
It is of a figure almost round, inclining somewhat to an oblong, in part resembling a pear; for, being broad at the bottom, it gradually terminates in the point of the orifice, which is narrow.
The length, breadth, and thickness of the womb differ according to the age and the disposition of the body. For in virgins not ripe it is very small in all its dimensions; but, in women whose terms flow in great quantities, it is much larger; and if they have had children, it is larger in them than in such as have had none; but, in women of a good stature, and well shaped, it is, (as I have said before), from the entry of the privy parts to the bottom of the womb, usually about eight inches; but the length of the body of the womb alone does not exceed three; the breadth thereof is near about the same, and of the thickness of the little finger, when the womb is not pregnant; but, when the woman is pregnant, it becomes of a prodigious greatness, andthe nearer she is to her delivery the more is the womb extended.
It is not without reason, then, that nature (or the God of Nature) has made the womb of a membranous substance; for thereby it does the easier conceive, is gradually dilated by the growth of the fœtus, or young one, and is afterwards contracted and closed again, to thrust forth both it and the after-burden, and it is to retire to its primitive seat. Hence also then enabled to expel any obnoxious humours which may sometimes happen to be contained within it.
Before I have done with the womb, which is the field of generation, and ought therefore to be the more particularly taken care of, I shall proceed to a more particular description of its parts, and the uses for which nature hath designed them.
The womb then is composed of various similar parts, that is, of membranes, veins, arteries, and nerves. Its membranes are two, and they compose the principal parts of the body; the outermost of which ariseth from the peritoneum, or caul, and is very thin; without smooth, and within equal, that it may the better cleave to the womb, as it is fleshier and thicker than anything else we meet with in the body when the woman is not pregnant, and is interwoven with all sorts of fibres and small strings, that it may the better suffer the extension of the child and the waters caused during pregnancy, and also that it may the easier close again after delivery.
The veins and arteries proceed both from the hypogastrics and the spermatic vessels, of which I shall speak by and by; all these are inserted and terminated in the proper membrane of thewomb. The arteries supply it with food for nourishment, which, being brought together in too great a quantity, sweats through the substance of it, and distils as it were a dew at the bottom of the cavity; from hence do proceed both the terms in ripe virgins, and the blood which nourisheth the embryo in enceinte women. The branches which issue from the spermatic vessels are inserted on each side of the bottom of the womb, and are much less than those which proceed from the hypogastrics, those being greater, and bedewing the whole substance of it. There are yet some other small vessels, which, arising the one from the other, are conducted to the internal orifice, and by these, those that are pregnant do purge away the superfluity of the terms, when they happen to have more than is used in the nourishment of the infant; by which means nature hath taken such care of the womb, that during its pregnancy it shall not be obliged to open itself for the passing away those excrementitious humours, which, should it be forced to do, might often endanger abortion.
As touching the nerves, they proceed from the brain, which furnishes all the inner parts of the lower belly with them, which is the true reason it hath so great a sympathy with the stomach, which is likewise very considerably furnished from the same, part; so that the womb cannot be afflicted with any pain but the stomach is immediately sensible thereof, which is the cause of those loathings or frequent vomitings which happen to it.
But, besides all these parts which compose the womb, it hath yet four ligaments, whose office is to keep it firm in its place, and prevent itsconstant agitation, by the continual motion of the intestines which surround it; two of which are above, and two below. Those above are called the broad ligaments, because of their broad and membranous figure, and are nothing else but the production of the peritoneum, which growing out of the side of the loins, towards the reins, come to be inserted in the sides of the bottom of the womb, to hinder the body from bearing too much on the neck, and so from suffering a precipitation, as will sometimes happen when the ligaments are too much relaxed; and do also contain the testicles, and as well safely conduct the different vessels as the ejaculatories to the womb. The lowermost are called round ligaments, taking their original from the side of the womb near the horn, from whence they pass the groin, together with the production of the peritoneum, which accompanies them through the rings and holes of the oblique and transverse muscles of the belly, by which they divide themselves into many little branches, resembling the foot of a goose, of which are some inserted into the os pubis, and the rest are lost and confounded with the membranes that cover the upper and interior parts of the thigh; and it is that which causeth the numbness which pregnant women feel in their thighs. These two ligaments are long, round, and nervous, and pretty big in their beginning, near the matrix, hollow in their rise, and all along to the os pubis, where they are a little smaller, and become flat, the better to be inserted in the manner aforesaid. It is by their means the womb is hindered from rising too high. Now, although the womb is held in its natural situation by these four ligaments, it has libertyenough to extend itself when pregnant, because they are very loose, and so easily yield to its distension. But besides these ligaments, which keep the womb as it were in a poise, yet it is fastened, for greater security, by its neck, both to the bladder and rectum, between which it is situated.—Whence it comes to pass, that if at any time the womb be inflamed, it communicates the inflammation to the neighbouring parts.
Its use or proper action, in the work of generation, is to receive and retain the seed, and deduce from its power and action, by its heat for the generation of the infant; and is therefore absolutely necessary for the conservation of the species. It also seems by accident to receive and expel the impurities of the whole body, as when women have abundance of whites; and to purge away, from time to time, the superfluity of the blood, as when a woman is not pregnant.
Our modern anatomists and physicians are of different sentiments from the ancients touching the woman’s contributing of seed for the formation of the child, as well as the man; the ancients strongly affirming it, but our modern authors being generally of another judgment. I will not make myself a party in this controversy, but set down impartially, yet briefly, the arguments on each side, and leave the judicious reader to judge for himself.
Though it is apparent, say the ancients, thatthe seed of man is the principal efficient and beginning of action, motion, and generation, yet that the woman affords seed, and contributes to the procreation of the child, it is evident from hence, that the woman has seminal vessels, which had been given her in vain if she wanted seminal excrescence; but since nature forms nothing in vain, it must be granted they were made for use of seed and procreation, and fixed in their proper places, to operate, and contribute virtue and efficiency to the seed.
But against all this, our modern authors affirm, that the ancients are very erroneous, inasmuch as the testicles in woman do not afford seed, but are two eggs, like those of fowls and other creatures; neither have they any such offices as in men, but are indeed an ovarium, or receptacle for eggs, wherein these eggs are nourished by the sanguinary vessels dispersed through them; and from thence one or more, as they are fecundated by the man’s seed, are conveyed into the womb by the ovaducts. And the truth of this, say they, is so plain, that if you boil them, the liquor will have the same taste, colour, and consistency, with the taste of birds’ eggs. And if it be objected, that they have no shells, the answer is easy; for the eggs of fowls, while they are in the ovary, nay, after they have fallen into the uterus, have no shell; and though they have one when they are laid, yet it is no more than a fence which nature has provided for them against outward injuries, they being hatched without the body; but those of women being hatched within the body, have no need of any other fence than the womb to secure them.
They also further say, there are in the generationof the fœtus, or young ones, two principles,activeandpassive; theactiveis the man’s seed elaborated in the testicles, out of the arterial blood and animal spirit; thepassiveprinciple is the ovum, or egg, impregnated by the man’s seed: for to say that women have true seed, say they, is erroneous. But the manner of conception is this: the most spirituous part of man’s seed, reaching up to the ovarium or testicles of the woman (which contains divers eggs, sometimes more, sometimes fewer), impregnates one of them; which being conveyed by the ovaducts to the bottom of the womb, presently begins to swell bigger and bigger, and drinks in the moisture that is plentifully sent thither, after the same manner that the seeds in the ground suck in the fertile moisture thereof, to make them sprout.
Having thus laid the foundation of this work. I will now proceed to speak of conception, and of those things that are necessary to be observed by women from the time of their conception to the time of their delivery.
CHAPTER II.OF CONCEPTION; WHAT IT IS; HOW WOMEN ARE TO ORDER THEMSELVES AFTER CONCEPTION.
Conception is nothing else but an action of the womb, by which the prolific seed is received and retained, that an infant may be engendered and formed out of it. There are two sorts of conception: the one according to nature, which is followed by the generation of the infant in the womb; the other false, and wholly against nature, in which the seed changes into water, and produces only false conceptions, moles, or other strange matter.
My design in this treatise being brevity, I shall bring forward a little of what the learned have said of the causes of twins, and whether there be any such things as superfœtations, or a second conception, in a woman, (which is yet common enough) when I come to show you how the midwife ought to proceed in the delivery of the women that are pregnant with them. But, having already spoke of conception, I think it now necessary to show how such as have conceived ought to order themselves during their pregnancy, that they may avoid those inconveniences whichoften endanger the life of the child, and many times their own.
A woman, after conception, during the time of her being pregnant, ought to be looked upon as indisposed or sick, though in good health: for child-bearing is a kind of nine months’ sickness, being all that time in expectation of many inconveniences which such a condition usually causes to those that are not well governed during that time; and therefore ought to resemble a good pilot, who, when sailing on a rough sea, and full of rocks, avoids and shuns the danger, if he steers with prudence; but if not, it is a thousand to one but he suffers shipwreck. In like manner, a pregnant woman is often in danger of miscarrying and losing her life, if she is not very careful to prevent those accidents to which she is subject all the time of her pregnancy: all which time her care must be double, first of herself, and secondly, of the child she goes with; for otherwise, a single error may produce a double mischief; for, if she receives a prejudice, her child also suffers with her. Let a woman, therefore, after conception, observe a good diet, suitable to her temperament, custom, condition, and quality: and if she can, let the air where she ordinarily dwells be clear and well tempered, free from extremes either of heat or cold; for being too hot it dissipateth the spirits too much, and causeth many weaknesses; and by being too cold and foggy, it may bring down rheums and distillations on the lungs, and so cause her to cough, which, by its impetuous motion, forcing downwards, may make her miscarry. She ought always to avoid all nauseous and ill smells; for sometimes the stench of a candle, not well put out, may causeher to come before her time; and I have known the smell of charcoal to have the same effect. Let her also avoid smelling of rue, mint, pennyroyal, castor, brimstone, &c.
But, with respect to their diet, pregnant women have generally so great loathings, and so many different longings, that it is very difficult to prescribe an exact diet for them. Only this I think advisable, that they may use those meats and drinks which are to them most desirable, though perhaps not in themselves so wholesome as some others, and, it may be, not so pleasant; but this liberty must be made use of with this caution, that what they desire be not in itself unwholesome: and also, that in every thing they take care of excess. But, if a pregnant woman finds herself not troubled with such longings as we have spoken of, let her take simple food, and in such quantity as may be sufficient for herself and the child, which her appetite may in a great measure regulate; for it is alike hurtful for her to fast too long, or eat too much; and, therefore, rather let her eat a little and often; especially let her avoid eating too much at night; because the stomach being too much filled, compresseth the diaphragm, and thereby causeth difficulty of breathing. Let her meat be easy of digestion, such as the tenderest parts of beef, mutton, veal, sows, pullets, capons, pigeons, and partridges, either boiled or roasted, as she likes best; new-laid eggs are also very good for her; and let her put into her broth those herbs that purify it, as sorrel, lettuce, succory, and burrage; for they will purge and purify the blood. Let her avoid whatever is hot seasoned, especially pies and baked meats, which, being of hot digestion,overcharge the stomach. If she desires fish, let it be fresh, and such as is taken out of rivers and running streams. Let her eat quinces of marmalade, to strengthen her child; sweet almonds, honey, sweet apples, and full ripe grapes, are also good. Let her abstain from all sharp, sour, bitter, and salt things; and all things that tend to provoke the terms—such as garlic, onions, mustard, fennel, pepper, and all spices except cinnamon, which in the last two months is good for her. If at first her diet be sparing, as she increases in bigness let her diet be increased; for she ought to consider she has a child as well as herself to nourish. Let her be moderate in her drinking; and if she drinks wine, let it be rather claret than white, (which will make good blood, help the digestion, and comfort the stomach, which is always weakly during her pregnancy); but white wine being diuretic, or that which provokes urine, ought to be avoided. Let her have a care of too much exercise; let her avoid dancing, riding in a coach, or whatever else puts the body into violent motion, especially in her first month. But to be more particular, I shall here set down rules proper for every month for the child-bearing woman to order herself, from the time she has first conceived to the time of her delivery.
As soon as a woman knows (or has reason to believe) she hath conceived, she ought to abstain from all violent motions and exercises; whether she walks on foot, or rides on horseback, or in a coach, it ought to be very gently. Let her beware she lift not her arms too high, nor carrygreat burdens, nor repose herself on hard and uneasy seats. Let her use moderately good juicy meat, and of easy digestion; and let her wine be neither too strong nor too sharp, but a little mingled with water; or if she be very abstemious, she may use water wherein cinnamon is boiled. Let her avoid fastings, thirst, watchings, mourning, sadness, anger, and all other perturbations of the mind. Let none present any strange or unwholesome thing to her, nor so much as name it, lest she should desire it, and not be able to get it, and so either cause her to miscarry, or the child to have some deformity on that account. Let her bowels be kept loose with prunes, raisins, or manna, in her broth; and let her use the following electuary, to strengthen the womb and the child:—
“Take conserve of burrage, buglos, and red roses, each two ounces; of balm an ounce; citron peel and shreds, myrobalans candied, each an ounce; extract of wood aloes, a scruple; pearl prepared, half a drachm; red coral, ivory, each a drachm; candied nutmegs, two drachms; and with syrup of apples and quinces make an electuary.”
“Take pearls prepared, a drachm; red coral prepared and ivory, each half a drachm; yellow citron peel, mace, cinnamon, cloves, each half a drachm; saffron, a scruple; wood aloes, half a scruple; ambergris, six drachms; and with six ounces of sugar dissolved in rose-water, make rolls.” Let her also apply strengtheners to the navel, of nutmeg,mace, mastich, made up in bags, or a toast dipped in malmsey, sprinkled with powder of mint. If she happens to desire clay, chalk, or coals, (as many pregnant women do), give her beans boiled with sugar; and if she happens to long for any thing she cannot obtain, let her drink a large draught of pure cold water.
In this month and the next, be sure to keep from bleeding; for though it may be safe and proper at other times, yet it will not be so to the end of the fourth month; and yet if blood abound, or some incidental disease happen, which requires evacuation, you may use a cupping-glass, with scarification, and a little blood may be drawn from the shoulders and arms, especially if she has been accustomed to bleed. Let her also take care of lacing herself too straitly, but give herself more liberty than she used to do; for, inclosing her abdomen in too strait a mould, she hinders the infant from taking its free growth, and often makes it come before its time.
In this month also you ought to keep the child-bearing woman from bleeding, unless in extraordinary cases; but when the month is past, bloodletting and physic may be permitted, if it be gentle and mild; and perhaps it may be necessary to prevent abortion. In this month she may purge, in the acute disease; but purging may be used only from the beginning of this month to the end of the sixth: but let her takecare that in purging she use no vehement medicine, nor any bitter, as aloes, which is disagreeable and hurtful to the child, and opens the mouth of the vessels; neither let her use coloquintida, scammony, nor turbith; she may use cassia, manna, rhubarb, agaric, and senna: but dyacidodium purgans is best, with a little of electuary of the juice of roses.
In these months child-bearing women are troubled with coughs, heart-beating, fainting, watching, pains in the loins and hips, and bleeding. The cough is from a sharp vapour that comes to the jaws and rough artery from the terms, or the thin part of that blood gotten into the veins of the breast, or falling from the head to the breast; this endangers abortion, and strength fails from watching; therefore purge the humours that come to the breast with rhubarb and agaric, and strengthen the head as in a catarrh, and give sweet lenitives, as in a cough. Palpitation and fainting arise from vapours that go to it by the arteries, or from blood that aboundeth, and cannot get out at the womb, but ascends, and oppresseth the heart; and in this case, cordials, should be used both inwardly and outwardly. Watching is from sharp dry vapours that trouble the animal spirits, and in this case use frictions, and let the woman wash her feet at bed-time, and let her take syrup of poppies, dried roses, emulsions of sweet almonds, and white poppy seed. If she be troubled with pains in her loins and hips, as in these months she is subject to be, from the weight of her child, who is nowgrown big and heavy, and so stretcheth the ligaments of the womb, and parts adjacent, let her hold it up with swathing bands about her neck. About this time also the woman often happens to have a flux of blood; either at the nose, womb, or hemorrhoids, from plenty of blood, or from the weakness of the child that takes it not in; or else from evil humour in the blood, that stirs up nature to send it forth. And sometimes it happens that the vessels of the womb may be broken, either by some violent motion, fall, cough, or trouble of mind, (for any of these will work that effect); and this is so dangerous, that in such a case the child cannot be well; but if it be from blood only, the danger is less, provided it flows by the veins of the neck of the womb; for then it prevents plethory, and takes not away the nourishment of the child; but if it proceeds from the weakness of the child, that draws it not in, abortion of the child often follows, or hard travail, or else she goes beyond her time. But if it flows by the inward veins of the womb, there is more danger by the openness of the womb, if it come from evil blood; the danger is alike from cacochimy, which is like to fall upon both. If it arises from plethory, open a vein, but with great caution, and use astringents, of which the following will do well:—Take pearls prepared, a scruple; red coral, two scruples; mace, nutmeg, each a drachm; cinnamon, half a drachm; make a powder: or, with sugar, make rolls. Or give this powder in broth: “Take red coral, a drachm; red sander, half a drachm; bole, a drachm; sealed earth, tormentil roots, each two scruples, with sugar of roses, and manus Christa; with pearl, five drachms; make apowder.” You may also strengthen the child at the navel; and if there be a cacochimy, alter the humours; and if you may do it safely, evacuate: you may likewise use amulets in her hands and about her neck. In a flux of hemorrhoids wear off the pain; and let her drink hot wine with a toasted nutmeg. In these months the bowels are also subject to be bound; but if it be without any apparent disease, the broth of a chicken, or veal sodden with oil, or with the decoction of mallows, or of marshmallows, mercury, or linseed, put up in a clyster, will not be amiss, but in less quantity than is given in other cases: viz. of the decoction five ounces, of cassia fistula one ounce. But if she will not take a clyster, one or two yolks of new-laid eggs, or a little peaspottage warm, a little salt and sugar, supped a little before meat, will be very convenient. But if her bowels be distended and stretched out with wind, a little fennel seed and aniseed reduced into a powder, and mingled with honey and sugar, made after the manner of an electuary, will do very well. Also, if the thighs and feet swell, let them be anointed with exphrodinum (which is a liquid medicine made with vinegar and rose-water, mingled with salt.)
The eighth is commonly the most dangerous, therefore the greatest care and caution ought to be used; the diet better in quality, but no more, nor indeed so much in quantity as before; but she must abate her exercise: and because then pregnant women, by reason that sharp humours alter the belly, are accustomed to weakentheir spirit and strength, they may well take before meat an electuary of diarrhaden or aromaticum rosatum, or diamagarton; and sometimes they may lick a little honey: as they will loath and nauseate their meat, they may take green ginger candied with sugar, or the rinds of citron and oranges candied; and let them often use honey for the strengthening of the infant. When she is not far from her labour, let her eat every day seven roasted figs before her meat, and sometimes let her lick a little honey. But let her beware of salt and powdered meat, for it is neither good for her nor the child.
In the ninth month let her refrain from lifting any great weight; but let her move a little more, to dilate the parts and stir up natural heat. Let her take heed of stooping, and neither sit too much, nor lie on her sides; neither ought she to bend herself much, lest the child be unfolded in the umbilical ligament, by which means it often perisheth. Let her walk and stir often, and let her exercise be rather to go upwards than downwards. Let her diet, now especially, be light and easy of digestion; and damask prunes with sugar, or figs with raisins, before meat; as also the yolks of eggs, flesh and broth of chickens, birds, partridges and pheasants; astringent and roasted meats, with rice, hard eggs, millet, and such like other things, are proper. Baths of sweet water, with emollient herbs, ought to be used by her this month with some intermission; and after the baths, let her belly be anointed with oil of violets; but for her privy parts it isbetter to anoint them with the fat of hens, geese, or ducks, or with oil of lilies, and the decoction of linseed and fenugreek, boiled with oil of linseed and marshmallows, or with the following liniment:—
“Take of mallows and marshmallows, cut and shred, of each an ounce; of linseed one ounce; let them be boiled from twenty ounces of water to ten; then let her take three ounces of the boiled broth; of oil of almonds and oil of flower-de-luce, of each one ounce; of deer’s suet three ounces.” Let her bathe with this, and anoint herself with it warm.
If for fourteen days before the birth she do every morning and evening bathe and moisten her belly with muscadine and lavender water, the child will be much strengthened thereby. And if every day she eat toasted bread, it will hinder any thing from growing to the child. Her privy parts may be gently stroked down with this fomentation.
“Take three ounces of linseed, and one handful each of mallows and marshmallows sliced, then let them be put into a bag and immediately boiled.” Let the pregnant woman, every morning and evening, take the vapour of this decoction in a hollow stool, taking great heed that no wind or air come to her in-parts, and then let her wipe the parts so anointed with a linen cloth, and she may anoint the abdomen and groin as at first.
When she is come so near her time as to be within ten or fourteen days thereof, if she begins to feel any more than ordinary pain, let her use every day the following:—“Take mallows and marshmallows, of each one handful; camomile,hard mercury, maiden-hair, of each a handful; of linseed, four ounces; let them be boiled in a sufficient quantity of water as to make a bath therewith.” But let her not sit too hot upon the seat, nor higher than a little above the navel; nor let her sit on it longer than about half an hour, lest her strength languish and decay; for it is better to use it often than to stay too long in it.
And thus have I shown how a child-bearing woman ought to govern herself each month during her pregnancy. How she must order herself at her delivery, shall be shown in another chapter, after I have first shown the intended midwife how the child is first formed in the womb, and the manner of its decumbiture there.
In the last chapter I treated of conception, showing what it was, how accomplished, its signs, and how she who has conceived ought to order herself during the time of her pregnancy. Now, before I come to speak of her delivery, it is necessary that the midwife be first made acquainted with the parts proper to a child in the womb, and also, that she be shown how it is formed; and the manner of its situation and decumbiture there; which are so necessary to her, that without the knowledge thereof, no one can tell howto deliver a woman as she ought. This, therefore, shall be the work of this chapter. I shall begin with the first of these.
In this section I must first tell you what I mean by the parts proper to a child in the womb; and they are only those that either help or nourish it, whilst it is lodged in that dark repository of nature, and that help to clothe and defend it there, and are cast away, as of no more use, after it is born; and these are two: viz. the umbilicurs, or navel vessels, and the secundinum. By the first it is nourished, and by the second clothed and defended from wrong. Of each of these I shall speak distinctly: and, first,
These are four in number: viz. one vein, two arteries, and the vessel which is called the urachos.
1. The vein is that by which the infant is nourished, from the time of its conception till the time of its delivery; till, being brought into the light of this world it has the same way of concocting its food that we have. This vein ariseth from the liver of the child, and is divided into parts when it has passed the navel; and these two are divided and subdivided, the branches being upheld by the skin calledchorion(of which I shall speak by and by), and are joined to the veins of the mother’s womb, from whencethey have their blood for the nourishment of the child.
2. The arteries are two on each side, which proceed from the back branches of the great artery of the mother; and the vital blood is carried by those to the child, being ready concocted by the mother.
3. A nervous or sinewy production is led from the bottom of the bladder of the infant to the navel, and this is calledurachos; and its use is to convey the urine of the infant from the bladder to the alantois. Anatomists do very much vary in their opinions concerning this; some denying any such thing to be in the delivery of the woman; and others, on the contrary, affirming it: but experience has testified there is such a thing; for Bartholomew Carbrolius, the ordinary doctor of anatomy to the College of Physicians at Montpelier, in France, records the history of a maid, whose water, being a long time stopped, at last issued out through the navel. And Johannes Fernelius speaks of the same thing that happened to a man of thirty years of age, who, having a stoppage at the neck of the bladder, his urine issued out of his navel many months together, and that without any prejudice at all to his health; which he ascribes to the ill lying of his navel whereby the urachos was not well dried. And Volchier Coitas quotes such another instance in a maid of thirty-four years of age, at Nuremberg, in Germany. These instances, though they happen but seldom, are sufficient to prove that there is such a thing as an urachos in men.
These four vessels before-mentioned, viz. one vein, two arteries, and the urachos, do join nearto the navel, and are united by a skin, which they have from the chorion, and so become like a gut or rope, and are altogether void of sense, and this is that which women call the navel-string. The vessels are thus joined together, that so they may neither be broken, severed nor entangled; and when the infant is born are of no use, save only to make up the ligament which stops the hole of the navel, and some other physical use, &c.
Setting aside the name given to this by the Greeks and Latins, it is called in English by the name of secundine, after-birth, or after-burden; which are held to be four in number.
I. Thefirstis called placentia, because it resembles the form of a cake, and is knit both to the navel and chorion, and makes up the greatest part of the secundine, or after-birth. The flesh of it is like that of the melt, or spleen, soft, red, and tending something to blackness, and hath many small veins and arteries in it; and certainly the chief use of it is, for containing the child in the womb.
2. Thesecondis the chorion. This skin, and that called the amnios, involve the child round, both above and underneath, and on both sides, which the alantois doth not. This skin is that which is most commonly called the secundine, as it is thick and white, garnished with many small veins and arteries, ending in the placentia before named, being very light and slippery. Its use is not only to cover the child round about, but also to receive and safely bind up the rootsof the veins and arteries or navel vessels before described.
3. Thethirdthing which makes up the secundine is the alantois, of which there is a great dispute among anatomists. Some say, there is such a thing, and others that there is not. Those that will have it to be a membrane, say it is white, soft, and exceeding thin, and just under the placentia, where it is knit to the urachos, from whence it receives the urine; and its office is to keep it separate from the sweat, that the saltness may not offend the tender skin of the child.
4. Thefourthand last covering of the child is called amnios; and it is white, soft, and transparent, being nourished by some very small veins and arteries. Its use is not only to enwrap the child, but also to retain the sweat of the child.
Having thus described the parts proper to a child in the womb, I will next proceed to speak of the formation of the child therein, as soon as I have explained the hard terms of this section, that those for whose help it is designed, may understand what they read. Aveinis that which receives blood from the liver, and distributes it in several branches to all parts of the body.Arteriesproceed from the heart, are in continual motion, and by their continual motion quicken the body.Nerveis the same withsinew, and is that by which the brain adds sense and motion to the body.Placentiaproperly signifies asugar cake; but in this section it is used to signify a spongy piece of flesh, resembling a cake, full of veins and arteries, and is made to receive the mother’s blood appointed for the infant’s nourishment in the womb. Thechorionis the outward skin which compasseth the child in the womb. Thealantoisis the skin that holds the urine of the child during the time that it abides in the womb. Theurachosis the vessel that conveys the urine from the child in the womb to theallantois. I now proceed to
The woman having conceived, the first thing which is operative in the conception is the spirit whereof the seed is full, which nature quickening by the heat of the womb, stirs up to action. The internal spirits therefore, separate the parts that are less pure, which are thick, cold and clammy, from those that are more pure and noble. The less pure are cast to the outside, and with these the seed is circled round, and the membranes made, in which that seed which is most pure is wrapped round, and kept close together, that it may be defended from cold and other accidents, and operate the better.
The first thing that is formed is the amnios; the next the chorion; and they enwrap the seed round like a curtain. Soon after this (for the seed thus shut up in the woman lies not idle) the navel vein is bred, which pierceth those skins, being yet very tender, and carries a drop of blood from the veins of the mother’s womb to the seed: from which drop the vena cava, or chief vein, proceeds, from which all the rest of the veins which nourish the body spring; and now the seed hath something to nourish it, whilst it performs the rest of nature’s work, also blood administered to every part of it, to form flesh.
This vein being formed, the navel arteries are soon after formed; then the great artery, of which all the others are but branches; and then the heart; for the liver furnisheth the arteries with blood to form the heart, the arteries being made of seed, but the heart and the flesh of blood. After this the brain is formed, then the nerves to give sense and motion to the infant. Afterwards the bones and flesh are formed; and of the bones, first the vertebræ or chine bones, and then the skull, &c. As to the time this curious part of workmanship is formed, having already in the preceding Chapter, spoken distinctly and at large upon this point, and also of the nourishment of the child in the womb, I shall here only refer the reader thereto, and proceed to show the manner in which the child lies in the womb.
This is a thing so essential for a midwife to know, that she can be no midwife who is ignorant of it: and yet even about this, authors extremely differ; for there are not two in ten that agree what is the form that the child lies in the womb, or in what fashion it lies there; and yet this may arise in a great measure from the different figures that the child is found in, according to the different times of the woman’s pregnancy; for near the time of its deliverance out of the winding chambers of nature, it oftentimes changes the form in which it lay before for another.
I will now show the several situations of the child in the mother’s womb, according to thedifferent times of pregnancy, by which those that are contrary to nature, and are the chief cause of all ill labours, will be more easily conceived by the understanding midwife. It ought, therefore, in the first place, to be observed, that the infant, as well male as female, is generally situated in the midst of the womb; for though sometimes, to appearance, a woman’s belly seems higher on one side than another, yet it is so with respect to the belly only, and not to her womb, in the midst of which it is always placed.
But, in the second place, a woman’s great belly makes different figures, according to the different times of pregnancy; for, when she is young with child, the embryo is always found of a round figure, a little oblong, having the spine moderately turned inwards, the thighs folded, and a little raised, to which the legs are so raised, and her heels touch the buttocks; the arms are bending, and the hands placed upon the knees, towards which the head is inclining forwards, so that the chin toucheth the breast; in which posture it resembles one sitting to ease nature, and stooping down with the head to see what comes from him. The spine of its back is at that time placed towards the mother’s, the head uppermost, the face downwards; and proportionably to its growth, it extends its members by a little and little, which were exactly folded in the first month.
In this posture it usually keeps till the seventh or eighth month; and then by a natural propensity and disposition of the upper part of the body, the head is turned downwards toward the inward orifice of the womb, tumbling as it were over itshead, so that then the feet are uppermost, and the face towards the mother’s great gut; and this turning of the infant in this manner, with its head downwards, towards the latter end of a woman’s reckoning, is so ordered by nature, that it may be thereby the better disposed for its passage into the world at the time of its mother’s labour, which is not then far off (and, indeed, some children turn not at all until the very time of birth); for in this posture all its joints are most easily extended in coming forth; for, by this means the arms and legs cannot hinder its birth, because they cannot be bended against the inward orifice of the womb; and the rest of the body being very supple, passeth without any difficulty after the head which is hard and big, being past the birth. It is true, there are divers children that lie in the womb in another posture, and come to birth with their feet downwards, especially if there be twins; for then by the different motions they do disturb one another, that they seldom come both in the same posture at the time of labour, but when one will come with the head, and another with the feet, or perhaps lie across; and sometimes neither of them will come right. But, however the child may be situated in the womb, or in whatever posture it presents itself at the time of birth, if it be not with its head forwards, as I have before described, it is always against nature, and the delivery will occasion the more pain and danger, and require greater care and skill from the midwife, than when the labour is more natural.
CHAP. IV.A Guide to Women in Travail, showing what is to be done when they fall in Labour, in order to their Delivery.
The end of all that we have been treating of is, the bringing forth a child into the world with safety both to the mother and infant, as the whole time of a woman’s pregnancy may very well be termed a kind of labour; for, from the time of her conception to the time of her delivery, she labours under many difficulties, is subject to many distempers, and in continual danger, from one effect or other, till the time of birth comes; and when that comes, the great labour and travail come along with it, insomuch that then all the other labours are forgotten, and that only is called the time of her labour; and to deliver her safely is the principal business of the midwife; and to assist her therein, shall be the chief design of this chapter. The time of the child’s being ready for its birth, when nature endeavours to ease it forth, is that which is properly the time of a woman’s labour; nature then labouring to be eased of its burden. And since many child-bearing women (especially the first child) are often mistaken in their reckoning, and so, when they draw near their time, take every pain they meet with for their labour, which often proves prejudicial and troublesome to them, when it is not so; I will in the first section of this chapter, set down some signs, by which a woman may know when the true time of her labour is come.
Sect. I.The Signs of the true Time of a Woman’s Labour.
When pregnant women, especially of their first, perceive any extraordinary pain in the abdomen, they immediately send for their midwife, as taking it for their labour; and then if the midwife be not a skilful and experienced woman, to know the time of labour, but takes it for granted without further inquiry (for some such there are), and so goes about to put her into labour before nature is prepared for it, she may endanger the lives of both mother and child by breaking the amnios and chorion. These pains, which are often mistaken for labour, are removed by warm cloths laid to the abdomen, and the application of a clyster or two, by which those pains which precede a true labour are rather furthered than hindered. There are also other pains incident to a woman in that condition from a flux of the abdomen, which are easily known by the frequent stools that follow them.
The signs, therefore, of labour, some few days before, are, that the woman’s abdomen, which before lay high, sinks down, and hinders her from walking so easily as she used to do; also there flows from the womb slimy humours, which nature has appointed to moisten and smooth the passage, that its inward orifice may be the more easily dilated when there is occasion; which beginning to open at this time, suffers that slime to fall away, which proceeds from the glandules, calledprostata. These are signs preceding the labour; but when she is presentlyfalling into labour, the signs are, great pains about the region of the reins and loins, which, coming and retreating by intervals, are answered in the bottom of the abdomen by congruous throes, and sometimes the face is red and inflamed, the blood being much heated by the endeavours a woman makes to bring forth her child; and likewise, because during these strong throes her respiration is intercepted, which causes the blood to have recourse to her face; also her privy parts are swelled by the infant’s head lying in the birth, which, by often thrusting, causes those parts to descend outwards. She is much subject to vomiting, which is a sign of labour and speedy delivery, though by ignorant people thought otherwise; for good pains are thereby excited by the sympathy there is between the womb and the stomach. Also when the birth is near, women are troubled with a trembling in the thighs and legs, not with cold, like the beginning of an ague fit, but with the heat of the whole body; though, it must be granted, this does not happen always. Also, if the humours which then flow from the womb are discoloured with blood, which the midwives callshows, it is an infallible mark of the birth being near. And if then the midwife puts up her fingers into the neck of the womb, she will find the inner orifice dilated; at the opening of which, the membranes of the infant, containing the water, present themselves, and are strongly forced down with each pain she hath; at which time one may perceive them sometimes to resist, and then again press forward the finger, being more or less hard and extended, according as the pains are stronger or weaker. These membranes, with the waters in them when they arebefore the head of the child, which the midwives callthe gathering of the waters, resemble to the touch of the finger those eggs which have no shell, but are covered only with a simple membrane. After this, the pains still redoubling, the membranes are broken by a strong impulsion of the waters, which flow away, and the head of the infant is presently felt naked, and presents itself at the inward orifice of the womb. When these waters come thus away, then the midwife may be assured the birth is very near, this being the most certain sign there can be; for theamnios alantios, which contained those waters, being broken by the pressing forward of the birth, the child is no better able to subsist long in the womb afterwards, than a naked man in a heap of snow. Now, these waters, if the child comes presently after them, facilitate the labour, by making the passage slippery; and, therefore, let no midwife (as some have foolishly done) endeavour to force away the water, for nature knows best when the true time of the birth is, and therefore refrains the water till that time. But if by accident the water breaks away too long before the birth, then such things as will hasten may be safely administered, and what these are I will show in another section.
When it is known that the true time of her labour is come by the signs laid down in the foregoing section, of which those that are most to be relied on are pains and strong throes in the abdomen, forcing downwards towards thewomb, and a dilation of the inward orifice, which may be perceived by touching it with the finger, and the gathering of the waters before the head of the child, and thrusting down of the membranes which contain them; through which, between the pains, one may in some manner with the finger discover the part which presents (as we said before), especially if it be the head of the child, by its roundness and hardness; I say, if these things concur and are evident, the midwife may be sure it is the time of the woman’s labour; and care must be taken to get all things necessary to comfort her in that time. And the better to help her, be sure to see she be not strait-laced: you may also give her one strong clyster or more, if there be occasion, provided it be done at the beginning, and before the child be too forward; for it will be difficult for her to receive them afterwards. The benefit accruing thereby will be, that they excite her gut to discharge itself of its excrements, that so, the rectum being emptied, there may be more space for the dilation of the passage; likewise to cause the pains to bear the more downward, through endeavours she makes when she is at stool; and in the meantime, all other necessary things for her labour should be put in order, both for the mother and the child. To this end, some get a midwife’s stool; but a pallet-bed, girded, is much the best way, placed near the fire, if the reason require; which pallet ought to be placed, that there may be easy access to it on every side, that the woman may be more readily assisted as there is occasion.
If the woman abounds with blood, to bleed her a little may not be improper, for therebyshe will both breathe better, and have her breasts more at liberty, and likewise the more strength to bear down her pains; and this may be done without danger, because the child being about that time ready to be born, has no more need of the mother’s blood for its nourishment: besides, this evacuation does many times prevent her having a fever after delivery. Also, before her delivery, if her strength will permit, let her walk up and down her chamber; and that she may have strength so to do, it will be necessary to give her some good strengthening things, such as jelly, broth, new-laid eggs, or some spoonfuls of burnt wine; and let her by all means hold out her pains, bearing them down as much as she can at the time when they take her; and let the midwife from time to time touch the inward orifice with her finger, to know whether the waters are ready to break, and whether the birth will follow soon after. Let her also anoint the woman’s privities with emollient oil, hog’s grease, and fresh butter, if she find they are hard to be dilated. Let the midwife likewise be all the time near the labouring woman, and diligently observe her gestures, complaints, and pains; for by this she may guess pretty well how her labour advanceth, because when she changes her ordinary groans into loud cries, it is a sign the child is very near the birth; for at that time her pains are greater and more frequent. Let the woman, likewise, by intervals rest herself on the bed, to regain her strength, but not too long, especially if she be little, short, and thick; for such women have always worse labour, if they lie long on their beds in their travail. It is better, therefore, that she walk about herchamber as much as she can, the woman supporting her under the arms, if it be necessary; for by this means, the weight of the child causeth the inward orifice of the womb to dilate the sooner than in bed; and if her pains be stronger and more frequent, her labour will not be near so long.
Let not the labouring women be concerned at those qualms and vomitings which perhaps she may find come upon her, for they will be much for her advantage in the issue, however uneasy she may be for the time, as they further her throes and pains by provoking downwards.
When the waters of the child are ready and gathered (which may be perceived through the membranes to present themselves to the inward orifice) to the bigness of the whole dilation, the midwife ought to let them break of themselves, and not, like some hasty midwives, who being impatient of the woman’s long labour, break them, intending thereby to hasten their business, when instead thereof they retard it; for, by the too hasty breaking of these waters (which nature designed to cause the infant to slide forth more easy) the passage remains dry, by which means the pains and throes of the labouring woman are less efficacious to bring forth than they would otherwise have been. It is therefore much the better way to let the waters break of themselves; after which the midwife may with ease feel the child by that part which first presents, and thereby discerns whether it comes right, that is, with the head foremost, for that is the most proper and natural way of its birth. If the head comes right, she will find it round, big, hard, and equal; but if it be any other part, she will find it unequal,rugged, and soft or hard, according to the nature of the part it is. And this being the true time when a woman ought to be delivered, if nature be not wanting to perform its office; therefore, when the midwife finds the birth thus coming forward, let her hasten to assist and deliver it, for it ordinarily happens soon after, if it be natural.
But if it happens, as sometimes it may, that the waters break away too long before the birth, in such a case those things that hasten nature may be safely administered. For which purpose, make use of pennyroyal, dittany, juniper-berries, betony, and feverfew, boiled in white wine, and give a draught of it; or it would be much better to take the juice of it when it is in its prime, which is in May, and having clarified it, make it into syrup, with double its weight of sugar, and keep it all the year, to use when occasion calls for it: mugwort used in the same manner, is also good in this case; also, a drachm of cinnamon powder, given inwardly, profits much in this case; and so does tansey, boiled, and applied to the privities; or an oil of it, so made and used, as you were taught before. The following prescriptions are very good to speedy deliverance to women in travail.
1. A decoction of white wine made in savory, and drank.
2. Take wild tansey, or silver weed, bruise it, and apply it to the woman’s nostrils.
3. Take date stones, and beat them to powder, and let her take half a drachm of them in white wine at a time.
4. Take parsley and bruise it, and press out the juice, and dip a linen cloth in it, and put itup so dipped into the mouth of the womb: it will presently cause the child to come away, though it be dead, and will bring away the after-burden. Also, the juice of parsley is a thing of so great virtue (especially stone parsley) that being drunk by a pregnant woman it cleanseth not only the womb, but also the child in the womb, of all gross humours.
5. A scruple of castorum in powder, in any convenient liquor, is very good to be taken in such a case; and so also is two or three drops of spirit of castorum in any convenient liquor; also eight or nine drops of spirit of myrrh, given in any convenient liquor, gives speedy deliverance.
6. Give a woman in such a case another woman’s milk to drink: it will cause speedy delivery, and almost without pain.
7. The juice of leeks, being drunk with warm water, highly operates to cause speedy delivery.
8. Take peony seeds, and beat them into powder, and mix the powder with oil, with which oil anoint the loins and privities of the woman and child; it will give her deliverance speedily, and with less pain than can be imagined.
9. Take a swallow’s nest, and dissolve it in water, strain it, and drink it warm; it gives delivery with great speed and much ease.
Note this also in general, that all things that move the terms, are good for making the delivery easy; such as myrrh, white amber in white wine, or lily-water, two scruples or a drachm; or cassia lignea, dittany, each a drachm; cinnamon half a drachm, saffron a scruple; give a drachm: or take borax mineral a drachm; and give it in sack: or take cassia lignea a drachm: dittany, amber, of each a drachm; cinnamon,borax, of each a drachm and a half; saffron a scruple; and give her half a drachm: or give her some drops of oil of hazel in convenient liquor; or two or three drops of oil of cinnamon in vervain water. Some prepare the secundine thus:—Take the navel-string and dry it in an oven, take two drachms of the powder, cinnamon a drachm, saffron half a scruple, with juice of savin make trochisks; give two drachms: or wash the secundine in wine, and bake it in a pot; then wash it in endive water and wine; take half a drachm of it: long pepper, galangal, of each half a drachm: plantain and endive seed, of each half a drachm; lavender seed four scruples; make a powder: or take laudanum two drachms; storax, calamile, benzoin, of each half a drachm; musk ambergris, each six grains; make a powder, or trochisks for a fume. Or use pessaries to provoke the birth; take galbanum dissolved in vinegar, an ounce; myrrh two drachms; with oil of oats make a pessary.
Take oil of keir two ounces, juice of savin an ounce, of leeks and mercury each half an ounce; boil them to the consumption of the juice; add galbanum dissolved in vinegar half an ounce; myrrh two drachms, storax liquid a drachm; round bistort, sowbread, cinnamon, saffron a drachm; with wax make an ointment, and apply it.
If the birth be retarded through the weakness of the mother, refresh her by applying wine and soap to the nose; confect. alkermas diamarg.
These things may be applied to help nature in her delivery, when the child comes to the birth the right way, and yet the birth be retarded:but if she finds the child comes the wrong way, and is not able to deliver the woman as she ought to be, by helping nature, and saving both mother and child (for it is not enough to lay a woman, if it might be done any other way with more safety and ease, and less hazard both to woman and child), then let her send speedily for better and more able help; and not as I once knew a midwife do, who, when a woman she was to deliver had hard labour, rather than a man-midwife should be sent for, undertook to deliver the woman herself (though told it was a man’s business), and in her attempting it brought away the child but left the head in the mother’s womb; and had not a man-midwife been presently sent for, the mother had lost her life as well as the child: such persons may rather be termed butchers than midwives. But supposing the woman’s labour be natural, I will next show what the midwife ought to do, in order to her delivery.
There are four things which denominate a woman’s natural labour; the first, that it be at the full time; for, if a woman comes before her time, it cannot be termed natural labour; neither will it be easy as though she had completed her nine months. The second thing is, that it be speedy and without any ill accident: for, whenthe time of her birth is come, nature is not dilatory in the bringing of it forth, without some ill accident intervene which renders it unnatural. The third is, that the child be alive; for all will grant that the being delivered of a dead child is very unnatural. The fourth thing requisite to a natural birth is, that the child come right: for if the position of the child in the womb be contrary to what is natural, the event will prove it so, by making that which should be a time of life, the death of both the mother and the child.
Having thus told you what I mean by natural labour, I shall next show how the midwife is to proceed therein, in order to the woman’s delivery. When all the foregoing requisites concur, and after the waters be broke of themselves, let there rather be a quilt upon the pallet bedstead than a feather bed, having thereon linen, and cloths in many folds, with other such things as are necessary, and that may be changed according to the exigency requiring it, so that the woman may not be incommoded with the blood, waters, and other filth which are voided in labour. The bed ought so to be ordered, that the woman, being ready to be delivered, should lie on her back upon it, having her body in a convenient posture; that is, her head and breast a little raised, so that she be between lying and sitting; for being so placed, she is best capable of breathing, and likewise will have more strength to bear her pains than if she lays otherwise, or sunk down in bed. Being so placed, she must spread her thighs abroad, folding her legs a little towards her loins, somewhat raised by a small pillow underneath, to the end her groin should have more liberty to retire back;and let her feet be stayed against some firm thing: besides this, let her take hold of some of the good women attending her with her hands, that she may the better stay herself during her pains. She being thus placed at the side of her bed, having her midwife at hand the better to assist as nature requires, let her take courage, and help her pains the best she can, bearing them down when they take her, which she must do by holding her breath, and forcing them as much as possible, in like manner as when she goes to stool; for by such straining, the diaphragm, or midriff, being strongly thrust downwards, necessarily forces down the womb and the child in it. In the meantime, let the midwife endeavour to comfort her all she can, exhorting her to bear her labour courageously, telling her it will be quickly over, and that there is no fear but she will have a speedy delivery. Let her midwife also, having no rings on her fingers, anoint them with oil of fresh butter, and thereby dilate gently the inward orifice of the womb, putting her finger ends into the entry thereof, and then stretch them one from the other, when her pains take her; by this means endeavouring to help forward the child, and thrusting, by little and little, the sides of the orifice towards the hinder part of the child’s head, anointing it with fresh butter, if it be necessary.
When the head of the infant is a little advanced into the inward orifice, the midwife’s phrase is, “It is crowned;” because it girds and surrounds it just as a crown; but when it is so far that the extremities begin to appear without the privy parts, then they say, “The child is in the passage;” and at this time the womanfeels herself as it were scratched, or pricked with pins, and is ready to imagine that the midwife hurts her, when it is occasioned by the violent distention of those parts, and the laceration which the sometimes bigness of the child’s head causeth there. When things are in this posture, let the midwife seat herself conveniently to receive the child, which will come quickly, and with her finger ends (which she must be sure to keep close pared) let her endeavour to thrust the crowning of the womb (of which I have spoken before) back over the head of the child; and as soon as it is advanced as far as the ears, or thereabouts, let her take hold of the two sides with her two hands, that when a good pain comes she may quickly draw forth the child, taking care that the navel-string be not entangled about the neck, or any other part, as sometimes it is, lest thereby the after-burden be pulled with violence, and perhaps the womb also, to which it is fastened, and so either cause her to flood, or else break the strings, both which are of bad consequence to the woman, whose delivery may thereby be rendered the more difficult. It must also be carefully observed, that the head should not be drawn forth straight, but shaking it a little from one side to the other, that the shoulders may sooner and easier take their place immediately after it is past, without losing any time, lest the head being past, the child be stopped there by the largeness of the shoulders, and so come in danger of being suffocated and strangled in the passage, as it sometimes happens, for the want of care therein. But as soon as the head is born, if there be need, she may slide her fingers under the arm-pits, andthe rest of the body will follow without any difficulty.
As soon as the midwife hath in this manner drawn forth the child, let her put it on one side, lest the blood and water which follow immediately, should do it an injury, by running into its mouth and nose, as they would do if it lay on its back, and so endanger the choaking of it. The child being thus born, the next thing requisite is, to bring away the after-burden: but before that, let the midwife be very careful to examine whether there be more children in the womb; for sometimes a woman may have twins that expected it not; which the midwife may easily know, by the continuance of the pains after the child is born, and the bigness of the mother’s abdomen. But the midwife may be sure of it, if she puts her hand up the entry of the womb, and finds there another watery gathering, and a child in it presenting to the passage; and if she finds it so, she must have a care of going to fetch the after-birth, till the woman be delivered of all the children she is pregnant with. Wherefore the first string must be cut, being first tied with a thread three or four double, and fasten the other end with a string to the woman’s thighs; and then removing the child already born, she must take care to deliver her of the rest, observing all the circumstances as with the first; after which it will be necessary to fetch away the after-birth or births. But of that I shall treat in another section; and first show what is to be done to the new-born infant.