ITsometimes also happens, that theDifficultyinLabourarises from theInfant: AndthatFIRSTwhenTwoorMorestrive forPriorityinBIRTH.
NOWthisConditiontheMidwifecan no otherways distinguish or discover, but by theTouch; and when theoneis moreforwardthan theother, ’tis not to be done or known, until she has eventouch’dthe veryFundof theWomb: Because sometimes it so happens, thatOneChildhas itsHandsandFeetso intermix’d, that whatever waySheturns herHand, she findsLegsorArms,HandsorFeet, which often deceivesMidwives, believing there areTWINS. But in this perplex’dCasethe most sure and only certainSign, is, when she feelstwo Headsortwo Backs; for then she cannot be Mistaken, sinceone Bodycannot havetwo Heads, unless it be aMonster, which may be soon discover’d by feeling if thedouble Headbe fix’d tooneand thesame Body.
BUTin theCaseofTWINSormore Children(as long as they come right) theDeliveryis perform’d, as if theWomanhad butOne, in theNatural Casealready Stated; so that I shall repeat or recapitulate Nothing of what I have said, only that theAfter-Birth, orBirthsare not to betouch’d, until all theCHILDRENare Born: Upon which drawing gently theNavel Strings(in their Turns) with theOne Hand, theOtherbrings them forth easily and orderly; as is set forth more fully inSect.IV.Chap.18.
A SECONDdifficult LABOURmay proceed from theWeaknessandDebilityof theInfant, or from its beingtooSmall-grown; in whichCase, both theWomanand theMidwifeare to use their best mutualEndeavoursto promote theBIRTH, since theCHILDcan do little or nothing for itself, and theLessit is, the less it is affected with theTHROWSof theMother, and the lessImpressionher Impulses make upon it: WhereuponNatureis to be assisted in this weakConditionby all convenientMeans, whereofTHATof theAgileorNimble Handis the most effectual.
A THIRDdifficult BIRTHmay proceed from theInfant’s being tooBig; In which Place I must previously apprize theREADER, that I no ways mean aMONSTERorHydropical CHILD, but onlyOne full,well, orBig-grown, which is only reckoned tooBigin regard of theMaternal Passages, which may be tooSmallin Proportion.
INthisCase, there is an absolute Necessity forManual Assistance, since thePAINS(however penetrating or forcible) cannot effect theWork. But and if theINFANTis fallen down (well turn’d) into thePelvis, theMidwifeusing her best and most skilful Endeavours todilatethePassagesbelow near theOs Coccygis, theChildmay be easily brought forth (without any dangerousInstrument) by her dextrousHandonly accomplishing theWork. In the mean Time, however, it is to be minded always, thatThisis still more safely and commodiously done by theFeet, than by theHead, after carefully dilating theOs Coccygis, taking this Opportunity in the beginning of theLabour, before theINFANTis too much press’d down into thePelvis.
NOWtheseare, in fine, the most commonCauseson the Part of theINFANT, whence I come to touch upondifficult BIRTHS, proceeding fromCausesof thePassages; which, because they are various, I subdivide into aFivefold Diversity; viz.DifficultBIRTHS, proceeding fromCausesof theMembranes, fromCausesof thePelvis, fromCausesof theBonesof thePelvis, fromCausesof theBladderandRectum, and fromCausesof theVagina: And because all these require to be singularly explain’d, and particularly insisted upon, I shall assign them as many respectiveChapters. AndFirst——