&c.
AFTERall, to perfect or finish theWoman’s DELIVERY, it still remains thatShebe freed of herAfter-Birth, orSecundine. Now this I advise to be done with all imaginable Speed, after theChildis born, even before theNAVEL-STRINGis cut: Because theWombimmediatelycontractsitself, so thatThiscannot be accomplish’d afterwards without greatDifficulty.
HOWEVER, I know beforehand, that my Method of performing this Work, which I am about to lay down, will be thought a strangeInnovationinMidwifery; but without any regard to that, in speaking to thisPoint, I shallFirstsuppose thisBodyto be already loosen’d from theWomb; in whichCasetheMidwifehas nothing to do, but to draw theSTRINGgently, which she holds inOne Hand, twisted twice or thrice around one or more of herFingers, while she passes theOther Handinto theWomb, following always theSTRING(as herGuide) to the Place where theBurthenlies: And where, as in thisCase, it naturally presents itself to theOrifice,Shestretches herHandup length-ways, taking hold of it betwixt herFingers; and thus, by the Assistance of theother Handalwaysattracting softly theSTRING, she brings it at last most commodiously away.
SECONDLY, I shall suppose, in the mean Time, thisBodyto continuefixedto theWomb, either inPartor inWhole: In whichCase, if inPart, theMidwifefinding by theTouchthe otherLoose Part, moves herHand thitherbetwixtThatand theWomb, shaking or stirring it gentlybackwardsandforwards, until such time as it is entirelyloosen’d, when she proceeds asBefore: But if inwhole, and that it sticks veryFast, then theMIDWIFEplaces herHindmost Fingerson itsExteriour Partagainst theWomb, and herFore-Fingersagainst theInside; so that thus by pulling softly on allSidesquite round, it is easilyloosen’dandextractedas Above.
THIRDLY, I shall suppose thisSECUNDINEalso (tho’ loosen’d successfully) to be so veryLarge, that it cannot pass through theORIFICE: In thisCase, I only desire mydeliver’d Womanto concur with me, and behave herself as if she was forcing or expelling theCHILD; for then whilst I at the same time gently attract theSTRING, it immediately follows.
I very well know that Mr.Mauriceauand allotherseitherinandbeforehis Time, teach quite differentMethodsof extruding theAFTER-BIRTH; such as are by theWOMAN’s blowing in her Fist, putting her Finger in her Throat, and the like; which when thepoor Patienthas done, and stood them All outineffectually, together with their many other variousuncertain Experimentsto noPurpose, and none of them have succeeded (as it has often happen’d): Then at last, and not till then, they direct the aforesaidMethodof theHANDto be used. But now-a-days, we know better Things than to run such indiscreetRisques, when we may go a safer Way to work; or to make use ofUncertainties, when we know moreInfallible Means. As I shall, I hope, make thisMethodplainly appear to be; notwithstanding all the greatCautionsof those Authors publish’d, and the Difficulties they make of it in our Practice ofMIDWIFERY: And that I will endeavour to do from the followingConsiderations, viz.
I.IFafter theBirthof theInfant, theHandbe presently pass’d into theWomb, it slips in together with Part of theArm, as far as is needful, without the leastTroubleorInconvenienceto theWoman; theWombas well as itsOrificecontinuing always, so long asthismay be done, sufficientlyOpen: And thus theBirthmaybe skilfully accomplished or perfected, as it were, in anInstant; whileothers(trying their vainProjects) spend many triflingHoursabout it, and it isten to one, if at last they succeed.
II.BYthese means, moreover, I presently know whether there beOne,Another, orMore INFANTSto follow; whether there be adead CHILD,false CONCEPTION, or anyForeign Bodywhatsoever, lodged in theWomb; whether anyPart, orPiecesof theSecundine, orMembranes, orLumpsofClotted Blood, be left behind and retain’d: All which I propose to bring away eitherbefore, oraftertheSecundine, as Occasion serves, with the greatestSafetyas well asExpedition.
III.AFTERhaving thoroughly searched on allSides, and thus duly cleans’d theWomb, by continuing myHandin it, until it contracts about thatHand, firstabovetowards theBottom, and thenbelowtowards theOrifice, which happens very quickly: I find myselfthen, by great Experience, able to rectify allObliqueandPreternatural Situationsof theWomb; as inCaseof aProlapsus, (orFalling down) I can hereby move it carefullyUpagain: If it lies too muchBackwards, by elevating it while it gradually contracts, I can easily bring itForwards, to itsNatural Position: If it hangs too muchForwards, I can quickly reduce itBackwards: If it tends toeither Side, I can directly move it to its Center. And thus, in short, I hope I may be allow’d gently and gradually to restore theWombto itsNatural PlaceandPosture, howPreternaturallyandObliquelysoever itsSituationmay happen to be disorder’d.
NOWThis being so successfully done, I can, in fine, assure and secure anyLying-in-Woman, that herWombis both dulypurg’d, and naturallyshutagain as it ought to be; which I take to be the greatestSatisfactiontheChild-Bed-Womancan conceive in her Condition. Whereas,
IV.THEYwho leave all these Things to mereNature, risque theirPatient’sfutureWelfare, and very often herLifetoo, as innumerableTragical Exampleswitness: ForNatureitself most particularly requires our specialAssistancein thisCase. But (according to their indifferentNotions) it isTimeenough to assistNature, when it is foundDeficient; and then, inCaseofExtremity, they unanimously agree that there is no other way to help or save theWoman’sLife, but by thisMethodofManual Operation. To which I answer, thatNatureoperates not in anInstant, but (in allCases) requires a competentTime, to discharge its respectiveFunctions; and being left too long to itself, for want of Help, is many a-time (by interveningAccidents) found at lastIncapable: Upon which, thenThey, beginning their Endeavours tosecond it, generally come too late. For if theCasedoes not prove to be past allRemedy, it is at least (by thisProtraction of Time) often rendred not onlydifficult, but alsodesperate; as will evidently appear in theCase in hand, from what follows,viz.
I.WHILEThey(conformable to the general and universalPracticeof commonMIDWIVES) expect thePerformanceofNature, or theSuccessof theirtrifling Means, in the mean time, theOrificeof theWombis soclosely shut up, that in the space of an Hour or two, it cannot bepenetrated, without renovating the most severe rackingPainsto theWoman, who (perhaps) has been sufficiently spent before, by theDeliveryof herInfant, and isnowconsequently incapable of standing out the renew’dPangs: whereby of courseShemust succumb at last, andgive uptheGhost, for want ofTimely Help; as innumerableInstancesconfirm for an undeniable Truth. But,
II.SUPPOSINGtheWomanto be able to undergo thePAINS, yet theWombis however contracted, and theSECUNDINEbound so close up, that thisBody, which before adher’dCake-waysto itsBottomin asmoothandbroad Form, is now so squeez’d into asmallandlong Figure, that it is even now aDifficultynext to Impossible, to reach theBottomof theWomb, and still aharder Taskto extract an entireSecundine, without prejudicing theWomb.
III.THEYwho altogether neglectManual Operation, may (I confess) sometimesdelivertheirWoman, whenSuccessaccidentally answers theirWish: But without thisMean, they cannot possibly restore aprolaps’d,fallen-down, or anobliquely situatedWomb, to itsnatural Position. No, to the Contrary, Nothing is more common among ignorant unwaryMIDWIVES, than toinvertanddraw downtheBottomof theWombitself, by pulling theNavel-String, as they foolishly intend bymeansof it only to extract theSECUNDINE. Neither does theMischiefalways end here, but mistaking thisBody, when so found by theirTouch, they immediately imagine it to be theHeadof anotherInfant; and persevering in thisfalse Conjecture, they manifestly expose the poorWomanto the Hazard of herLife. Neither,
IV.POSSIBLYcanThey, without theUseof theHand, so cleanse theWombof theReliquesof theSECUNDINE, which may stick up and down to theWomb; or of thePiecesorPartsof theMembranes, which may remain there; or of theclotted Blood, which commonly stays behind. From hence therefore it necessarily follows, that (without theMeansof theHand)Theycannot be Positive or Certain in anyCircumstance, relating to theTrue State of the Woman.Theycan neither assure Herself, nor those concern’d, that herWombis duly purged; if (perchance) of theSECUNDINE, which they may guess at by theSight, yet not of theFragmentsof theMembranes, nor of theclotted Blood, which they can never be certain of, but by thisMethod. I mention theseThings, because theleast PartofEitherbeing retain’d, or leftBehindin theWomb, may cost theWomanherLife, as innumerablePrecedentsdo testify. Nor,
V.CANthey possibly secure theWoman, that herWOMBisduly shut and contracted; much less can they (without theseMeans) affirm that it is orderlysituatedin itsproper naturalCenter: By the Neglect or Fault of whichCondition, she is not only rendredBarrenafterwards, but also most infirm all the Days of herLife.
BUTnotwithstanding howplainandeasysoever, I have endeavour’d to make out the above-mention’dMethod, I would over and above recommendItonly to thejudiciousandwell-qualify’d MIDWIFE; by no Means to those that areignorantin thePartsofGENERATION, nor to anystiff clumsy-fisted Person: And that for theTwo following Reasons; viz.
I.LESTtheString(by someAccidentor other) should break, and she, missing thisGuideto theSECUNDINE, should takeOne PartforAnother, and consequentlydislodgetheWombinstead of theAfter-Birth; which has undoubtedly often happen’d by such blindDoings, notwithstanding this very remarkableDifferencebetweenThem, that theSECUNDINEdistinguishes itself from theOther, by a great many littleInequalitieson the Outside, occasion’d by theRootsof theUmbilical Vessels. And,
II.LESTsheshould unwarily eitherbreak,tear, orscratchtheWomb, with herthick,fleshy,rough, andrigidHand, or with herstiffandcrookedFingers:Eitherof whichAccidents, may giveOriginto variousMisfortunes; such as aProlapsus, orFalling-down, apreternatural Flooding, anInflammation, orGangrene, &c.
BUTwe will now, in fine, suppose that theIngenuous MIDWIFEhas after All discharged her faithfulDutyin these Respects, withCare,Lenity, and goodConduct, as well as with greatArtandJudgment: In whichCase, it only remains, thatshetake the necessaryand usualCareof theChild-Bed-WomanandInfant; as hereafter will be directed in the respectiveChaptersofSECTIONVIth, to come.
INthe mean Time, these curiousThingsbeing thus amply premised in this Place, theReaderhas no more superfluousRepetitionsto expect concerningthemin the followingPerformance: And therefore with thesePreliminariesI conclude myFourth SECTION.