[
{"source_document": "", "creation_year": 1728, "culture": " English\n", "content": "Produced by RichardW and the Online Distributed Proofreading\nimages generously made available by The Internet Archive)\n The Province of Midwives in the Practice of their Art,\n by William Clark, M. D. 1698\u2013ca. 1780.\n THE PROVINCE OF MIDWIVES\n IN THE\n Practice of their ART:\n Instructing them in the timely Knowledge of such\n _Difficulties_ as require the Assistance of MEN,\n For the Preservation of\n MOTHER and CHILD.\n Very necessary for the Perusal of ALL the SEX\n interested in the Subject,\n And interspersed with some\n _New_ and _Useful_ OBSERVATIONS.\n _By_ WILLIAM CLARK, _M. D._\n _And of the_ College _of_ PHYSICIANS.\n _Molliter Aufer Onus._      OVID. FASTI.\n Printed for _William Frederick_, in BATH; and sold by\n _M. Cooper_, in _Pater-Noster-Row_, LONDON.\n MDCCLI.\nADVERTISEMENT TO THE READER.\n_The following small Tract will appear contemptible to those who\njudge of the Worth of Books by their Bulk; but the Author believes\nsuch as are practis\u2019d in Midwifry will acknowledge both the Want\nand Usefulness of an Essay of this Kind._\n_The Division of the Chapters, naturally arising from the various\nCircumstances which are treated of, will rather assist than\nburden the Memory, and admit of a ready Recourse to the short\nInstructions, in the Knowledge and Practice_ absolutely necessary,\n_given under each Head._\n_The Reader will the more readily excuse any Defect in the Stile,\nwhen he considers_ _the Necessity of a strict Expression on the\nSubject and the Difficulty a Man lies under, who writes not to\nthe learned and experienced, but chiefly for the Sake of Persons\nignorant in Anatomy and Philosophy, on a Subject which for the most\nPart excludes Information by Sight._\n_On such a Subject it will not be imagined Vanity or Applause can\nincline a Man to write a Pamphlet, rather than a Volume; when the\nAuthor is not conscious of having omitted the Instruction to be\nfound in any Book extant, within the Limits of his Design; and\nhopes Experience will teach its Value both to Midwives and Matrons;\nand that the Perusal will not at all injure, if it does not\nimprove, the most knowing and experienced._\nThe READER is desir\u2019d to correct the following ERRORS with the Pen.\n Page 9, Line 16, _read_ Pains about the Back, Navel, _&c._\u2014P. 33,\n l. 12. omit the Period after the Word Pain; and make a Semicolon,\n instead of the Comma, after touch\u2019d it.\nCHAPTER I.\n_The_ DESIGN.\nThe Case of _Child-bearing_ Women is very lamentable, in the\nCountry especially, by Reason of the Ignorance and Unskilfulness\nof _Midwives_; for by their Negligence and perverse Management,\nmany Mothers and Children are destroyed, to the great Misfortune of\nparticular Families, as well as of the _Publick_, at a Time when it\nsuffers by the Loss of useful Hands, from too many other Causes. It\nwere therefore to be wished, that all Midwives were so far appris\u2019d\nof their Duty, as to be able to distinguish between Cases within\ntheir Abilities, and such Difficulties as may occasion the Loss of\nthe Mother, or Child, or both, for Want of necessary Assistance.\nThey who intend to practice Midwifry in PARIS, are oblig\u2019d to\nattend _anatomical_ Lectures and _Dissections_, that their\nJudgments may be inform\u2019d, by the Knowledge of the Structure of the\nBody, for an Undertaking so hazardous in ignorant Hands.\nLondon, at present, affords equal Advantages of Information; for\nthe _anatomical_ Wax-work, with suitable Lectures, might furnish as\ngood a Qualification, with less Offence than real Dissections; and\nthere are not wanting those who professedly instruct both Sexes by\n_mechanical Demonstrations_.\nAnd for the future, it is to be hoped, there will be no Necessity\nfor Men to have Recourse to PARIS for _Observation_, since we have\n_Infirmaries_ at Home for the Accommodation of Women in Child-bed;\nand tho\u2019 they are expos\u2019d naked to the Eye in the _Hotel de Dieu_,\nit must be confess\u2019d, that the fundamental Rules of the _Art_ are\nnot built on what the Eye of the Observer can possibly discover in\nthe most expert _Operators_; but depend on Circumstances conceal\u2019d\nfrom Sight, within the Body of the Patient.\nBut whatever Advantages LONDON and WESTMINSTER afford for the\nInstruction of Midwives, the Country is entirely destitute of them;\nand the best Books on the Subject, adorn\u2019d with elegant Figures,\ncan give but a very imperfect Notion of the Parts they represent,\nto any who have not attended _Dissections_, or seen more natural\n_Resemblances_ than Cuts.\nThe Figures in Books, exhibit the _Bones_ of the _Pelvis_, a\nVariety of _Situations_ of the Infant, and _Uterus_, the Placenta\nand umbilical Vessels and Membranes, _&c._ whereas it would be\nno less serviceable to those, who assist Women in Travel, to be\nacquainted with the Viscera, liable to suffer by a difficult\nLabour; for the _Liver_, _Spleen_, _Sweetbread_ and _Kidneys_,\nif not the principal Contents of the Chest, may be so injured by\nthe ill _Position_ of the Child, Compression of the Parts, and\nrash Assistance, as to prove fatal, more or lets immediately;\noccasioning _Inflammations_, _Suppurations_, _Mortifications_,\n_Schirrhu\u2019s_, _Cancers_, or _Consumptions_.\nThe best Writers of Midwifry, such as _Mauriceau_, _Deventer_, _De\nla Motte_, _Heister_ and others, explain the Causes of difficult\nBirths, and the proper Methods of Assistance; but instead of\nimproving most _Country_ Midwives, fill them with Conceits of what,\nit is impossible, they should understand, and thereby occasion the\nLoss of great Numbers of Women and Children.\nIn order therefore that Midwives may acquit themselves with\nReputation, and that _Child-bearing_ Women may be the better\nJudges for themselves, or the charitable Part of the Sex, who are\npast these Dangers, the better able to assist their Friends and\nNeighbours, I shall endeavour to shew how far they may act with\nSafety under the Disadvantage of Country Practice, and describe\nthose Symptoms, which for the most Part accompany hard Labours,\nvery probably beyond their Abilities; when they will justly incur\nthe Censure of Inhumanity and Rashness to depend upon their own\nSkill.\nCHAPTER II.\nIn this Chapter I have avoided the Use of Terms of Art, or\nexplain\u2019d them, in Regard to those for whom I chiefly write, as\nfar as my Regard to Decency admits; but if any Word should occur\nnot easily understood by any of my Readers, almost any _English_\nDictionary will explain its Meaning; and it cannot be expected that\nany Book can instruct those who cannot read, tho\u2019 I am sorry to say\ntoo many such assume the Office of _Midwives_.\nAs Curiosity may reasonably induce many of the Sex concern\u2019d in\nthe Subject of these Sheets, to be inform\u2019d of somewhat of the\nProvision supreme Wisdom has made for the Existence of Children in\nthe Womb, I shall briefly mention the most obvious _Instruments_\nrelating to their Breeding and Birth, without puzzling my Readers\nwith minute _anatomical_ Descriptions.\nThe Vagina, or Passage, lies between the Neck of the _Bladder_ and\nthe large or strait Gut; it is connected at the inward extreme to\nthe _Womb_, and called the _outward Orifice_ at its beginning.\nThe _Womb_ lies between the _Bladder_ and _Strait Gut_, and is\nconnected to both; during the Time of _Breeding_ it increases in\nits _Dimensions_, and rising higher in the Body, by Reason of\nthe Weight and Substance of it, with its Contents, at the Fund,\nor remote End of it, may be liable to swag too much _forward_ or\n_backward_, or incline more or less to either Side, especially in\nsuch, as by their Occasions of Industry in Life are obliged to\na Variety of _indirect_ Situations; by which Means the _inward_\nOrifice is perverted from a _direct Site_ with Respect to the\nPassage, and obstructs an easy Exclusion of the Infant in Travel.\nThe _Placenta_ or _After-birth_, adhering to the _Fund_ of the\n_Womb_, receives the _Mother_\u2019s Blood, by the _Umbilical-Vessels_,\nor _Navel-String_, conveys it to the Child for its Nourishment, and\nretransmits what is superfluous; maintaining by the Intercourse of\n_Arteries_ and _Veins_, the Circulation of the Blood between Mother\nand Child.\nThe _Membranes_ closely connected to the _Placenta_, and the _Fund_\nof the _Womb_, between both which they seem to take their Rise,\ncontain the _Humours_ in which the Infant swims, the better to\npreserve it from Injuries, by its Pressure against _unyielding_\nParts, and the _Humours_ before, and after the _Breaking_ of the\n_Membranes_, commonly call\u2019d the _Breaking of the Waters_, in the\nBirth, very much facilitate it, by opening the _inward Orifice_\nof the _Womb_, and lubricating the _Passage_ for the Child: These\n_Membranes_ come away with the _Placenta_, under the Name of the\n_After-birth_, or _Secundines_, indifferently.\nThe _Pelvis_ or _Bason_, wherein the _Uterus_ or _Womb_ is seated,\nis form\u2019d by the _forward_ Bones, commonly call\u2019d the _Share-Bone_,\nthe _Hip-Bones_ and their Continuation on each Side, and the lower\nPart of the _Back-Bone_, all which are so contiguous to each other,\nas to form this Cavity, generally much larger in Women than Men,\ncloathed with Muscles, between which the _Vagina_ is inserted.\nThe right Formation of the _Pelvis_, is of the greatest Consequence\nin Favour of an _easy_ Birth; when the _Bones_ forming it,\n_forward_ and _backward_, and on _each_ Side, both above and below,\ndon\u2019t too much approach each other, and prevent the Exclusion of\nthe Child between, by a free Admission.\nCHAPTER III.\n_The Symptoms preceeding_ Natural Labours.\nI shall pass over the Symptoms of Pregnancy, and the Distinctions\nof true and false Conceptions, as Things of which Midwives can\nseldom be expected to be _proper_ Judges, and proceed to their\nBusiness, _Natural Labours_; comprehending, under this Name, all\nsuch Cases, which require no further Assistance than _Midwives_, in\na general Way, may easily give; or in their Absence a Nurse, or any\nsensible Woman, who has attended Deliveries.\nAfter the Woman has gone her due Time of Nine Months, the most\nusual Term; the Signs preceeding Labour are Pains about the Back,\nNavel and Loins; a considerable Falling of the Tumour of the Belly,\nby the Burden\u2019s sinking lower; and incommoding the Woman in\nwalking; a more frequent Inclination to make Water: These Symptoms\nincrease in Proportion as the Birth approaches; but as the most\ncertain Knowledge of _natural_ Births, can only be obtained by\n_Touching_ the Woman in Labour, after having premised some Things\nconcerning her _proper_ Situation; I shall direct how it ought to\nbe done.\nCHAPTER IV.\n_Of_ SITUATION.\nMany in the Country choose to be on their _Legs_ or _Knees_,\nsupported by a Woman on each Side, or _lean_ on a Chair or Bed, and\npass well enough through the present Scene of their Miseries: But\nI would preferably advise a Posture between _lying_ and _sitting_,\non a _Pallet_ or _common_ Bed, the _Head_ and _Shoulders_ being\n_rais\u2019d_ by Bolsters or Pillows, the Feathers _beat back_ from the\nBed\u2019s Feet, to support the hollow of the Loins, and prevent the\nPressure of any Thing against the _Bottom_ of the Back Bone, to\nobstruct the Passage of the Child.\nThis _Situation_ is most commodious, during Labour, for a Woman to\n_assist_ her Pains with the greater Freedom of Respiration, and the\nleast Fatigue and Expence of Spirits; especially if the _labouring_\nWoman lay hold of a _folded_ Napkin, held stiffly for that Purpose,\ndrawing her Feet _upwards_ towards her Seat, _separating_ her\nKnees, and _fixing_ her Feet against something that will not easily\ngive Way.\nIf the Person in Labour will not be in Bed, the End may be\nanswered by her _sitting_ in _another_\u2019s Lap, with the _Bottom_ of\nher Back-Bone situate between the other\u2019s Knees, with her _own_\nseparated and supported, and Feet fixed as aforesaid, to favour\nher bearing down.\n\u2019Tis inconsistent with the Design of my Writing to describe all\nthe _convenient_ Situations, necessary in Cases of Difficulty, yet\nwhen the Operator has rectified all Obstructions to the Birth, the\nsame Situation of the Body upon a _Slope_, from the Head downwards\nis most suitable, even altho\u2019, for Conveniency, she should be\ndeliver\u2019d lying on one Side.\nI shall, on this Occasion, observe, what I have found Advantageous\nin my own Experience, as well as consonant to the Advice of the\nbest Writers on the Subject: That the Delivery on the _Back_, by\nthe Assistance of one placed on _each Side_, supporting her by\nthe _Hams_, with her Knees _separated_, and raising her _Back\nBone_ a little from the Bed during the _Activity_ of Pains, and\nthe _Midwife_\u2019s _Assistance_ of either Sex, is vastly preferable\nto the Delivery on _one Side_, to which I impute the Loss of many\nChildren brought by _Turning_, as well as a more _tedious_ Labour\nin other Cases; because this Posture, in some Degree, _contracts_\nthe _Passage_, and only admits the proper Separation of _one_ Knee.\nCHAPTER V.\n_Concerning_ TOUCHING.\nThis ought to be put in Practice, as soon as, from the Symptoms\ngiven in the Third Chapter, it is reasonable to expect the Birth\napproaching; and a _Child-bearing_ Person would be very much her\nown Enemy to refuse the only Means of giving a _true_ Information\nof her Case, and the Knowledge how to do her the most effectual\nService.\nThe Midwife, having her Nails well pared, and very smooth, and her\nFingers anointed with Oil or Lard, must introduce the two _fore\nFingers_ of either Hand into the _Passage_ or _Neck_ of the _Womb_,\nas far as its _inward_ Orifice, directing them with a _gentle_\nand _easy_ Motion, somewhat upwards, as it were with a Tendency\nthrough the _Passage_ towards the _Navel_; in this Search she will\nfind the _internal_ Orifice, joining the _Passage_ or _Neck_ of\nthe _Womb_ more or less open, relaxed, and thinner than usual;\nand cautiously protruding her Fingers farther, she may possibly\ntouch the _Crown_ of the Child\u2019s Head; she will easily, by the\n_Sutures_, or _Opening_ between the Bones of the Skull, distinguish\nthe _Crown_: Keeping her Fingers in this Situation, _during_ the\nBeginning, and Continuance of _strong_ Pains, she will observe the\n_Waters_ contain\u2019d in the _Membranes_ including the Child, and\nAfter-birth _forming_ within the _inward_ Orifice, as if something\nlike a Bladder _blown_, or _distended_ with Water, presented to\nthe _Touch_, dilating the _Orifice_ with each _Throw_; these\nAppearances presage a _speedy_ and _easy_ Birth.\nCHAPTER VI.\n_Of a natural_ Birth, _and the_ Office _of the Midwife._\nAs the _Birth_ approaches, the Woman grows _hotter_ and _red_ in\nthe Face; the Pains bear more _strongly_ down; the _internal_\nOrifice _opens_; the _Vagina_ or _Passage_, at its _Entrance_,\nbecomes more swell\u2019d, as the Child\u2019s Head advances; and the\n_Membranes_ are more and more _tensely_ stretched; before the\n_Birth_, the Person is often seized with a _Vomiting_, and\n_universal_ Tremor, without the Coldness of an _Ague_; and very\noften a _Humour_, _discolour\u2019d_ with _Blood_, immediately preceeds\nthe _Breach_ of the _Membranes_; when these Symptoms, or several\nof them, become urgent, \u2019tis Time to put the Woman in a proper\nSituation, as describ\u2019d in the preceeding Chapter: The Midwife\nought by no Means to break the _Membranes_, but _encourage_ the\nWoman now to make the best of her Pains, by _strongly bearing\ndown_, as if going to Stool; the Midwife with her Fingers well\nanointed, putting them gently within the _internal_ Orifice, may\ncautiously, by separating them, assist its _opening_, and Removing\nit more behind the Child\u2019s Head, thereby gradually promote its more\neasy Transmission, and at the same Time prevent, if necessary, the\nWomb from being too far protruded: After the _Waters_ are _broke_,\nas it is called, and the _Head_ of the Child comes into the\n_Passage_, the Midwife may lay hold on each Side of it, taking Care\nnot to bruise it by rough Handling, and drawing it, by _Waving_ her\nHands, if necessary, to loosen it, when fixed, rather than in a\nstrait Line, assist the Birth; and if obstructed by the Shoulders\nin the Passage, inserting a Finger under each Arm-Pit, extricate\nthem by the like Action.\n\u2019Tis true, it happens, tho\u2019 unobserv\u2019d by Writers, as far as\nI remember, that _many_ Women have no _Waters breaking away_,\neither before or after the Birth; whether absorbed or not, in\nTime of Labour, I shall not at present determine; this is called,\nby the Country People, a _dry_ Labour, and often attended with\nDifficulty; however, if the _Crown_ appear _forward_, the Issue may\nnevertheless be favourable.\nThe Child being born, the next Business is to tie the\n_Navel-string_ with a _waxed_ Thread, so _doubled_, as not to\nendanger _cutting_, about _two_ Inches from the Child\u2019s Body,\nmaking another Ligature near the Body of the Mother, so far distant\nfrom the former, as may be convenient for _Cutting_ between _both_\nLigatures, and separating the Infant from its _After-birth_.\nMidwives are too apt to leave a greater Length, which can be of no\nService, but has been thought, on the contrary, by our Countryman\nCHAPMAN, to occasion _Navel_ Ruptures.\nAfter the _Separation_ of the _Navel-string_, the Care to get the\n_After-birth_ succeeds; this will often come by the Assistance of\nNature, with a gentle Motion of the Hand gradually drawing and\nloosening it, by the Navel-string: But if it adheres to the _Fund_\nof the _Womb_, which is frequently the Case, whether from the\n_Waters_ being come away before the Birth or otherwise; it must\ncautiously be separated, and extracted by the Hand, to prevent the\nmost mischievous and fatal Consequences.\nThe Assistant holding the _Navel-string_ with _one_ Hand, must\nwith great Caution introduce the _other_ into the _Womb_, avoiding\n_all Violence_ to any Part in the Way, \u2019till she reaches the\n_After-birth_, some Part of which probably, being loosened, will\nbe found more _forward_ than the rest; which _taking_ between her\n_Thumb_ and _Fore-Fingers_, she must, by an easy Motion of her\nother Fingers, between the _Womb_ and _After-birth_, gradually\n_separate_ the Parts adhering all _round_, \u2019till finding the\nwhole free, before the Palm of the Hand and Fingers, she brings it\nintirely away; for should any Part remain, the poor Woman\u2019s Labour\nwould still continue, and occasion _dangerous_ Floodings, requiring\nthe immediate Assistance of an able Hand, to rescue the Patient\nfrom the immediate Hazard of Death.\nSometimes when the _Womb_ has discharged its _Waters_, and the\n_Child_, by Reason of a Defect of Pains, or otherwise, remains\n_long_ very _forward_ near the _Birth_, the _Womb_ so _contracts_\nabout the _After-birth_, as to make the _Separation_ of it very\ndifficult; in which case Assistance is requisite, from one well\nacquainted with the Structure of the Body; and the longer this is\ndelay\u2019d, the more Danger there will be of all the bad Consequences\nof the Retention, and Corruption of the _After-birth_ in the Body.\nIt requires great Care to prevent the _Protrusion_ of the _Womb_ in\nsome Women of a _large Pelvis_, or _Opening_ between the _Bones_;\nor if the _After-birth_ remains closely fixed, the _Womb_, in a\nvery _open Pelvis_, may be _thrust_ by the Violence of the Pains;\nor _drawn_ out of the Body by an _unskilful_ Hand, which is\ncommonly very soon fatal to the poor Woman; and I believe happens\nmuch oftner than is apprehended, tho\u2019 industriously conceal\u2019d,\nby _guilty_ Midwives, under the Colour of the poor Woman\u2019s dying\nin Child-bed, from some other Cause. DEVENTER says, he saw a sad\nSpectacle at the HAGUE, the _Head_ of the Child excluded to the\n_Shoulders_ quite without the _Passage_, when Three-fourth Parts of\nthe _Head_ were conceal\u2019d within the _Womb_, the _Crown_ appearing\nwithin its _inward Orifice_\u2020.\n \u2020 See Chir. Op. Part ii. Page 32.\nA much worse Case happen\u2019d in my Neighbourhood, _Sept._ 23, 1749. I\nwas call\u2019d to a Woman, whose Child, on the 21st came unexpectedly,\nwithout the least Assistance, in the Presence of an _old_ Midwife\nof _large_ Practice; she puzzled an Hour, as I was inform\u2019d, to\nbring away the _After-birth_, which closely adhered to the _Fund_\nof the _Womb_; while the _unfortunate_ Woman lay senseless, saving\nthe Memory of being long expos\u2019d to the Cold, when she came to\nherself; after which she continued in violent _Labour-like_ Pains;\nupon Scrutiny, I found a large _Substance_ in the _Pelvis_, of the\nSize of a Child\u2019s Head, considerably resisting my Touch; I observ\u2019d\non Trial, a Part of the Woman\u2019s Body every Way _interposed_\nbetween my Fingers and this _Substance_, by her Sensibility of\nmy _Touch_; therefore contenting myself with giving her some\npalliative Medicines, and telling the Persons present, a Mole, as\nI thought, or Child still remain\u2019d to come away, I for that Time,\ntook my Leave: On the 24th, she was said to be much better; on the\n29th, I was again call\u2019d to this poor Woman, and inform\u2019d, that\nupon her first going to Stool, since I had before seen her, which\nhappen\u2019d the same Day, the large _Substance_ before-mention\u2019d,\ncame intirely out of her Body; to which it join\u2019d by a thinner\nSubstance, of some length: I now perceived it was no less than\nthe _Womb_ turned _inside out_, suspended by its _Ligaments_, and\njoining to the _Vagina_, but very much swell\u2019d by the Obstruction\nof the circulating Humours; And an old Gentlewoman, who was present\nwhen the Child was born, inform\u2019d me, she saw the Midwife draw\nthis _Body_ from the Woman, by the _Navel-string_, and indeed,\nthe Impression of her _Nails_, in separating the _After-birth_,\nremain\u2019d still visible at the _Bottom_ of the _Womb_, and the\nMidwife having long expos\u2019d the Patient, put this _inverted Womb_\nagain into her Body.\nThe Condition of the Part, after so long Delay, did not admit the\nPossibility of rightly reinstating it; I therefore return\u2019d it,\nas well as I could, into the Pelvis, and introduc\u2019d a Pessary to\nretain it; and as this Person had already contracted a Hectick, I\ncharg\u2019d her, as she valu\u2019d her Life, to confine herself strictly\nto a _cooling Milk_, or _vegetable Diet_; she has since had\nlarge Discharges of a _bloody_ Corruption, with Portions of a\nfleshy Confidence from the Parts affected. In _April_, 1751, she\ntold me the Discharge coming from her had long been much abated\nin Quantity, and what remain\u2019d was the Whites; that she had an\ninward Fever, and the Piles, for which I gave her my Advice; her\nComplexion was chang\u2019d from the most florid to a languishing\nPaleness.\nMy Brother, much better known in this Country, and longer practis\u2019d\nin Midwifry, has been concern\u2019d in furnishing Medicines for the\nPerson, whose History I have given, altho\u2019 by Means of his Absence,\nhe did not attend her on the most emergent Occasions.\nI have since been call\u2019d to the Assistance of the _old_ Midwife,\nwho attended, and she frankly told me, she had another Woman under\nthe like Circumstance, who died the same Day.\nHaving related such Things as occur in the most favourable\nCircumstances of Travil, about which all Midwives ought to be well\ninform\u2019d, and those Injuries to which Women are sometimes liable,\nnotwithstanding the most _promising_ Appearances: In the next Place\nI proceed to shew, what are the Symptoms preceeding _difficult_\nLabours, which by timely Assistance, may be secured from the most\ndangerous, if not fatal Consequences, and are of great Moment to be\nknown by Midwives, as well as Matrons and Child-bearing Women, to\nenable them to judge when it is absolutely necessary to recommend\ncalling that Aid, which is beyond their Capacity to give.\nCHAPTER VII.\n_The Difficulty from the_ Membranes.\nAn _unforeseen_ Difficulty may occur, when Appearances are\notherwise favourable, from the Strength of the _Membranes_,\nobstructing the _Birth_, and requiring great Caution to prevent;\nfor in this Case, the Operator must break the _Membranes_, in order\nto promote the _Birth_; and as the _Waters_, they contain, are a\nMeans to open the _internal Orifice_, lubricate the _Passage_, and\nfacilitate the _Birth_; the _breaking_ the _Membranes_ too soon,\nwill render the Labour more _tedious_; and should it be too long\ndelay\u2019d, the Patient\u2019s Misery would be _prolonged_; wherefore\nthe Midwife must not break _them_, before the _Orifice_ is\nsufficiently _open_ to admit the Head, when she may tear them with\nher _Nails_, but by no Means pull them, for as they adhere to the\n_After-birth_, she might by that Means separate it, and bring on a\nFlooding.\nCHAPTER VIII.\n_Difficulties occasion\u2019d by the_ Navel-String.\nThe _Navel-string_, by a Variety of Convolutions, sometimes\nobstructs the Birth, for being shortned, by its Contortions\nabout the Neck, or any Part of the Body, the _Labour_ will\nbecome _unnatural_, by Reason tho\u2019 the Pains are _strong_, the\n_Navel-string_, by its _shortness_, will pull the Child back with\neach Pain; and here an unskilful Management may break the String,\nand occasion a dangerous Flooding; but as the Woman\u2019s Pains will\nprove _ineffectual_, notwithstanding their Strength and Force, the\nMidwife will, by this Means, find the Case out of her Province; I\nmean, where the _Navel-string_ is very much _abbreviated_.\nIf the _Navel-string_ comes forward before the Child\u2019s Head, it\nwill seldom remain, when put backward by the Hand; therefore, if\nthe Midwife has any Regard for the Life of the Child, she ought to\ncall for Assistance, before the Birth is further advanc\u2019d, or it\nwill be extremely difficult, if not impossible, to save the Infant;\nand she would probably be foil\u2019d for want of sufficient Strength,\nhad she Skill to save it.\nCHAPTER IX.\n_Difficulties from the_ Placenta _or_ Secundines.\nThe _Placenta_ or _After-birth_, being from any violent Shock\nor Accident, more or less, _separated_ from its Seat, during\nany Time of Breeding, will produce a Flooding, in Proportion to\nits Quantity, _dangerous_, which is sometimes so violent, as\nto occasion Death in an Hour\u2019s Time; and nothing but _instant_\nDelivery can prevent it. When the Case is not so desparate, as all\nthe _Blood_ in the Mother\u2019s Body, necessary to support her own and\nInfant\u2019s Life, may be drain\u2019d away, the Consequence may be equally\nfatal in a more lingering Way.\nThe 26th _Feb._ 1748, I was sent for to a Woman at\nMOUNTAIN-DEVEREL, within about Five Weeks of her Time, in a violent\nFlooding; her Midwife gave her an Opiate, which she thought check\u2019d\nher Flooding, excepting that once a Week, it became very violent,\nfor about three Weeks past; when I came, the Neighbours told me she\nhad lost a Pail full of Blood; the poor Woman was so weak, that\nher Pulse were scarcely perceptible, and her Voice but a Whisper;\nI was unwilling to meddle, for fear she should die under my Hands,\nbut yielded to the Importunity of her Friends: It was with great\nDifficulty I introduced the _Tops_ of my two Fore-fingers and\nThumbs into the _internal Orifice_, which I gradually dilated,\n\u2019till I could pass my Hand, when by _turning_, I brought away a\n_dead_ Child, depriv\u2019d of its Nutriment by the great Loss of its\n_maternal_ Blood; but had considerable Trouble in getting the\n_After-birth_, by Reason of its _Adhesion_: After Delivery, the\nFlooding immediately very much abated, the poor Woman reviv\u2019d\nto Admiration, and I left her the next Day, as well as could be\nexpected in so low a Circumstance, tho\u2019 dubious of her Recovery: I\nheard she died five or six Weeks after; but I am well satisfied,\nhad she had an earlier Recourse for Assistance, she might have\nrecover\u2019d.\nIn these Cases, Midwives are too apt to trust to their own\nJudgments, instead of calling for better Assistance; and tho\u2019\nthey have Recourse to external _Applications_, _Ligatures_, and\n_Opiates_, these Things, injudiciously practis\u2019d, are frequently\nmore detrimental than beneficial: For Instance, should the\n_Arteries_ be compress\u2019d by too tight a Ligature of the _Arms_ and\n_Legs_, the _Flooding_ would become more violent.\nWhen ignorant Midwives, by rashly pulling the _Navel-string_, break\nit, or by the Adhesion of the _After-birth_, find it out of their\nPower to bring it away, they are apt to persuade People, it will\ncome without further Help, which seldom happens; on the Contrary\nit most frequently occasions Death, more or less suddenly, or\nHecticks and Consumptions, when left to corrupt in the Body: The\n_Uterus_ sometimes so strongly contracts about, and embraces it,\nthat it may be impossible, after a few Hours Delay, to procure\nit, as I found in a Case that occur\u2019d to me at COLEHORN, the 30th\n_Sept._ 1748, tho\u2019 little more than four Hours passed, from the\nTime the Midwife broke the _String_ close to the _Placenta_, for\nthe Part of the _Uterus_ next the _Placenta_ was so contracted, as\nbarely to admit the _Tops_ of my two Fore-fingers; I endeavour\u2019d,\nwith all possible Caution, to make a larger Aperture, but in the\nill _Situation_ of the _Uterus_, at the Extent of my Reach, all\nmy Attempts were in Vain; this Woman rested well the succeeding\nNight, and had no extraordinary Complaints when I left her in the\nMorning, first prescribing what I thought most suitable to her\nCondition: I afterwards heard she died with a Frenzy, succeeding a\n_Suppression_ of the _usual_ Purgations; where the Corruption of\nthe _Placenta_ takes Place, the Case is, at least, more Chronical,\nand the _Secundines_, gradually wasting, come away Piece-meal, the\nPatient labouring under a Hectick from the Contagion of putrid\nHumours, mixing with the circulating Fluids.\nI have at other Times, after a longer Delay, been more successful;\nthe 28th _December_, the same Year, I was call\u2019d, by Order of\nthe late Lord WEYMOUTH, to the Assistance of a poor Woman at\nHORNISHAM, whose _After-birth_ had been retain\u2019d three Days; she\nhad contracted a Fever from its Putrefaction, which was so great,\nthat scarcely any Body could bear the Room, and had lost a great\ndeal of Blood by Flooding; the poor Woman soon recover\u2019d after her\nDelivery, in the Use of a little Medicine, from his Lordship\u2019s\nHouse: I have seldom found the Business difficult, when speedily\ncall\u2019d in the like Cases.\nCHAPTER X.\n_Difficulties attending the Contraction, or Ill-site of the_ Inward\nOrifice.\nIn the Fifth Chapter I have told, how the Midwife may judge,\nby touching, of an easy Birth; carefully introducing her two\nFore-fingers into the Passage, to find the internal Orifice of\nthe Womb in the Beginning of Labour; now, in doing this, if the\nOrifice, she is in Search for, does not readily occur, she has\ngreat Reason to apprehend Difficulty; and if not well acquainted\nwith the Parts she handles, by rude Usage, piercing through any\nPart of the _Vagina_, which presents to the _Touch_, may do\nMischief. Such an Injury was done to one of Box, where I was\ncalled _Sept._ 21, 1748. This Woman had been in Labour several\nDays; the Midwife having, the last Time, been with her eighteen\nHours, the Pole of the Child\u2019s Head lay upon the Share-bone, which\nwas rectifyed by one Limb of the Extractor and brought into the\nPassage; the other Limb being joined, the Infant was soon born; but\nwhat before surprized me, was to find a _Passage_, for my Fingers,\nconsiderably remote from the _internal Orifice_, with great\nComplaints of a smarting Pain when I touch\u2019d it; a Suppuration\nfollow\u2019d, but the Woman soon recover\u2019d, after the frequent Use of\nan emollient and discutient Fomentation.\nWhen the _Orifice_ presents rightly, and is easily found, it\nis next of Consequence to observe, whether the Pains _relax_,\n_open_ and _enlarge_ it; for should it remain _thick_ and\n_contracted_, instead of relaxing and growing thinner, if the\nInfant comes rightly directed, the Woman\u2019s Pains are not _genuine_\nbut _spurious_; it will then be proper to give an emollient\nand carminative Glyster, and probably the false Pains will be\nreliev\u2019d, and the true succeed; or some Time may intervene, before\nher true Labour, especially if the full Time of Breeding should not\nbe expired.\nIf the Midwife cannot reach the _internal Orifice_, and the Child\u2019s\nHead lays _high_, the Orifice may possibly lay _high_, _backwards_\nor _forwards_, or more or less so, inclining _Sideways_; the Reason\nof which may be apprehended, from the brief Account of the _Womb_,\nand the _Pelvis_, in the Second Chapter. In this Case it may be\nwith great Difficulty, the Assistant can reach the nearest Margin\nof the _internal Orifice_, tho\u2019 well instructed and experienced,\nand it will often require the Hand of an expert Artist, early in\nLabour to rectify it, or turn the Child, when Travil is advanced;\nor if too long neglected may occasion the Death of one, or both\nMother and Child.\nCHAPTER XI.\n_Difficulties attending a wrong Position of the_ Child_\u2019s_ Head.\nIf in the Progress of Travil, the Midwife perceives any Part of\nthe Head, besides the _Crown_, discoverable by its _Sutures_,\npresenting, and it appear _broad_, and very _hard_ to the _Touch_:\nIf the _Waters_ may be _felt_ descending in a _long_ Form through\nthe _internal Orifice_, somewhat like a Piece of a Gut distended\nwith Water: These Appearances presage the utmost Difficulty and\nDanger, commonly owing to the small Distance between the _forward_\nand _back_ Bones; an ill Situation of the _internal Orifice_; the\n_comparative Largeness_ of the Child\u2019s Head; or the _ill_ Site\nof the _Womb_; whereby the Head may be pressed against the Bones\n_forward_ or _backward_, or somewhat inclined to _either_ Side,\nin a wrong Direction for the _Passage_. These Causes, singly or\nconcurring, render the Case much beyond the Skill, and very often\nthe Strength, of a Midwife to redress.\nWhen unqualified Midwives observe the Head present to the inward\nOrifice, they are too apt to promise good Success, and behave with\nthe utmost Confidence, wherein they are often egregiously mistaken;\nfor there cannot be a more difficult Birth, than frequently\nhappens, when any other Part, instead of the Crown, offers; and\nthe Misfortune is, the longer Recourse to proper Assistance is\ndelay\u2019d, the greater the Difficulty becomes every Moment; and the\npoor Woman may think herself happy, if she escapes with her Life,\nthe Danger of a most _fatiguing_ and _tedious_ Labour, succeeded,\nperhaps, by such a Relaxation of the _Vagina_ or _Passage_, as\nwill occasion great Uneasiness in going, or being in an _upright_\nPosture, without the immediate Help of Medicines, both externally\nand internally; or wearing a _Pessary_ for its Support, during\nLife.\nWhereas \u2019tis certain, that if the Mother\u2019s Pains, _strongly bearing\ndown_, the Muscles of the Belly contracting and becoming sensibly\n_hard_ to the _Touch_, don\u2019t manifestly promote the Birth, it must\nneeds be owing to some Obstruction beyond the Midwife\u2019s Skill;\nwho in this Circumstance is apt to complain, the Pains are not\nsufficiently _strong_, \u2019till the poor Woman is ready to expire,\nfrom the Loss of her Strength, by her long Suffering under them;\nand told she must patiently wait God\u2019s Time, who in Case he\nmiraculously interpos\u2019d, wants not the Midwife\u2019s Assistance: And\nwhat still adds to this deplorable Calamity, \u2019tis likely she is\nput upon exerting her utmost Strength, assisted by Cordials; when\n_encouraging_ her _Labour_ and _provoking_ her _Pains_, \u2019till the\nObstructions in the Way of the _Birth_ are remov\u2019d, contribute\nstill further to the Danger attending.\nI don\u2019t deny but that in some Cases, a _tedious_ Labour may be\nowing to a Defect of _sufficiently_ strong Pains; but as this\noften proceeds from _Circumstances_ obstructing the _Birth_,\ntrue Labour naturally takes Place, when they are remov\u2019d; and, by\na right Management of the Hand, is more _effectually_ promoted,\nwithout Cordials or _forcing_ Medicines, where the Pains are\ndeficient.\nUnder this Sort of unnatural Birth, may very well be enumerated,\nthe _Face_ presenting _towards_ the Mother\u2019s Belly, or the _Side_\nof the Head coming _Foremost_, for its Passage must be extreamly\ndifficult in these Postures; as well as when the _Face_ comes\n_forward_; for then by Reason of the great Tumour, about the\n_Head_, _Face_, _Eyes_, and _Mouth_, from Lodging between the\nBones, the Infant expiring in the Birth, has been often taken for\na Monster. I have often been so happy, when the Head has long\nremain\u2019d, wedg\u2019d between the Bones, as to bring the Child alive,\nby the _Forceps_, in a few Minutes, if seasonably call\u2019d, when the\nWoman in Travil has been in the utmost Danger of Death.\nThe 5th of _May_, 1751, I met with as bad a Case, as most of this\nKind at WIGGLETON: This Woman, by the Midwife\u2019s Account, seem\u2019d to\nbe in _Labour_ at Times near a Month, and for a Week last, almost\nin continual Pain, with her first Child: as I was call\u2019d late to\nher Assistance, I could not judge, by early Appearances, of the\nSituation of the _Uterus_, or _Infant_; this is most commonly only\nin the Power of the Midwife to observe; her _Waters_ had gradually\ndrain\u2019d away above a Week, and there still remain\u2019d some Part of\nthe _Membranes_ depending like a _Gut_ in the _Vagina_, the _Head_\noffer\u2019d, firmly wedg\u2019d in the _Pelvis_; the Part most obvious\nto the _Touch_, by its Softness and fleshy Consistence, seem\u2019d\nto be the _Cheek_: The poor Woman\u2019s Pains, for some Hours, were\n_ineffectual_ for want of Strength, her Spirits being exhausted, by\na Labour so fatiguing; there was no Possibility of _turning_ the\nChild; I endeavour\u2019d, with some Success, to promote the _Birth_, by\nbearing _strongly_ against the inferior Part of the _Os-sacrum_,\nbut her Weakness, depriving me of the small Benefit of her Pains,\nI had for a Time; there was an absolute Necessity for a speedy\nDelivery, for the Mother\u2019s Sake: \u2019Twas with some Difficulty I\novercame her Prejudice, and those Present against the Use of any\nInstrument, tho\u2019 at length they yielded; when introducing a _Limb_\nof the Extractor on each Side of the Head, and Co-operating with a\nsmall Pain, encouraging the Woman to bear down as strongly as she\ncould, I immediately brought a Daughter, with a monstrous long Head\nalive.\nI HAVE, however, met with some Cases, which I could relieve by\nno better Method, than lessening the Head; but considering for\nwhose Benefit I am chiefly Writing, and how dangerous the Use of\nInstruments may be in injudicious Hands, I rather choose to advise\nWomen not to meddle with them, than pretend to relate the Method of\nusing them.\nCHAPTER XII.\n_Difficulties from other_ ill Positions _of the Infant._\nThe _Arm_ or _Shoulder_ presenting, is so well known to be attended\nwith Difficulty, that few Women will attempt such Deliveries,\nunless they are so very ignorant, as to imagine they can bring the\nChild by _pulling_ at an _Arm_.\nAs our Miscarriages, or rather Misfortunes, in Practice, may no\nless contribute to the Information of others, by Caution, than our\nSuccess, by Example; I shall not scruple to give a candid Relation\nof the most fatal Occurrence, which ever fell to my Lot.\nThe 12th _September_, 1748, I was called to a Woman at TROUBRIDGE,\nher _Matrix_ lay _forward_ in a _prominent Abdomen_ hanging very\nlow, the _Os-uteri Internum_ lay very much _backward_, _both_ Hands\n_presented_ to it, this Woman had been very ill the preceeding\nWeek, and in extreme Misery the last Twenty-four Hours; with a\ngreat deal of Trouble, I got and drew towards me one _Foot_,\nwith the _Heel turn\u2019d towards the Mother\u2019s Belly_; in drawing\nthe _Infant_ so far as the _Arm-pits_, I found the _Face_ of the\nChild did not _turn_ so readily as I expected towards the Mother\u2019s\n_Back_; as soon as I had brought the _Feet_ some Distance without\nthe _Vagina_, while I endeavour\u2019d to extract the Child by hold of\nits _Thighs_, the Midwife, unknown to me, officiously laying hold\nof the Infant\u2019s _Feet_, exerted her Strength at the same Time with\nmine; I intended to leave the _Arms_ according to DEVENTER, as a\nSecurity to the more safe Transmission of the _Head_; and while\nour united Strength was exerted, I found the _Neck_ gave way, with\nsomething of an _audible_ Crack; and with some Surprize, looking\nabout me, saw the Midwife _labouring_ at the Child\u2019s _Feet_, and\ncheck\u2019d her, as acting very rashly, without my Direction; thus\nwe had really separated the _Spine_ of the _Neck_, and the _Head_\nonly adhering to the _Body_ by the _Skin_, was with little or no\nForce separated from it: In passing my Hand, after a tye on the\n_Navel-string_, I found the _Head_ fell _back_ into the prominent\nPart of the _Abdomen_, insomuch that I could only reach the\nseparated Part of the _Neck_, and I endeavour\u2019d, in vain, to get\nhold of the _Head_ by the _Crotchet_: While I was thus employ\u2019d,\na _Flooding_ came on, by the Separation of the _Placenta_, which\nquick\u2019ned my Endeavours, from the Apprehensions of her sudden\nDeath, if she was not immediately deliver\u2019d; but the poor Woman,\nmuch spent with Fatigue and Loss of Blood, begg\u2019d I would desist,\npreferring Death to Life; in which being join\u2019d by the People\npresent, and not a little exhausted of Spirit and Strength myself,\nI was, much against my Will, obliged to leave her to her Fate.\nHere I would observe, it appear\u2019d the _Body_ was that of a large\nBoy, and tho\u2019 I find GIFFARD and others made no Scruple of leaving\nthe _Arms_ of a small Child, I must join with them in advising\nnot to bring a _large one_, without first _procuring_ the _Arms_;\ntho\u2019 I will not say, whether the Method of delivering on one Side\ninstead of the _Back_, the lower Part somewhat _raised_ from the\nBed, at the same Time _encouraging_ Labour with Hopes of immediate\nDelivery, recommended by DEVENTER, may not occasion the Danger of\nleaving the _Arms_.\nThere are Variety of other wrong _Situations_, and _Cases_ of\nDifficulty, which I could illustrate by Examples in my own\nPractice, and may be found in the Observations of MAURICEAU\nDE-LA-MOTTE, GIFFARD and others, for the Information of such as\npractise Midwifry, that have no Relation to the Information of\nMidwives, either in their own Practice, or Occasions of Assistance.\nCHAPTER XIII.\n_Of_ TWINS.\nThe Case of _Twins_ may, in many Country Places, be esteemed beyond\nthe Skill of Women _practicing_ Midwifry; but as they are not alike\nignorant, and this Delivery, with a right Management, is attended\nwith no great Difficulty, I shall describe it as plainly as I can.\nIf a Child comes naturally by the Force of the _Mother_\u2019s Pains,\nand the _After-birth_ does not easily follow, the Midwife, by\npassing her Hand to separate its Adhesion as directed in the sixth\nChapter, will readily find whether _another_ Child still remains\nto be born, by the Appearance of other _Membranes_, including\n_Waters_, &c. And as where more than one is to be born, they are\ngenerally proportionably smaller, and tho\u2019 the first Child comes\nnaturally, the second may not, she need not wait for the _Birth_\nof the other, by the meer Force of Nature, for this would greatly\nhazard the Life of the Child, and sometimes of the Mother, by\na Flooding; but ought to break the _Membranes_, and search for\nthe _Feet_, carefully preventing their being intangled with the\n_Navel-string_; and having got both in her Hand, draw them into\nthe _Passage_; if the Child\u2019s _Toes_ point to the _Mother\u2019s Back_,\nthere will be no Danger of the _Chin_ or _Nose_ being hung on the\n_Bones_ before, and she may draw the _Feet_ forth with the rest of\nthe _Body_, without delaying to bring down the _Arms_, encouraging\nthe Mother to assist in the mean Time, by _bearing down with or\nwithout Pains_.\nIn Case the _Child\u2019s Toes_ should point to the _Mother\u2019s Belly_,\nthe Midwife, in drawing the Child forth from the _Hips forward_,\nmust gradually _turn_ the _Belly_ of the Child towards the\n_Mother\u2019s Back_, by the Assistance of the other Hand in the\nproceeding.\nIf the Woman be straiter, or the Child larger, than ordinary,\nwhen she has brought the Infant into the _Passage_ somewhat short\nof the _Arm-pits_, she must, by introducing her Fingers, first\nover one _Shoulder_, cautiously bring down one _Arm_, and then in\nlike Manner the _other_, and drawing the Child forward, she must\nmake Use of both Hands to extricate the _Head_; the _Fingers_ of\none Hand between the _Mother\u2019s Back_ and _Child\u2019s Jaws_, bearing\nand drawing them from the _Back-bone_, and with the Fingers of\nthe other Hand over the _Shoulders_, and the _flat_ against the\n_Child\u2019s Back_, draw it forth, the Mother as aforesaid assisting\nall the while.\nWriters advise putting two Fingers into the _Child\u2019s Mouth_; but\nas great Injury has often been done that Way, it is much safer to\nbring the Child by _bearing_ with the Fingers against its _Jaws_.\nIf an _Arm_ should be broke in _bringing down_, let it be spliced\nwith thin Paste-board, and bound at its full Extent to preserve its\nright Shape.\nIn fetching an Infant by _turning_, \u2019tis necessary to draw its\n_Feet_ into the _Passage_, with the _Toes situate_ towards the\n_Infant\u2019s Belly_, for it may be extreamly difficult, if not\nimpossible, to draw it backwards, contrary to the natural _Bent_\nof its _Thighs_ and _Back_; and a _Limb_ may sometimes as easily\nbe pull\u2019d off, as the Child brought to the _Birth_ this Way; the\nMidwife must therefore make Use of the _right_, or _left_ Hand\nin doing it, which happens to be most convenient, to the natural\n_bending_ of the Infant\u2019s Body.\nI THINK it cannot be safe for a Woman to _turn_ a Child upon ether\nOccasions requiring it; their Strength, as well as Skill being\nfrequently inferior to the Task; besides, there may be great Danger\nof injuring the Vitals of the Mother in other Cases, especially\nafter the Operation is unseasonably delay\u2019d.\nAs each Child has a Navel-string, as well as After-birth belonging\nto it (tho\u2019 both _Placenta_\u2019s are sometimes so joined as easily\nto be distinguished) the Care respecting the _Navel-string_,\nalready related in the Sixth Chapter, must of Course be taken for\nthe First-born, and its _Secundines_ left, \u2019till after the Birth\nof the Second, when both, if necessary, must be separated and\nbrought away, as there advis\u2019d, with Regard to one alone, and the\n_Navel-string_ of the last Infant tied after the same Manner as in\nthe Birth of one Infant.\nCHAPTER XIV.\n_Of a_ Dead Child.\nA Dead Child is often born with abundantly more Difficulty than a\n_living_ one, for the last by its Struggles considerably promotes\nits own Birth; whereas, the first lies _immoveably_ in the _same_\nPosture, without changing Situation by its own Activity.\nWhen the Death of the Child proceeds from any _accidental_ Injury,\nthe _breeding_ Woman commonly knows it, by the Perception of a\n_Weight_ within her, in the Part where it lies, instead of its\n_usual_ Motions, which from that Time cease, and occasion, not\nwithout Reason, a Solicitude for the best Assistance.\nOne of my Neighbours, whom I lately deliver\u2019d, had the Misfortune\nto fall flat on her Face, between the 7th and 8th Month of her\nPregnancy; from which Time to that of her Labour, above three\nWeeks after, she had a continual Sensation of a Weight within her,\nwithout _any_ of the Child\u2019s Motions, as before this Accident,\nalthough it was not succeeded by a _Flooding_, as is common upon\na _partial_ or _total Separation_ of the _Placenta_: She had\nfrequently been attacked with Pains resembling Travil, for above\ntwo Weeks before it came on effectually; in this Case after I had\nbrought the Child by _turning_, I found the Secundines extremely\noffensive, by Reason of their Putrefaction.\nFrom Causes less manifest, \u2019tis a Thing more precarious to judge\nof the Infant\u2019s Death; the Woman in Travil has not perceived the\n_Motion_ of the Child for some Days, while it was yet living;\na _cadacerous_ Smell is not infallible; the coming away of the\nChild\u2019s _Excrement_, may proceed from the _Compression_ of its\nAbdomen in the _Birth_, especially when the _Buttocks_ present;\nthese Appearances therefore can only be a Foundation at best for\n_probable_ Conjecture; nothing short of the Peeling of the Cuticle\nor Scarf-Skin of the Child upon _Touching_ it, can be a _certain_\nToken of its Death.\nCHAPTER XV.\n_The necessary Care of a_ Mother _and_ Child.\nAfter Delivery, tis too universal a Practice to palliate the\nAfter-pains by _Opiates_, which if given beyond the Proportion,\nnecessary to take off the Spasms attending, are mischievous,\ntending to obstruct the natural Cleansings, so absolutely\nnecessary to succeed; and as these Pains cease of Course for\nthe most Part in two or three Days, it were much better to have\nrecourse to _Sperma Ceti_ dissolv\u2019d with the Yolk of an Egg in a\nDraught of Caudle, or a Linctus of Sallad Oil and Sugar, if Oil\nof Sweet Almonds cannot be had fresh, as often as the Pains are\nviolent.\nParticular Occasions may indeed require other Methods, but\nthen \u2019tis best to be well advis\u2019d, whether _Opiates_, or other\n_Medicines_ are necessary. During their Purgations, the Woman, in\nChild-bed, ought to be kept warm, from all Danger of taking cold,\nto a Degree of sensible Perspiration, and if she has no Stool by\nthe third Day, which commonly brings, with the Milk, a feverish\nHeat, a Kitchen Glyster ought to be given and repeated in costive\nHabits, as there is Occasion.\nI SHALL conclude with some Things of the Care of Infants newly\nborn; a Subject the more interesting, as our Natives are known\ngreatly to decrease from the free Use of Spirituous Liquors; which\nLoss might in some Degree be repaired by a better Care of their\nOffspring, who are not only expos\u2019d to suffer by the Ignorance of\nMidwives, but must undergo a second Martyrdom from swadling and\ncramming.\nTheir fond Nurses greatly contribute to the general Cause of all\ntheir Distempers, _Indigestion_, frequently feeding them \u2019till they\nreturn it by the Mouth, which under these Circumstances, unless\nsupply\u2019d by a Looseness, is the only Means of their Preservation\nfrom more immediate Death.\nThis Overcharge of their Stomachs, producing Crudities, gives them\nthe most excruciating Pains in their Bowels; occasioning very\noften Fevers and Convulsions, and yet their Cries are customarily\nappeas\u2019d by more Food, furnishing an Encrease of sharp Crudities\nin their Bowels; and \u2019tis well if Syrup of Poppies, _Godfrey_\u2019s\nCordial, or some other Opiate, be not given to stifle their\nComplaints, but in Effect to encrease the Mischief, by confining\nthe Acrimony of an Overload within them.\nInfants are born with their Stomachs and Intestines charged with\nthe Recrements of the Humours in which they swim, before Birth, and\nthe glandular Secretions within them, which will naturally purge\naway with the first Milk they draw from the Mother\u2019s Breast; and\nthey would sleep, were they not too soon fed, \u2019till this Provision\nof Nature is ready for them, as Dr. CADOGAN found from Experience\nin his own Family; but as the Humour of Feeding them sooner\ngenerally obtains, and the Mother too often is not the Nurse; Half\na Drachm of _Castile_ Soap diffolv\u2019d in a Spoonful or two of thin\nCaudle, and sweetened with Honey, would cleanse the Child, and\nprevent many Distempers, owing to a Retention of Impurities within\nthem before the Birth, if given soon after.\n\u2019Tis well worth remarking, that the Food the Nurse takes\ncommunicates its Nature to the Milk, so that the Child may be\nintoxicated by her giving Suck too soon after strong Drink or\nSpirituous Liquors, by which Means many are destroy\u2019d; it is\nlikewise well known, if the Nurse takes a Purge, her Milk will\npurge the Child.\nThis informs us, that when the Child is troubled with Gripes,\nattended with green, sour-smelling Stools, the Mother, or Nurse, by\nbeing confin\u2019d to an Animal Diet, will, in a great Degree, prevent\nthe Gripes, Looseness, or Convulsions, occasion\u2019d by the Acidities\nof the Child\u2019s Stomach and Bowels, from the contrary Qualities\ncommunicated to her Milk. On the Contrary, a vegetable Diet will\ngreatly relieve the same Complaints, attended with strong smelling\nStools, and a Tendency to the Putrefaction of the Humours, and the\nChild\u2019s Spoon-meat, when any Thing is given besides the Mother\u2019s\nMilk, may be regulated accordingly: In the mean Time, in both\nCases, these Indigestions ought to be purged off with a few Grains\nof Rhubarb, or double the Quantity infus\u2019d at Night in a Spoonful\nof common Drink, strain\u2019d and sweetened with Honey.\nThis, with a suitable and commodious Dress, leaving them Freedom\nfor all their Motions, taking Care not to fill them with Crudities,\nby over-charging their Stomachs, would preserve the Health of young\nChildren, they would then sleep away most of their Time, without\nthose continual Cries of Misery, calling on the Compassion of all\nabout them, whereby abundance of Trouble to their Nurses, and the\ncontinual Occasion of Medicines, to sweeten and purge away the\nEffects of Indigestion, would be prevented.\n_FINIS._\nTRANSCRIBER\u2019S NOTE\nOriginal spelling and grammar were generally retained. The\nfollowing two corrections were made in conformance with the spirit\nof the list of errata on page vi.\n Page 9, l. 16. \u201cPains about the Navel and Loins\u201d was changed to\n \u201cPains about the Back, Navel and Loins\u201d.\n Page 33, l. 12. Changed \u201cgreat Complaints of a smarting Pain;\n when I touch\u2019d it a Suppuration\u201d to \u201cgreat Complaints of a\n smarting Pain when I touch\u2019d it; a Suppuration\u201d. This correction\n is not quite what the erratum on page vi recommends\u2014but the\n recommendation is not quite correct.\nPage 21. Changed \u201cwhich happpen\u2019d the same Day\u201d to \u201cwhich happen\u2019d\nthe same Day\u201d.\nPage 49. Changed \u201cand its _Secondines_ left\u201d to \u201cand its\n_Secundines_ left\u201d.\nEnd of the Project Gutenberg EBook of The Province of Midwives in the\nPractice of their Art, by William Clark\n*** END OF THIS PROJECT GUTENBERG EBOOK MIDWIVES ***\n***** This file should be named 52086-0.txt or 52086-0.zip *****\nThis and all associated files of various formats will be found in:\nProduced by RichardW and the Online Distributed Proofreading\nimages generously made available by The Internet Archive)\nUpdated editions will replace the previous one--the old editions will\nbe renamed.\nCreating the works from print editions not protected by U.S. copyright\nlaw means that no one owns a United States copyright in these works,\nso the Foundation (and you!) can copy and distribute it in the United\nStates without permission and without paying copyright\nroyalties. 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{"created_timestamp": "11-20-1728", "downloaded_timestamp": "10-18-2021", "url": "https://founders.archives.gov/API/docdata/Franklin/01-01-02-0032", "content": "Title: Articles of Belief and Acts of Religion, 20 November 1728\nFrom: Franklin, Benjamin\nTo: \nFranklin mentioned this private liturgy in his autobiography. Though he had had a conventional religious upbringing and contributed to the support of the Presbyterian meeting in Philadelphia, he seldom attended public worship, preferring to use Sundays for his own studies. Once, however, persuaded to go to church, he went five successive weeks but, finding no morality in the minister\u2019s sermons, \u201cwas disgusted, and attended his Preaching no more. I had some Years before compos\u2019d a little Liturgy or Form of Prayer for my own private Use, viz, in 1728. entitled, Articles of Belief and Acts of Religion. I return\u2019d to the Use of this, and went no more to the public Assemblies.\u201d The manuscript in Franklin\u2019s hand survives, except for a few pages, and there is a transcript of the whole by William Temple Franklin.\nArticles of BeliefandActs of Religion\nIn Two Parts.\nHere will I hold\u2014If there is a Pow\u2019r above us\n(And that there is, all Nature cries aloud,\nThro\u2019 all her Works), He must delight in Virtue\nAnd that which he delights in must be Happy.\u00a0\u00a0\u00a0\u00a0Cato.\nPart I.\n  Philada.\n  First Principles\nI Believe there is one Supreme most perfect Being, Author and Father of the Gods themselves.\nFor I believe that Man is not the most perfect Being but One, rather that as there are many Degrees of Beings his Inferiors, so there are many Degrees of Beings superior to him.\nAlso, when I stretch my Imagination thro\u2019 and beyond our System of Planets, beyond the visible fix\u2019d Stars themselves, into that Space that is every Way infinite, and conceive it fill\u2019d with Suns like ours, each with a Chorus of Worlds for ever moving round him, then this little Ball on which we move, seems, even in my narrow Imagination, to be almost Nothing, and my self less than nothing, and of no sort of Consequence.\nWhen I think thus, I imagine it great Vanity in me to suppose, that the Supremely Perfect, does in the least regard such an inconsiderable Nothing as Man. More especially, since it is impossible for me to have any positive clear Idea of that which is infinite and incomprehensible, I cannot conceive otherwise, than that He, the Infinite Father, expects or requires no Worship or Praise from us, but that he is even INFINITELY ABOVE IT.\nBut since there is in all Men something like a natural Principle which enclines them to Devotion or the Worship of some unseen Power;\nAnd since Men are endued with Reason superior to all other Animals that we are in our World acquainted with;\nTherefore I think it seems required of me, and my Duty, as a Man, to pay Divine Regards to Something.\nI CONCEIVE then, that the Infinite has created many Beings or Gods, vastly superior to Man, who can better conceive his Perfections than we, and return him a more rational and glorious Praise. As among Men, the Praise of the Ignorant or of Children, is not regarded by the ingenious Painter or Architect, who is rather honour\u2019d and pleas\u2019d with the Approbation of Wise men and Artists.\nIt may be that these created Gods, are immortal, or it may be that after many Ages, they are changed, and Others supply their Places.\nHowbeit, I conceive that each of these is exceeding wise, and good, and very powerful; and that Each has made for himself, one glorious Sun, attended with a beautiful and admirable System of Planets.\nIt is that particular wise and good God, who is the Author and Owner of our System, that I propose for the Object of my Praise and Adoration.\nFor I conceive that he has in himself some of those Passions he has planted in us, and that, since he has given us Reason whereby we are capable of observing his Wisdom in the Creation, he is not above caring for us, being pleas\u2019d with our Praise, and offended when we slight Him, or neglect his Glory.\nI conceive for many Reasons that he is a good Being, and as I should be happy to have so wise, good and powerful a Being my Friend, let me consider in what Manner I shall make myself most acceptable to him.\nNext to the Praise due, to his Wisdom, I believe he is pleased and delights in the Happiness of those he has created; and since without Virtue Man\n   *See Junto Paper of Good and Evil, &c.\n can have no Happiness in this World, I firmly believe he delights to see me Virtuous, because he is pleas\u2019d when he sees me Happy.\nAnd since he has created many Things which seem purely design\u2019d for the Delight of Man, I believe he is not offended when he sees his Children solace themselves in any manner of pleasant Exercises and innocent Delights, and I think no Pleasure innocent that is to Man hurtful.\nI love him therefore for his Goodness and I adore him for his Wisdom.\nLet me then not fail to praise my God continually, for it is his Due, and it is all I can return for his many Favours and great Goodness to me; and let me resolve to be virtuous, that I may be happy, that I may please Him, who is delighted to see me happy. Amen.\n1. Adoration.  2. Petition.\t3. Thanks.\nPrel.\nBeing mindful that before I address the Deity, my Soul ought to be calm and Serene, free from Passion and Perturbation, or otherwise elevated with Rational Joy and Pleasure, I ought to use a Countenance that expresses a filial Respect, mixt with a kind of Smiling, that signifies inward Joy, and Satisfaction, and Admiration.\nO wise God,\nMy good Father,\nThou beholdest the Sincerity of my Heart,\nAnd of my Devotion;\nGrant me a Continuance of thy Favour!\nPowerful Goodness, &c.\nO Creator, O Father, I believe that thou art Good, and that thou art pleas\u2019d with the Pleasure of thy Children.\nPraised be thy Name for Ever.\nBy thy Power hast thou made the glorious Sun, with his attending Worlds; from the Energy of thy mighty Will they first received [their prodigious] Motion, and by thy Wisdom hast thou prescribed the wondrous Laws by which they move.\nPraised be thy Name for ever.\nBy thy Wisdom hast thou formed all Things, Thou hast created Man, bestowing Life and Reason, and plac\u2019d him in Dignity superior to thy other earthly Creatures.\nPraised be thy Name for ever.\nThy Wisdom, thy Power, and thy GOODNESS are every where clearly seen; in the Air and in the Water, in the Heavens and on the Earth; Thou providest for the various winged Fowl, and the innumerable Inhabitants of the Water; Thou givest Cold and Heat, Rain and Sunshine in their Season, and to the Fruits of the Earth Increase.\nPraised be thy Name for ever.\nI believe thou hast given Life to thy Creatures that they might Live, and art not delighted with violent Death and bloody Sacrifices.\nPraised be thy Name for Ever.\nThou abhorrest in thy Creatures Treachery and Deceit, Malice, Revenge, [Intemperance] and every other hurtful Vice; but Thou art a Lover of Justice and Sincerity, of Friendship, Benevolence and every Virtue. Thou art my Friend, my Father, and my Benefactor.\nPraised be thy Name, O God, for Ever.\nAmen.\nAfter this, it will not be improper to read part of some such Book as Ray\u2019s Wisdom of God in the Creation or Blacmore on the Creation, or the Archbishop of Cambray\u2019s Demonstration of the Being of a God; &c. or else spend some Minutes in a serious Silence, contemplating on those Subjects.\nThen SingMilton\u2019s Hymn to the Creator\nThese are thy Glorious Works, Parent of Good!\nAlmighty: Thine this Universal Frame,\nThus wondrous fair! Thy self how wondrous then!\nSpeak ye who best can tell, Ye Sons of Light,\nAngels, for ye behold him, and with Songs,\nAnd Choral Symphonies, Day without Night\nCircle his Throne rejoicing. You in Heav\u2019n,\nOn Earth, join all Ye Creatures to extol\nHim first, him last, him midst and without End.\nFairest of Stars, last in the Train of Night,\nIf rather thou belongst not to the Dawn,\nSure Pledge of Day! That crown\u2019st the smiling Morn\nWith thy bright Circlet; Praise him in thy Sphere\nWhile Day arises, that sweet Hour of Prime.\nThou Sun, of this Great World both Eye and Soul\nAcknowledge Him thy Greater, Sound his Praise\nIn thy Eternal Course; both when thou climb\u2019st,\nAnd when high Noon hast gain\u2019d, and when thou fall\u2019st.\nMoon! that now meet\u2019st the orient Sun, now fly\u2019st\nWith the fix\u2019d Stars, fix\u2019d in their Orb that flies,\nAnd ye five other Wandring Fires, that move\nIn mystic Dance, not without Song, resound\nHis Praise, that out of Darkness call\u2019d up Light.\nAir! and ye Elements! the Eldest Birth\nOf Nature\u2019s Womb, that in Quaternion run\nPerpetual Circle, multiform; and mix\nAnd nourish all Things, let your ceaseless Change\nVary to our great Maker still new Praise.\nYe Mists and Exhalations! that now rise\nFrom Hill or steaming Lake, dusky or grey,\nTill the Sun paint your fleecy Skirts with Gold,\nIn Honour to the World\u2019s Great Author rise.\nWhether to deck with Clouds th\u2019 uncolour\u2019d Sky\nOr wet the thirsty Earth with falling Show\u2019rs,\nRising or falling still advance his Praise.\nHis Praise, ye Winds! that from 4 Quarters blow,\nBreathe soft or loud; and wave your Tops ye Pines!\nWith every Plant, in Sign of Worship wave.\nFountains! and ye that warble as ye flow\nMelodious Murmurs, warbling tune his Praise.\nJoin Voices all ye living Souls, ye Birds!\nThat singing, up to Heav\u2019n\u2019s high Gate ascend,\nBear on your Wings, and in your Notes his Praise.\nYe that in Waters glide! and ye that walk\nThe Earth! and stately Tread, or lowly Creep;\nWitness if I be silent, Ev\u2019n or Morn,\nTo Hill or Valley, Fountain or Fresh Shade,\nMade Vocal by my Song, and taught his Praise.\nHere follows the Reading of some Book or part of a Book Discoursing on and exciting to Moral Virtue\nPetition.\n  Prel.\nIn as much as by Reason of our Ignorance We cannot be Certain that many Things Which we often hear mentioned in the Petitions of Men to the Deity, would prove REAL Goods if they were in our Possession, and as I have Reason to hope and believe that the Goodness of my Heavenly Father will not withold from me a suitable Share of Temporal Blessings, if by a Virtuous and holy Life I merit his Favour and Kindness, Therefore I presume not to ask such Things, but rather Humbly, and with a sincere Heart express my earnest Desires that he would graciously assist my Continual Endeavours and Resolutions of eschewing Vice and embracing Virtue; Which kind of Supplications will at least be thus far beneficial, as they remind me in a solemn manner of my Extensive.\n  Duty\nThat I may be preserved from Atheism and Infidelity, Impiety and Profaneness, and in my Addresses to Thee carefully avoid Irreverence and Ostentation, Formality and odious Hypocrisy,\n  Help me, O Father\n  That I may be loyal to my Prince, and faithful to my Country, careful for its Good, valiant in its Defence, and obedient to its Laws, abhorring Treason as much as Tyranny,\n  Help me, O Father\n  That I may to those above me be dutiful, humble, and submissive, avoiding Pride, Disrespect and Contumacy,\n  Help me, O Father\n  That I may to those below me, be gracious, Condescending and Forgiving, using Clemency, protecting Innocent Distress, avoiding Cruelty, Harshness and Oppression, Insolence and unreasonable Severity,\n  Help me, O Father\n  That I may refrain from Calumny and Detraction; that I may avoid and abhor Deceit and Envy, Fraud, Flattery and Hatred, Malice, Lying and Ingratitude,\n  Help me, O Father\n  That I may be sincere in Friendship, faithful in Trust, and impartial in Judgment, watchful against Pride, and against Anger (that momentary Madness),\n  Help me, O Father\n  That I may be just in all my Dealings and temperate in my Pleasures, full of Candour and Ingenuity, Humanity and Benevolence,\n  Help me, O Father\n  That I may be grateful to my Benefactors and generous to my Friends, exerting Charity and Liberality to the Poor, and Pity to the Miserable,\n  Help me, O Father\n  That I may avoid Avarice, Ambition, and Intemperance, Luxury and Lasciviousness,\n  Help me, O Father\n  That I may possess Integrity and Evenness of Mind, Resolution in Difficulties, and Fortitude under Affliction; that I may be punctual in performing my Promises, peaceable and prudent in my Behaviour,\n  Help me, O Father\n  That I may have Tenderness for the Weak, and a reverent Respect for the Ancient; That I may be kind to my Neighbours, goodnatured to my Companions, and hospitable to Strangers,\n  Help me, O Father\n  That I may be averse to Craft and Overreaching, abhor Extortion, Perjury, and every kind of Wickedness,\n  Help me, O Father\n  That I may be honest and Openhearted, gentle, merciful and Good, chearful in Spirit, rejoicing in the Good of Others,\n  Help me, O Father\n  That I may have a constant Regard to Honour and Probity; That I may possess a perfect Innocence and a good Conscience, and at length become Truly Virtuous and Magnanimous,\n  Help me, Good God,Help me, O Father\nAnd forasmuch as Ingratitude is one of the most odious of Vices, let me not be unmindful gratefully to acknoledge the Favours I receive from Heaven.\nThanks.\nFor Peace and Liberty, for Food and Raiment, for Corn and Wine, and Milk, and every kind of Healthful Nourishment,\n  Good God, I Thank thee.\n  For the Common Benefits of Air and Light, for useful Fire and delicious Water,\n  Good God, I Thank thee.\n  For Knowledge and Literature and every useful Art; for my Friends and their Prosperity, and for the fewness of my Enemies,\n  Good God, I Thank thee.\n  For all thy innumerable Benefits; For Life and Reason, and the Use of Speech, for Health and Joy and every Pleasant Hour,\n  my Good God, I thank thee.\nEnd of the first Part.", "culture": "English", "source_dataset": "Pile_of_Law", "source_dataset_detailed": "Pile_of_Law_founding_docs", "source_dataset_detailed_explanation": "Letters from U.S. founders.", "creation_year": 1728},
{"created_timestamp": "01-01-1728", "downloaded_timestamp": "10-18-2021", "url": "https://founders.archives.gov/API/docdata/Franklin/01-01-02-0033", "content": "Title: Epitaph, 1728\nFrom: Franklin, Benjamin\nTo: \nThree autograph texts of the Epitaph are known\u2014two in manuscript, one a facsimile of the now lost Upcott holograph. Each differs from the other two, and all vary, significantly or in details, from eighteenth-century transcripts or printed versions. This is not surprising, since Franklin used to make copies of the Epitaph for his friends and, writing from memory, would make changes, either inadvertently or as improvements. His friends in turn gave copies to their friends, and at any point in this process a printer might be allowed to take a copy to brighten his almanac or magazine. No version is known that can be called Franklin\u2019s first or corrected draft, and no one can know which of the three holographs listed above Franklin would have chosen as best had he considered them\u2014or whether he might not have preferred yet another version of which no autograph survives. So the three must be regarded as equally authoritative. The text presented here is the one in the Mason Collection at Yale; from its handwriting it seems to be the earliest.\nNor is the date of composition certain. Franklin himself wrote on the Upcott holograph, probably in 1784, that he had composed the piece in 1728. William Temple Franklin accepted this date. And Dr. John Coakley Lettsom, sending a copy to a friend in 1785, declared that it was done \u201cwhen Dr. Franklin was a printer ... as each of the club [Junto?] in rotation did the same.\u201d On the other hand, Benjamin Vaughan apparently believed that it had been composed earlier than 1728, but his substantiating details are incorrect. When Franklin\u2019s friend and admirer Ezra Stiles copied a version in Jane Mecom\u2019s possession in 1779, he indicated that it had been \u201ccomposed 20 years ago\u201d or about 1759. In the absence of stronger evidence to the contrary, Franklin\u2019s own statement that he wrote the Epitaph in 1728 seems the most acceptable.\nWhether the concept of the Epitaph, comparing a printer\u2019s body to an old book, was original with Franklin has also been the subject of discussion and inquiry. He has been charged with plagiarizing a Latin epitaph on Jacob Tonson that was printed in the Gentleman\u2019s Magazine in 1736. This charge is without foundation, of course, if Franklin composed his Epitaph in 1728. But he could have seen other applications of the simile, not uncommon in his day, such as Benjamin Woodbridge\u2019s epitaph on John Cotton, printed in Mather\u2019s Magnalia Christi Americana (1702).\nThe Body ofB. Franklin,Printer;Like the Cover of an old Book,Its Contents torn out,And stript of its Lettering and Gilding,Lies here, Food for Worms.But the Work shall not be wholly lost:For it will, as he believ\u2019d, appear once more,In a new & more perfect Edition,Corrected and amendedBy the Author.He was born Jan. 6. 1706.Died 17", "culture": "English", "source_dataset": "Pile_of_Law", "source_dataset_detailed": "Pile_of_Law_founding_docs", "source_dataset_detailed_explanation": "Letters from U.S. founders.", "creation_year": 1728}
]