SECT. III.

CHAP. I. Of CONCEPTION.

CONCEPTION, in a word, is Two-fold; True and Natural, or False and Præternatural. It is call’d True, in opposition to a False Conception; and Natural, because it answers to the Institution of Nature. Wherefore I shall begin with This, and conduct the Woman, who has truly and naturally conceiv’d, thro’ the different Stages of Life she is to pass; describing plainly, and laying before her the many various Scenes of every respective Stage, which can any ways affect her Person.

IN this nice Affair, like a faithful Pilot, in a narrow Channel, I shall not only point out the Barrs and Rocks, on which she may be Shipwreck’d; but also direct and prescribe her Course, by which she may sail safe into her wish’d-for Port: Where when I have duly secur’d Herself and her Cargo to the Best of my 71Capacity, I shall thereafter proceed in their Order, to treat of the different Preternatural Conceptions; as I shall in this place now discourse only of the Natural.

THIS Natural Conception then, is the first principal Action, and peculiar Function of the Womb, in duly commixing and fomenting the retain’d Seeds of Man and Woman: Since as the Seed of Plants requires the Matrix of the Earth, to nourish it well, and safely defend it; so doth That Seminal Virtue of Men, the Womb, in this Act of CONCEPTION.

BUT as to the Time of CONCEPTION, I cannot but differ from Those, who protract and put it off till the seventh Day from the first Seminal Retention, for I am clearly of Opinion with Lud. Mercatus^[52], that if the Seed be retain’d seven Hours, the Woman hath Conceiv’d: Neither can I find sufficient Reason to think Nature one Moment Idle, much less seven Days. Therefore CONCEPTION ought to be reckoned, from the very Day^[53] of the First Retention.

HOWEVER yet, it is certain that, if the Debility of the Seed, or Womb, or Both, happen to hinder or impugn the Work, Nature ejects the Genitura, or Thing conceiv’d, on the seventh Day; which Time is the common Crisis of all Diseases, and Morbifick Accidents: Whereas if no such Effluxion happens about that Time, CONCEPTION^[54] is certain, and Formation goes on.

THIS True CONCEPTION is likewise known by many various Signs; whereof I shall mention a Few, not out of any vain Curiosity, but meer Necessity: Because, supposing a Woman to labour under any dangerous acute Disease, it is of the greatest Importance, to be certain, whether she hath conceiv’d, or not; by reason that the Means of her future Relief must (of Necessity) be adapted to her present Condition.

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CHAP. II. Of the Signs of CONCEPTION.

THE Signs of Conception are many and various, and accordingly some more, some less certain, as hereafter set forth; whereof I shall only mention such as are most common and familiar to the Generality of Women: viz.

I. THE Retention or Suppression of the Menstrua; when not occasion’d by some other Indisposition.

II. SUDDEN Weakness, Feebleness, and Imbecility of the Body and Limbs.

III. LAZINESS, Weariness, and Sleepiness, with a Heaviness of the whole Body; but especially of the Reins and the Thighs.

IV. A sort of little Spots, or hard Warts, arising in the Face and Forehead.

V. A small Pain about the Navel, and Commotions in the lower Belly.

VI. COLD Shivering, and trembling Fits; wandring Pains, and Head-Aches.

VII. LOSS of wonted Colour, sunk Eyes, discolour’d Eye-Balls: A sparkling Dimness, and Glimmering of the Eyes; the Ball growing less, and the White larger.

VIII. A Protuberancy or Swelling of the Veins, and Breasts; their growing Hard, and giving Pain: As the Nipples become firm, large, and dark-colour’d, with a livid Circle around them.

THESE and many other Signs often occur upon CONCEPTION; but except a Plurality of them meet in one Person, they are not absolutely to be rely’d on: It being a Vulgar Error among Women, to calculate precisely from the Time of missing their Months; for 73as These are often suppress’d, without any such manifest Cause; so I have known some Plethorick Persons, who have had them several repeated times after Conception.

YEA, I was once given to understand by a Lady of Distinction, in the City of Berlin, that she never had Them, till she first conceiv’d in the 19th Year of her Age; and then they came in regular Course, without any Detriment, during the whole Foetura, or time of Gestation: After which, she had Them no more, till she conceiv’d again, when They return’d, and continued as formerly; and thus it constantly happen’d to her, till she had done Child-bearing.

THERE are other more certain Signs of CONCEPTION; touching which, let it suffice, that the Physician knows them, from the Relation of the Patient: And to these may be added the Symptoms of the MONTHS.

BUT notwithstanding all the positive Diagnosticks, which most Men have been, hitherto, guided by; I have met with so many Fallibilities in this Point, that I shou’d readily have come into the Opinion of^[55] Paulus Sacchias, and deny’d the Certainty of PREGNANCY, even at an advanc’d Time, had I not been better instructed by Those most excellent Physicians and Men-Midwives, Sig. Garofanzzo of Padua, and Pfizerus of Wittenberg; who agree in certain infallible Signs, which put an end to all my Doubts, as well as to the grand Controversy, touching CONCEPTION.

AS to those common Signs, which discover the CONCEPTION of a Boy from a Girl, or Vice Versa; finding them tend only to Curiosity, and to no real Advantage, I cannot think it worth while to allow them any Place Here.

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CHAP. III. Of the DIET and REGIMEN of the Pregnant Woman.

I Come now, agreeable to my Promise, in the First Chapter of this Section, to direct and prescribe to the Woman conceiv’d her due Course: Whom I would have to consider, First, that she is in a very narrow and dangerous Sea; and, Secondly, that, as the Pilot cannot be always upon the Watch; so the Safety of Ship and Cargo depends entirely upon the Care, Conduct, and Steady Hand of the skilful Steersman.

WHEREFORE the Woman being now satisfy’d of her CONCEPTION, she is to observe a quite different Oeconomy in her Way of Living, from what she formerly practis’d: Since a double Mischief may be the Result of one single Fault in this Case; the INFANT always participating of what affects the MOTHER. And therefore she is now not only to take Care of Herself, but also of her Embryo, or the Fruit of her Womb; especially in the First Months, when it may be justly compared to the tender Blossoms of Trees, which are easily blasted, or shaken-off by the least Accident of Wind or Rain.

THIS Regimen, which I am about to speak of, is Two-fold; the One for such Women as find themselves in a good State of Health, by way of Prevention: The Other for those of the tenderer Sort of Constitutions, who begin to suffer immediately under the common Symptoms: Upon which Affair I shall give a few necessary Precautions adapted to Both, with all possible Discretion and Judgment.

I. THE Conceiv’d Woman then is to observe a good, wholesome, and regular DIET; since Errors committed 75that way, with respect either to Quantity or Quality, may be of double Damage; I mean, both to the Mother and the Infant. She should therefore eat rather Often, than Much at a Meal; especially at Nights, without fasting too long at any Time.

II. SHE is discreetly to avoid all unwholesome, or intemperate Air, and not expose herself to any Excess of Heat or Cold.

III. SHE must not desire rashly to walk much abroad in Moon-Shine, nor to wash her Head in Sun-Shine.

IV. SHE ought not to frequent Gardens; and that for the following Two-fold Reason: First, lest perchance she happen to sit or tread upon some Herb of a pernicious Quality; as divers are, in provoking Abortion: Secondly, lest she covet some Fruit or Herbs, which may be of Damage or Inconveniency if allow’d, and the same if deny’d Her.

V. SHE is prudently to avoid all Odoriferous or Perfum’d, as well as Stinking Nauseous Smells.

VI. SHE must carefully shun sitting or lying hard, and also lifting any heavy Weight, or her Arms above her Head.

VII. SHE ought purposely to forbear all hard Labour, and violent Emotions of Body.

VIII. SHE is prudently to avoid all Apprehensions of Fears and Frights, and not to be surpriz’d at any thing she hears or sees.

IX. SHE is cautiously to decline Watchings, and sitting up late at Nights; but must indulge moderate Sleep.

X. SHE must not lace herself (as before) with Whalebone-Stays, nor use Busks; which may not only spoil her Breasts and Belly, but also mis-shape the Infant, if Abortion does not immediately follow.

XI. SHE ought discreetly to suppress all Anger, Passion, and other Perturbations of Mind, and avoid entertaining too serious or melancholick Thoughts; since all 76such tend to impress a Depravity of Nature upon the Infant’s Mind, and Deformity on its Body.

XII. SHE is not to be too Busy, or Attentive, fixing her Eyes too much upon any one Object; especially on deformed ugly Persons, or any such accidental disagreeable Sight.

XIII. AS to her Appetite, she ought to set the Delphick Oracle before her (Nil nimium cupito) and desire nothing but what she can have to her Satisfaction.

XIV. SHE must carefully avoid all strong purging Medicines,^[56] especially before the fourth, and after the sixth Month: And even Then also, unless a Necessity of turgid Matter, or unfix’d Humours, oblige her to it, or require Evacuation. She is also likewise to abstain from all Phlebotomy^[57], especially in the latter Months.

XV. AS to her Exercise, of what kind soever, the following general Rule may suffice; viz. the first Month she ought not to exercise herself at all: The second, but seldom and slowly: The third, oftner and briskly: The fourth, fifth, and sixth, moderately and boldly: The seventh, eighth, and to the middle of the ninth, she should study by degrees to reduce Herself discreetly, and abstain from all her wonted Exercise, and act very circumspectly in all Regards; especially^[58] the eighth Month, which is the most dangerous and troublesome of all the Time of Pregnancy.

XVI. LASTLY, Let her State of Health be never so good, she ought to take proper Medicines to strengthen the Womb, as well as the Fœtus, in order to prevent Accidents, which may happen to the strongest Woman.

BUT as to Women of more tender Constitutions, they are not only subject to the common Symptoms, but often liable also to acute Diseases; such as Fevers, Pleurisies, 77Squincies, Inflammations, Epilepsies, Apoplexies, Convulsions, Contractions of the Limbs, Joints, &c. In which Cases, I may reasonably recommend the Patient to the ablest Physician; since none but the most Judicious ought to undertake them in such critical Conjunctures. Because it is no ways Safe to use the same Means and Medicines with the Pregnant Woman (which those incident Diseases would otherways regularly require;) without a due Distinction and a nice Regard had to her other Habits of Body.

THESE tender Women are also sometimes seiz’d with Chronical Distempers; such as intermitting Fevers, lingring Coughs, &c: But, in those Cases, Prescriptions are not so Proper or Convenient, unless the Distemper be very severe and extremely prejudicial to the Foetus, because they commonly wear off before the Delivery.

HOWEVER, be the Constitution, or Condition, of the Woman as it will, I mean, Strong or Weak, Healthy or Sickly, all prudent Parents, who desire to be bless’d with comely, tractable, and hopeful Children, ought not only to perform their Nuptial Duties with great Serenity of Mind, but also to take mutual Care to prevent and suppress all Family-Tumults or Domestick Storms: For there never ought so much as a Cloud to appear in their Conjugal Society; since all such unhappy Accidents strongly affect the growing Infant, and intail the same Qualities of Disposition almost indelibly imprinted upon it.

CHAP. IV. Of the SYMPTOMS of the first three Months.

THE Prolifick Seed being duly coagulated by a gentle Ebullition of its own vegetative Faculty, by the Power of the Plastick Virtue of the vital Spirits, and by the peculiar innate Quality of the Matrix; this 78inlivened Substance produceth an Organical Body, of a perfectly form’d, and delineated Foetus: Which Foetus, according to the various Steps of its Progression in Formation, Animation, and Maturation, occasions as many various and different Effects upon the Bearing Woman; as necessary Consequences of the said three principal Acts of the Infant’s Constitution.

NOW these consequential Effects may be properly divided into Three Classes; which are accordingly call’d Symptoms of the First, Second, or Middle; and of the last Three Months.

BUT it is to be observ’d by the Way, that all Women are not alike subjected to them; Some being more troubled with Those of the First; Others also with Those of the Second; and Others again with the Symptoms of the last Three Months. But there are some Women, in fine, that continue to be troubled, in the Middle Months, with the Symptoms of the First; and in the Latter, with some of Those of the Second: All which happens according to their various Regimens, Dispositions and Habits of Body.

HOWEVER, to proceed methodically, with all Submission, according to what competent Knowledge and Experience I have of the Conceiv’d Woman; the Symptoms most common to Her, in the First Three Months, may be briefly reduced to the following principal Eight in Number; namely, (1.) Vomiting or Nauseating. (2.) Fastidy or Loathing. (3.) Pica or Longing. (4.) Painful Cholicks or Gripes. (5.) Diarrhea or Looseness. (6.) Tooth-Aches. (7.) Head-Aches. And, (8.) Swimmings of the Head. Of all which, I shall now separately treat in their Order.

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CHAP. V. Of VOMITING, or NAUSEATING.

VOMITING is a strong and sudden Contraction of the whole Stomach, occasion’d by the Animal Spirit’s being preternaturally expanded in its orbicular as well as oblong Fibres, and the too quick and violent Exertion of their Elastick Power: Or otherwise, it is a Convulsive Motion of the Stomach, whereby, when the Fibres, which compose its middle or muscular Tunick, are all at once strongly contracted, it endeavours to eject through the Oesophagus and Mouth the Contents of its Cavity; to which the Gullet itself (being of a piece with the Stomach) and the Muscles of the Belly contribute not a little.

WHICH Definition comprehends the immediate Cause of all Vomitings; and tho’ there be many external and internal mediate Causes, yet, I think, in the present Case of the pregnant Woman, the Cause of this Symptom proceeds chiefly from the Vapours of the exhaled Humours, and the worse Part of the Blood; infesting the Tunicks of the Orifice of the Ventricle, and flying into the Cavity of the Stomach.

WHICH, if slightly affected, occasions only a nauseous Spitting, or gentle Vomiting; but if more severely, it excites a far worse Vomiting, with a certain grievous Pain and Torment of the Person afflicted. Now if those Vapours be of a calid Quality, they commonly occasion a stinking and burning kind of Belching; but if frigid, perhaps, on the contrary, a troublesome sour, acid, breaking of Wind: Both of which promote frequent Vomiting, that carries off the vicious Juices; so that the Symptom commonly ceases (of itself) in the second or third Month. Wherefore this ill Habit need not be industriously restrain’d, unless very Troublesome; as in the 80above-mention’d Case, when attended with extreme Severity of Pain: For then it is not without Danger, and therefore requires immediate Remedy or Cure.

WHICH Cure, I humbly conceive, maybe judiciously effected by expelling the Cause, and strengthening the Ventricle; so that it may be capable to repel those Vapours, or Humours, ascending from the Womb; and may either entirely subvert or repress Those previously receiv’d.

CHAP. VI. Of FASTIDY, or LOATHING.

THE Cause of this Symptom proceeds from the worse Sort and more ignoble Part of the Blood; which, in concert with the Humours, perverts the Temperature of the Stomach, by flowing towards its Orifice: And This, upon emitting Vapours to the same, strongly impresseth such vicious Qualities upon it, as doth occasion sometimes a Loathing of All Meats, and sometimes only an Aversion to some certain particular Dishes of Meat.

WHICH last Case happens most commonly, and especially at the Time of New and Full-Moon. Now this Loathing may be thus distinguished: To wit; if it rises from bilous or cholerick Humours, the Woman feels a gnawing or biting of the Ventricle, and is afflicted with a frequent great Thirst: If from putrid Humours, she is (at several Times) feverishly inclined: And if from moderate gross Humours, the only Sign is a frequent Spitting.

THIS Symptom ceases (of itself) in due Progress of Time: For as the Foetus (which as yet is only sustain’d by the better and nobler Part of the Blood) grows bigger, it requires the larger Quantity, and at 81last the Whole of the Menstruous Blood for its Sustenance; at which Time also the accumulated Humours likewise are lodg’d in their proper Place: Both which Causes being thus remov’d, the Effect ceases of course by degrees. However it is prudent, to prevent this Evil, from the beginning of Conception, by proper Medicines; but otherways (whenever it happens) unless the Foetus be endanger’d for want of sufficient Aliment, Time and Patience are the fitted Remedies.

CHAP. VII. Of the PICA or LONGING.

WOMEN subject to this Symptom, are indeed desirous of Meat and Drink; yet commonly of such, as is not only disagreeable, but also offensive and prejudicial to Nature.

THE violent Excess of this vicious or degenerate Appetite is wonderful; as frequently appears by many unnatural Instances, which I shall forbear mentioning in this Place, for fear of ill Consequences; so that I can only recommend the Curious to the^[59]Authorities of the Margin.

THE Cause of this SYMPTOM proceeds from the various Humours of deprav’d Qualities, inherent in the Tunicks of the STOMACH, vitiating the Ferment of the VENTRICLE; and so affecting the Orifice, that it becomes the very Seat and Source of this Evil: from whence arises the Variety of the Humours, exciting a strange and uncommon Variety of Appetite.

82THE Nature and Quality of these HUMOURS, have occasion’d many learned Disputes, which yet remain undecided. But tho’ Platerus takes upon himself to call them Malignant and Poisonous, yet it is the Opinion of many learned Men, and as excellent Authors, that They are not to be justly accounted for, any farther than that they are of an occult perverse Quality, generated in the STOMACH, from irregular Diet, improper Food, and bad Concoction, attended with an erroneous Regimen in other Cases.

THIS Symptom begins commonly about the 40th Day from Conception, and continues to the 4th Month: Against which time, part of the vitious Humours are excreted or thrown up by Vomiting, and the Remainder (by degrees) imbib’d by the growing Infant; which Humours being so consum’d, the Distemper ceases of Course.

THIS Effect is more extreme and disorderly in bearing a Girl than a Boy; the pituitous Humours having less Concoction, because of the want of requisite Heat: Which for the same Reason also occasions disagreeable Flatulencies, Belchings, and Fluctuations.

I have, in the Course of my Experience, observ’d this Evil to be most common in Holland; partly because of the thick condensed Air of the Country, and partly because the Commonalty of the Women live but on gross and cold Food, Fruit, Acids, &c. and are consequently of a cold humid Temperature, very subject to this Evil.

THE Diagnostick Signs of this SYMPTOM, are Weakness of Body, Dissolution of Limbs, Gnawing of Stomach, Loathing of wholesome Food, (and even That very often which the Party lov’d before) Anxiety, Pensiveness, frequent Spittings, and (at several times) Vomitings.

IF the Ventricle or Stomach is only slightly affected with some sort of viscous and frigid Humours, the Party generally longs for sharp and tart Meats; if with calid and hot ones, she craves for those which are bitter and biting: But if more severely affected, with Humours of 83some perverse occult Quality, she longs for strange unaccountable Matters; and hence it is that all monstrous APPETITES proceed.

BUT if such Humours become Connatural to the Woman, by the deep Impression of Diuturnity, she longs for things resembling the very same Nature of the Humours: As for Example, if they be of a burning or parching Nature, she covets to eat COALS, CINDERS, &c. if of a gross and thick Quality, CHALK, LIME, &c. if of a Saltish Kind, SALT itself: if of a Melancholick Temper, EARTH, CLAY, DUST, &c. For because, as the Thing containing changes the Contents, so the Contents (in process of time, by Force of constant Impression) change the Thing containing. In like manner as deprav’d Wine imparts a vitious Taste or Savour to the CASK, so those Humours convert the Temperature of the STOMACH into their own Natural Qualities.

THE Similitude and Dissimilitude of Humours and Temperature, may be thus known and distinguished, viz. The Appetite, longing for things of a like or resembling Nature (as above), remains still unsatisfy’d, tho’ plentifully indulg’d with the Thing desir’d: Whereas the Appetite of different or^[60]discording Things, having obtain’d the Thing long’d for, is easily satiated, and immediately ceaseth.

THIS Malicious or Lusting SYMPTOM, is most dangerous; degenerating commonly into a Cacochymy, Dropsy, Phthisick, or some other heavy Disease.

BUT the greatest Hardship or Misfortune, after All, is This; that, if the Woman doth not indulge her corrupt APPETITE, she languishes and pines to such a degree, that her^[61]Life is often endanger’d, together with the Foetus, by the Disappointment: and if she 84does so gratify herself, This often proves of the worst of Consequences, even sometimes to a mortal Fatality.

HOWEVER, in short, this SYMPTOM is like many Others, more easily prevented, than cur’d: Wherefore all Women, as soon as they conceive, ought (at repeated Times) to use proper Anti-kittean Medicines (that is, against PICA or Longing) and be very careful of their Regimen and Diet: But when, perhaps, by neglect of those Means, the Distemper appears inordinate, the Method of Cure consists in evacuating the Humours, and in absterging, alterating, and corroborating the Stomach.

CHAP. VIII. Of CHOLICKS and GRIPES.

THO’ the Cholick derives its Name from the Gut Colon, I mean by it not precisely that Pain which affects This only, but that also which usually invades other Guts, whether thin or thick; because one Gut seems not to be more subject than another to this Pain; the Contexture of all of them being the same every where. So that the Cholick is nothing else than a sorrowful Sensation of a very sharp Pain, infesting the Guts, or the Nervous Plexus, or Membranes in their Neighbourhood, proceeding from wandering Winds and Flatulencies in the Abdomen, or lower Belly; arising from the Humours aggregated about the Womb: which, dissipating themselves, distend the Intestines, and excite most severe Pains about the Navel.

THESE Effects may also proceed from indurated Excrements in the Rectum; or from any other Matter, which either compresses, obstructs, or erodes the Intestines: Hence Physicians commonly take notice of Three different Sorts of Cholicks; namely, the Flatulent, the Bilous, and the Pituitous.

85NOW These are All thus distinguished: The Wind-Cholick traverses the Belly, and gives an excruciating wandring Pain in the Viscera, or Bowels, &c. The Bilous induces a certain Pain, with a very sensible Mordacity; and is generally attended with Thirst and a Bitterness in the Mouth: The Pituitous gives a most sharp penetrating fixed Pain, resembling (as it were) a driven Stake, or perforating Instrument; attended with a Nausea, Vomiting, and Retention of Excrements, &c. This last Sort Galen calls the most cruel Cholick.

HOWEVER I take it to be the First of these, which most commonly afflicts the Conceiv’d Woman; generated of improper Diet, or proceeding from an irregular Regimen: And This is also sometimes so excessive, that I’ve seen the PATIENT fall by its Extremity into a Lipothymia, or Swooning-Fit, which generally presages ABORTION, if not seasonably prevented by proper Discutients, and convenient Diet, &c.

CHAP. IX. Of a DIARRHEA, or LOOSENESS.

A Looseness, in my Sense, is an immoderate, frequent and sudden going to Stool: in which the liquid and diluted, as well as sharp and peccant, Excrements are voided, which is commonly preceded by the Belly-ach and Gripes.

IT differs from a Lienteria, in that the Excrements are not indigested, unaltered, or Chylous, nor the Stools so quick after Meals: As it also differs from the bloody Hepatick, and Hemorrhoidal Flux, in that no Blood, Matter, or Liquor like that, in which Meat may have been wash’d, is voided with the Excrements.

SOME Loosenesses are call’d Bilous, when so much of the sharp Gall is expell’d as tinges the Excrements Yellow, 86however mix’d with other serous Matter: Others are call’d serous and pituitous, in which viscous watery Humours, less impregnated with Gall, are frequently and copiously voided.

THIS Symptom may proceed from a great Variety of Causes: For an Error committed accidentally in eating or drinking, or any Irregularity in the way of Living may occasion it. ^[62] HIPPOCRATES and many others, justly observe this Case to be dangerous; because it not only relaxes and debilitates the Body of the Woman, and Ligaments of the Infant; but also necessarily impairs its requisite Nourishment, and provokes Nature to an untimely Expulsion of the tender Fruit. Which unhappy Consequence ought (by all means) to be prevented, if possible, and the grievous Affection to be cured without any Loss of Time: Now I presume That may be done first, by gentle Abstergents and Corroborants; and Then afterwards by proper Restringents and Strengthners.

CHAP. X. Of the TOOTH-ACH.

THE Cause of this Symptom, proceeds from the sharper part of the Humours; which, ascending to the Head, vitiates the Blood, and thence occasions a effluxion of Rheum upon the Teeth: So that This vitious Rheum fixing itself at some of their Roots, affects the Membranous Parts so sensibly, that instead of a small Ach, it proves a great Pain, and almost intolerable Torment to the Sufferer.

87THIS ill Affection may also proceed from some Frigid or Calid, Serous or Salt-Humour, falling down upon the Membrane of the Jaws, or Nerves of the Teeth: Where, if it corrupts and lies putrefying, it commonly engenders Worms.

IN all which Cases, I humbly conceive, it may be cur’d by Variety of respective Means, according to the different Quality of the Cause, whether Frigid, Calid, Serous, Saltish, or Acrimonious: Otherways it ceases (of itself) in process of Time, by good Conduct and keeping warm, &c.

CHAP. XI. Of the HEAD-ACH.

OF all the Parts of the Body, the Head is most expos’d to Pains; that is, to a troublesome and grievous Sensation of the Membranous Parts; proceeding from Vapours of the noxious Humours; which ascending to the Head, distend and rend, in a manner, the Membranes of the Brain.

THE Parts most commonly affected, are the Hairy Scalp, the Pericranium, and the Diploe; That is, the medullous Duplicature of the Cranium, otherways call’d the Meditullium: For these Parts, by a continual Solution, when it happens so, are always most severely pain’d. But besides, in a Woman that has conceiv’d, the Pains commonly shift and move from one Place, to another, of the Head; and take certain Intervals, longer or shorter, betwixt their Access and Recess.

BUT as the Infant grows, and exhausts a greater Quantity, or at last the whole of the Blood; and as the Humours fix in their proper Place: So this Symptom gradually goes off, and quite ceases.

HOWEVER, in case the Accesses be long and violent, they may be discreetly cur’d by repelling and 88mitigating Applications, or by peculiar Corroboratives and Discutients, or proper Alteratives, according to the Nature and Quality of the Cause. I refer what may be farther added on this Head, to Sect. IX. Chap. 3.

CHAP. XII. Of the MEGRIM, or VERTIGO.

THIS Symptom begins with a Swimming, Giddiness, or Dizziness of the Head, and proceeds (in the conceiv’d Woman) from Vapours of the Humours; which, ascending partly thro’ the Veins and Arteries tending to the Brain, and partly thro’ the Oesophagus or Gullet, disturb the Animal Spirits.

NOW This Distemper is Two-fold, and distinguished by the Words Vertigo and Tenebricosa; which last the Arabian Physicians have call’d Scotomia, I suppose from the Greek Word Σκοτος, Tenebræ, Darkness; and is now generally receiv’d by that Name.

BUT because this sad Affection is too common to both Sexes, young and old, I shall proceed to a farther Dilucidation of it, for the universal Good and Benefit of All.

FIRST then, the^[63]VERTIGO is a deprav’d Imagination, attended with the vitiated Senses of Hearing and Seeing; proceeding from the violent Commotion of the Animal Spirits. Secondly, The SCOTOMIA is also a deprav’d Imagination, accompany’d with loss of Sight, and sometimes of the Motion of the Animals affected with it, because of some Interruption in their circular Passage. In the first Case, the PATIENT imagines his Head only to be turn’d round, or winded about: In the other, he thinks that circular Motion to consist in the external Objects.

89NOW the VERTIGO is attended with the vitiated Sense of Hearing, as well as Seeing: Because, as something like a Cloud, Smoak, or Web, seems to appear before the Patient’s Eyes; so there is a certain Whistling, Hissing, or Tinkling always in his Ears. The Scotomia, in like manner, is attended with Loss of Sight, and Motion; because of some Disorder of the Ventricles of the Brain obstructing or impeding the Transition of the Spirits.

IN the Vertigo, an Agitation happens in the Membranes of the Veins and Arteries, as also in the Membranes of the Brain; by which violent Motion, the very Continent Parts are vehemently shaken and concuss’d, and at length so disquieted, that the Patient thinks his Head wheels round about.

IN the Scotomia, the Animal Spirits having in themselves the Species of all Sensibles, and those Species being presented to the Imagination: As such Images of external Objects are moved in it, so the Party thinks the same real Objects to be moved. For, according to Avicen, it is the same thing, whether that which is seen, or that by which we see, is moved: As seeing Land from on board a Ship, in a smooth Sea, being insensible of the Ship’s Way, we imagine (and sometimes very strongly too) that the Land is in Motion.

THAT by which we see, is the visible Species reserved in the Spirit: Hence when this Species is moved, the external Object seems also to be moved.

BUT in explaining the Circular Motion of the Animal Spirits, we must consider it to be twofold; namely, Natural and Preternatural: The Natural Motion is that which begins in the Carotide Arteries, thence tending to the Plexus Choroideus, or the anteriour Ventricles of the Brain; from These to the middle; from the middle to the Posteriours; and from the posteriour Ventricles of the Brain, the Spirits are imparted to the Nerves. The Preternatural Motion is just the Reverse of this Case.

THE Causes of both these Cases and Conditions are either immediate or mediate. The immediate Causes may be reduced to Three Classes; to wit, Causes of an 90inordinate Motion of the Animal Spirits, Causes of the Circular Motions, and Causes of lost Sense, Sight, and Motion.

THE Causes of the Spirits^[64] moving inordinately, are either External or Internal. The Externals are the Sun, Hot Baths, Frictions, and Concussions of the Head; or a Fall, Blow, Contusion, and all inordinate and immoderate Motions of the whole Body: such as Running, Leaping, Riding, Dancing, too much Venery, or hard Drinking; as also the Use of Acids, or acrimonious Things, and all Things replenishing or stuffing the Head; such as Garlick, Mustard, Anise, Parsley, Leeks, Onions, Radish, strong Snuffs, Drinks, &c.

THE internal immediate Causes are the Imagination of the Patient, Vapours of the whole Body, frigid Flatulencies, and^[65]a sudden Fluxion of the vital Spirits into the Head.

THE mediate Causes are Material; and this Matter^[66] (almost all Physicians agree) is frigid. From hence it is certain, that the Distemper proceeds from Crudities, and Victuals of a crude Juice; such as Pulses, Cheese, Tarts, Fish, and all other Sorts of the like frigid and humid Qualities: But these are only to be reckon’d concurring, not efficient Causes.

THE most common material Cause is, according to Galen^[67], the Bile; which, seeking for Vent at the Mouth of the Stomach, is the Cause of these Symptoms, and is^[68]properly to be educed or evacuated by a due Vomit.

BUT in Case of Vapours, Heat is always the efficient Cause, elevating them from the peccant Matter; since a Cold, or a refrigerated Body, can never engender Vapours or Wind from any Material Cause.

91I shall not now enter upon the particular Diagnosticks of this Distemper, because they are as Various, as the Causes, and affected Places are different. Let me observe only, that the simple Vertigo is easily known by the Imagination of the Circular Motion of the Patient’s Head, or That of external Objects, or by vitiated Seeing and Hearing.

BUT the Scotomia differs from the Vertigo, in that besides the Imagination of the circular Motion, the Patient often loses his Sight, staggers, tumbles, or falls to the Ground. And yet the same is distinguished from the Epilepsy, in that the Patient retains his principal Functions, and neither Foams at Mouth, nor is Convulsive.

HOWEVER, as to the Distinction of Causes, if the internal Cause proceeds from Calidity, it is known by the hot Temperament of the whole Body, as well as by a Swelling and Pulsation of the Arteries about the Throat: Besides that this Vertigo easily accedes and recedes, it is always attended with Calidity and Redness of Face and Eyes; with Watchings, Deliriums, &c: And it commonly follows Fevers, Watchings, Anger, the Use of Calids, hot Things, &c. In which Cases, it is always to be helped by the Use of Frigids, or Coolers.

IF it arises from frigid Flatulencies, the Paroxysms or Fits are preceded by a Hissing or Tingling in the Ears; the Patient turns pale and wan, and is taken with an odd extensive Pain of the Head: And if these Flatulencies generate in the Head, the Party feels it ponderous, lumpish, and heavy; and is consequently much inclin’d to Sleep, Stupidity, Dullness, and Inactivity.

IF the Distemper is derived from a flatulent Stomach, the PATIENT is troubled with Rifting and Rumbling of the Belly; with Sobbing and Sighing, with Hickups, Yawnings, Extensions, Inflations, and frequent Spittings.

IF it comes from a Mordacity of the Mouth of the Stomach, the Party is infested with a Nausea, Loathing and Fastidy; with a Dejection of Appetite, a lasting or frequent Thirst, and a Bitterness of the Mouth. But this 92Affection also very often proceeds from the Womb, and that either because of the suppress’d Menstrua, or longretain’d Seed; as will hereafter more fully appear in Sect. ix. Chap. 8.

AS to the Prognosticks of this Distemper, it does not always seem Dangerous, much less Lethal, at first; but its Consequences are (however) very Fatal^[69], if not timely prevented: For it often turns to Inflammations^[70] of the Head, or Convulsions; sometimes to Melancholy or Madness; and sometimes to Epilepsies or Apoplexies.

NOW because this Affection observes Lunar Periods, and in extreme Cases, is near a-kin to the Falling-Sickness;^[71] Cœlius Aurelianus informs us, That it was call’d by the Ancients the little Epilepsy: And as it admits of periodical Accessions and Circulations (I mean coming and going Fits) which depend chiefly upon the Power and Influence of the New and Full-Moon; so it is to be treated with respect to Cure, in a different manner; one way in the Access, another in the Interval.

BUT this Cure is as different, as the Causes and Degrees of the Distemper are various; wherefore I can, by no means, enter upon it in this place, for Brevity-sake.

CHAP. XIII. Of the SYMPTOMS of the middle Three Months.

THE Foetus having receiv’d a distinct Form, constituted of various Organical Members, and produced of divers substantial Matters, takes a various Situation; the different Members possessing different Places, according to the Institution of NATURE.

93AFTER an absolute and compleat Conformation of Organs, the rational Soul is infus’d and adapted; which is the ultimate Perfection of the Human Foetus: By which it becomes Man and receives Life, living and subsisting henceforward by its own vivacious Faculties, distinct from those of the Mother. Now the Great and All-wise Creator undoubtedly is the only Supream, Efficient, and Immediate Author and Finisher of this noble Work; which, according to the nicest Calculation of the greatest Masters of Nature, is most commonly accomplished about the Beginning of these Middle Months: At which time, the usual Turn of Nature necessarily occasions different Effects to the Child-bearing Woman; which are call’d SYMPTOMS of the Middle Months.

AND these SYMPTOMS, in short, I reduce to the following Seven in Number; viz. 1. Coughs; 2. Palpitations or Heart-Beatings; 3. Swoonings or Syncopes; 4. Watchings; 5. Pains in the Hips and Loins; 6. Hemorrhages or Bleedings; and, 7. Fluxes of Blood. Of which, in their due Order.

CHAP. XIV. Of COUGHS.

COUGHS are either Humid or Siccid: They are call’d Humid, when the Humours contain’d in the Aspera Arteria, of whatsoever Nature, are expell’d by its own Force thro’ the Mouth. And Siccid, or dry Coughs, when, notwithstanding great Pains and Trouble, nothing is excreted, only the whole Body fatigued by a continual irritated Endeavour to Cough and spit-out; whence arise Pains of the Head, Hypochondriacks, and other Parts.

94THE Cause of which SYMPTOM is Four-fold, and proceeds either from the sharp acid Vapours of the Humours flying towards the Lungs, Wind-pipe, and Jaws; irritating the natural Faculty to Expulsion: Or, from the finer Part of the Blood, converting itself to the pectoral Veins: Or, from the Humours themselves ascending to the Head, and relapsing upon the Breast: Or, in fine, from the suppressed Albedines or Whites, and whatsoever may vellicate the Aspera Arteria, or in any respect oppress or irritate the same.

THIS Symptom (however slighted or lightly esteem’d) is very Dangerous; forasmuch as it attenuates and weakens the whole Body, enervates or destroys its Strength and Vigour, causes difficult Respiration, excites Head-Aches, hinders natural Rest, occasions Watchings, promotes Defluxions, and finally gives Origin to Fevers, as well as most other Diseases: Besides that, it continually exagitates and distresses the Muscles of the Abdomen, or lower Belly; and thereby too commonly provokes Miscarriage.

FOR these Reasons this SYMPTOM ought to be carefully mitigated, if not cur’d, without any loss of Time: But the Cure itself, in my humble Opinion, may be easily effected, by evacuating the peccant Humours, by purging and corroborating the Head, and by the right Use of proper Thoracick Medicines.

CHAP. XV. Of HEART-BEATINGS and SWOONING-FITS.

THESE Beatings or Palpitations are nothing else but a sudden Loss of all the Strength, with an immoderate Concussion, by a vehement Diastole, and molestous Systole of the HEART: From hence this SYMPTOM easily turns to a Cardialgia, Lipothymia, or Syncope; 95which are All of near Affinity, in the Case of the Pregnant Woman, so that I shall treat of them conjunctly, and first observe; that

THE Cause of all such SYMPTOMS are but Two-fold, and proceed either from a flatulent Substance of the Humours, ascending, thro’ the Arteries, or the Vena Cava, to the HEART: Or from the Abundance of Blood, which (not finding passage by the Womb) seeks to the superiour Parts, and thence oppresses the HEART and vital Faculty.

THIS Last is the most dangerous Condition, being (in such Plethorick Women) the certain Prognostick of imminent ABORTION: To prevent which unhappy Accident, the principal Part of the Cure, depends very much on cautious Venæ-Sections, or letting Blood, proper Diet, &c: Whereas, in the First Case, proper Discutients, Cordials, and Corroborants, are the most convenient and successful.

CHAP. XVI. Of WATCHINGS.

THIS Symptom is nothing else, more than an immoderate Exercitation of the Senses, from too great a Motion of the Animal Spirits: Proceeding from some acrimonious and siccid Vapours of the Humours, ascending to the Brain, and there disturbing the Spirits, by exciting their vehement Motion; which so exagitates the Senses, that the vigilant restless Woman gets either none at all, or but very short Sleep.

THIS watchful Affection is distinguished by a siccid, or calid and siccid Intemperature; attended sometimes with a Melancholick, Bilous, or Pituitous, Saltish Matter; which is either essentially lodg’d in the Head, or communicated to it from the Mouth of the Stomach, or the Veins of the whole Body.

96SOME have been so overtaken with this SYMPTOM, that they have not only continued Awake for some Days and Nights, but also Weeks and Months: Insomuch that Hercules Saxon^[72] relates of his own Father, that He, being melancholick, suffer’d such like Watchings, without the least Sleep, seven Months long.

HOWEVER in the Child-bearing Woman, the least Degree of such immoderate WATCHING^[73] is dangerous; insomuch that it often occasions Deliriums, and Convulsions, by the continual Stretch and Tension of the Fibres.

HOWEVER the Cure of this SYMPTOM may (I hope) be well perform’d both by external and internal Means; externally, by proper Lotions, Inunctions, and Frictions; internally, by proper Soporiferous Medicines adapted to the Quality of the Intemperature.

CHAP. XVII. Of PAINS in the Hips, Loins, &c.

ALTHOUGH these PAINS (in general Terms) are the Effects of the Compression of the extended Womb, hanging on, and bearing too much upon the neighbouring Parts, by its Gravity and Weight: Yet the particular Cause of such SYMPTOMS (in my Opinion) is Two-fold; and proceeds either from the Abundance of Blood lodging in the Veins of those Parts; or from the growing Foetus, so extending the Ligaments of the Womb, as to oblige the neighbouring Parts to sympathize. From hence the broad Ligaments cause the PAINS of the Back and Loins, answering to the 97Reins, to which Parts they are strongly fixed; as the round Ones affect the Groins, Hips, and Thighs, where they terminate. Which Ligaments are sometimes so violently extended, especially in the first Time of Pregnancy, that (by the Concurrence of any slight procatarctick Cause) they have been often known to break.

THE Cure of these SYMPTOMS, in the first Case above-mentioned, depends chiefly upon cautious Phlebotomy, and good Repose in Bed; and in the Second, upon proper Swathes, Unguents, &c.

CHAP. XVIII. Of HÆMORRHAGIES, or BLEEDINGS.

THESE Symptoms are to be understood to happen only from the superiour Parts; as Nostrils, Mouth, or Ears: And the Cause seems to be Three-fold: proceeding either from a more than ordinary Plenty of Blood; or from a gross Mixture of Humours and Blood, prompting Nature to Excretion; or, lastly, from a Debility and Weakness of the Infant, when not able to attract the due Quantity of Blood to its Subsistence.

IN the first Case, the Woman usually looks sanguine and well-colour’d, and hath more Plethorick Marks upon her; which, if it happens, without any great Inconvenience, as it is without Danger, the Woman may easily bear and dispense with it.

IN the second Case, the Blood so lost falls dropping away, and with Pain; it is ugly and ill-colour’d, of an acid Quality, and stinking Smell: And the Patient hath more Cacochymic Signs upon her, whereby she is threatned with Abortion and imminent Danger.

IN the third Case, the Signs of a Debilitated Fœtus, and instant Abortion, are evidently presented; as mention’d in Chap. 29, and 30, of this Section: When, if she chance to escape Miscarriage, (which most commonly 98happens in this Condition, if not timely and artfully prevented) a difficult and laborious Birth is the certain Consequence; and sometimes a protracted Time of Bearing to the Close of the 10th, or (as I have observ’d) to the Beginning of the 11th Month.

THIS Symptom is to be judg’d of, and cur’d according to the above-mention’d, and what other concomitating Diagnostick Signs appear.

CHAP. XIX. Of FLUXES of BLOOD.

THIS Symptom is to be understood to happen from the inferiour Parts; namely, by way of the Hæmorrhoidal Veins, or by the Passage of the Womb, but most commonly by the Last.

THE Cause then of this SYMPTOM, happening by the Hæmorrhoids, is Three-fold; and proceeds, either from too great a Quantity of Blood abounding; or from the disorder’d and deprav’d Quality of that Blood; or from Both these Indispositions jointly: And this sanguine Affection is commonly without any great Danger (tho’ not without some Trouble) to the Woman; ceasing gradually (of itself) after a safe and successful DELIVERY.

THIS Symptom from the Womb, happens Four different Ways; to wit, either by the Vessels, which run to the Neck of the Womb; or by Those, which tend to the Body and Cavity of the Same; or by Those, that adhere to the Membrane call’d Chorion, and to the Infant, by which it attracts its Nutriment; or by Those, that Nature hath reserv’d for a Superfœtation, or the Necessity of expurging this Blood when it chances to be Superfluous.

WHATEVER way this Flux happens, its Cause is Three-fold; and proceeds, either from an Apertion of 99some of the mentioned Uterine Vessels; or from their Dilatation; or from a Rupture of those Vessels.

THEY are open’d by a Redundancy or Superfluity of Blood; which Wise Nature takes this Method of fiercing and throwing-off, the Natural Evacuation being stopped. They are dilated by the Acrimony of the Humours, or by their own rarefy’d and thin Contexture, And, in fine, they may be bursten or broken, by a great Variety of Accidents; such as Running, Leaping, Falling, Striking, Lifting a heavy Weight, violent Motion, Coughs, great Pains, Vapours, Costiveness, Looseness, immoderate Heat, or Cold; as also by any violent Perturbation of Mind.

THE First Case (being the Work of Nature) happens with great Ease, and without any Pain or Trouble; it flows moderately and regularly, is of short Continuance, and not attended with any immediate Danger, so long as the Woman enjoys her Health, and continues well-colour’d in Complexion.

THE Second Case is called an Anastomosis; and what happens by such irregular Dilatations, falls Drop by Drop away; and is All Acid, Ill-colour’d, Stinking, Thin, Pale, Serous Stuff.

THE Third Case is known by an immoderate and irregular Flooding, as it were in Heaps; attended with Pains of the Groins, Loins, &c: And at last aggravated with Faintings and Convulsions. The true State of which Case is particularly noted in Sect. V. Chap. 7. Only give me leave to add here, that the Procatarctick Cause, is always sufficiently known, from the Relation of the Patient.

BUT however, it is also proper to know in all the above-mention’d Cases, from what Place, and by what Vessels this Flux happens: Which may be rightly thus distinguished; for if from the Neck of the Womb, it flows orderly and moderately; as it likewise does, if it comes from Vessels no ways adhering to the Infant: but if it arises from the Bottom of the Womb, it flows in less Order, and greater Quantity; and if it 100happens, in fine, from the Vessels fixed to the Infant, and the Chorion, then it does flow most irregularly of all, and in very great Quantities.

THE Prognosticks of this SYMPTOM are, either a^[74] weak debilitated Infant, or an approaching Abortion: But besides also, it sometimes portends a hard, laborious, and protracted BIRTH, perhaps even to the 11th Month.

WHICH Prognosticks are indeed founded upon sufficient relative Reasons: The First, because the INFANT is not able to convert the whole of the superabundant Blood, to its Aliment: The Second, because the INFANT (tho’ perhaps Strong and Able enough) is depriv’d of its requisite Sustenance: The Third, because (according to Hippocrates, &c.) a sickly Gestation always indicates a difficult and laborious BIRTH: And besides the reason of a protracted Birth (beyond the ordinary Time) is very plain and perspicuous; because, if a strong healthy CHILD requires two Months, to recover itself after the first Onset or Attempt of the 7th Month, (as is more amply explain’d in Chap. 34. of this Section) it is but highly reasonable to think, that a weak sickly One, requires a longer Time of Gestation.

THE first Case of this SYMPTOM, seems to be the most favourable of the Three; yet I would advise such Sanguine or Plethorick Women, to guard against one ill Consequence, which I have known sometimes to happen in the same burthensome Condition: Namely, that from too great a Plenty or Superfluity of Blood, it sometimes runs through the interiour Veins into the Cavity of the Womb, which renders the Case by far the most dangerous; because this Blood^[75] (being out of its proper Canal or Center) irregularly extravas’d, immediately corrupts and suppurates; which corrupted Blood, in Concert with the INFANT, (whose Aliment is thereby impair’d) always obliges the Womb, to dilate and yield 101up its Contents: So that, in short, this particular SYMPTOM^[76] is, in all its different Cases or Conditions, the most Pernicious and Dangerous.

WHEREFORE it is, that the respective Cures of these sundry Cases, belong only to the Ablest Physician, and That (most properly) to Him who professes and practices Midwifery: Because, when Medicinal Helps fail, and cannot prevent Misfortunes, He will at least know best then, how to Compose, and Mitigate them, by delivering the Woman, if Necessity so require.

CHAP. XX. Of the SYMPTOMS of the last three Months.

TWO third Parts of the common Duration and Conjuncture of Child-bearing, being, by this time faithfully, if not so fully, accounted for; it remains now, that we also more particularly consider the Mother and her Infant throughout the last Three Months-Travail. These are the Finishing Maturating Months of the INFANT: I mean peculiarly, as to its Strength and Vigour; since in other respects, the Middle Months have duly perfected the Ornaments of the particular Members, and gracefully compleated the Shape and Form of the whole Body.

WHEREFORE, as, in these latter Months, the CHILD encreases in Bulk, Vigour, and Activity, it then affords the tender Mother incredible Uneasinesses, and grows sometimes almost Obstreperous: Which Augmentation of the Foetus (of natural Consequence) occasions 102in her Constitution of Body various different Effects; call’d SYMPTOMS of the last Three Months.

NOW these SYMPTOMS, I hope I may pertinently reduce to the following Nine, in Number; namely, 1. Dysuries; 2. Ischuries; 3. Stranguries; 4. Costiveness; 5. Tenesms; 6. Varices; 7. Inflations of the Legs; 8. Fissures of the Belly; and 9. and lastly, Water-Fluxes. Of which I shall take leave to treat separately, in their proper Order.

CHAP. XXI. Of DYSURIES, ISCHURIES, and STRANGURIES.

THE Dysuria is a painful and difficult Excretion of Urine; as the Ischuria is an entire Suppression of the Same: And the Stranguria nothing but an Effect of the other Two; being an Excretion made Drop by Drop, with a continual Stimulation or Propensity to make Water, however without any acute Pain, tho’ not without some Uneasiness.

NOW these three SYMPTOMS have all their respective Causes, which I shall not particularly enter upon here at large; but only, take notice by the By, that in the Pregnant Woman, they most commonly proceed from One and the same Original: Wherefore I shall in this Place discourse of them conjunctly; and observe that all three SYMPTOMS may proceed from the ponderous Womb, lying upon, and depressing the Neck of the Bladder; and that the more heavily, the nearer the Woman is to her Time. The pungent Acrimony of the Urine sometimes also occasions Incontinence, or want of Retention; as its Inflammatory Heat causeth almost a total Suppression. However, in short, such SYMPTOMS may 103likewise proceed from some crude and unconcocted Matter, obstructing and oppressing the Sphincter-Muscles.

BE That as it will, in the present Case, the Cure is but very seldom of great Difficulty; being frequently effected, by lifting up the Bottom of her Belly with both Hands when she is about to make Water: Or, by wearing a convenient large Swathe. But if Need require, the Region of the Bladder may be cherished with proper emollient Fomentations, Injections, or Cataplasms; as (upon any Extremity at last) a Catheter may be prudently used.

IF the SYMPTOM however proceeds from any Inflammatory, or Acrimonious Quality of the Urine; it may be sufficiently helped by a proper, regular, cooling Diet: As, if it arises from any undigested, crude Matter; it may be assisted or reliev’d by a good Draught^[77] of warm generous WINE; which not only helps Concoction, but also facilitates and promotes URINE: But in case of absolute Necessity, after all, gentle Phlebotomy ought to be carefully used.

CHAP. XXII. Of COSTIVENESS.

THE Belly discharges it self sometimes more seldom or infrequently; sometimes with more Pain and Difficulty; and sometimes in less Quantity than is convenient for Nature.

THERE have been many Instances given of this Disorder, by^[78]Learned Men, where some Patients have gone to Stool but once in Eight, once in Fourteen, and once in Twenty or more Days.

104YEA,^[79]Dominicus Panarolus relates of a certain Friend of his, whose Belly was so exsiccated, that he sometimes liv’d three Months without going to Stool.

BUT what I mean by Costiveness, is not that Distemper, where there is a total Suppression, for that rather belongs to the Iliack Passion; but that only, where the Excrements lodging longer than their due natural Time, perhaps three or four Days more or less, are at last voided hard and dry with some small Straining.

Which irregular Accident may proceed from many different Causes. Although in the pregnant Woman, I take the following to be the most Common: That is to say, the Calidity and Siccity of the LIVER, or SPLEEN; occasion’d by the Lusty Child’s attracting too much of the Radical and Succid Moisture of the MOTHER, and compressing the Intestines.

THIS Symptom proves often of dangerous Consequence: For by the pressing Force, commonly us’d in such a Case to ease the Belly, some Vessels or Ligaments may be easily and readily broken. And not only so, but the retain’d Fæces always affect the Head, and contaminate the Blood with noxious Vapours; and thereby impede or hinder the Concoction of the Ventricle, and the Separation of the better and purer, from the grosser and impurer part of the Chyle: Whence proceed many other various Disorders to the whole Body, from the long Retention of the Excrements.

THE Cure consists in temperating the Calidity of the VISCERA, and relaxing the BELLY by proper Diet, Dissolvents, &c. And in Case of any sudden VOMITING, which sometimes happens upon Costiveness, humectant and emollient Clysters may be most properly and cautiously used, to restrain and prevent all such Revulsions.

105

CHAP. XXIII. Of TENESMS.

A Tenesms is an irregular Retention of Nature, and nothing else but a continual Desire or Inclination of going to STOOL; attended with Pain, without voiding any thing but Slime, or an indigested Mucosity: And this is in the Anus, what a Strangury is in the Bladder; being Both a violent Contraction of the Fibres, or Disorder of the Sphincter-Muscles.

WHICH tenacious Symptom proceeds from a great Variety of Causes, occasionally provoking the expulsive Faculty of the strait Gut, call’d the Rectum, without a Power to expel; such as may happen to be an unusual Exulceration, or Constriction of, or an Acid-Salt-Humour in the same Intestine: So likewise a Stone in the Neck of the Bladder, a Tumour of the adjacent Parts, or seminal Vessels, a frigid Intemperature, the Hemorrhoides, a Dysenteria, Dysuria, Ischuria or Stranguria, &c. may very shrewdly occasion the Tenesmus.

WHICH binding SYMPTOM is of the same dangerous Nature and^[80]Consequence with the preceding Case; both having an equal Effect of Power, if not prevented, to expel and dislodge the Infant. Which Notion cannot be otherways better maintain’d; for the Womb being situated upon the Intestinum Rectum, must suffer great Commotions by continual Needings and Strainings in both Cases.

BUT the safest Cure, in short, in my humble Opinion, is to be perform’d by proper Decoctions, Fomentations, and absterging Clysters.

106

CHAP. XXIV. Of the VARICES, or Vein-Tumours.

THIS Symptom is nothing else, than a Distention or Dilatation of the Hip, Thigh, and Leg-Veins: Which however chiefly appears about the Ham; and it happens most commonly to Plethorick Women, who walk much, or exercise themselves more freely upon any Occasion.

THE Cause proceeds only from a Plenty, or Superfluity of the suppressed Blood, more than the Infant can consume: which being carry’d by the Arteries to the lower Parts, is thence received by the Crural and Saphene or Ankle-Veins. Insomuch that the Womb, being (by this time) both Ponderous and Bulky, so presseth the Iliac-Veins, that it hinders the Blood in its Course, and obstructs its free Motion and Circulation; whereby (of consequence) these inferiour Veins must swell and distend themselves proportionably.

HOWEVER, the Danger of the SYMPTOM is not great; because after a safe BIRTH, when the super-abounding Blood and Humours are evacuated, these preternatural Tumours settle, and the Veins return to their Pristine State.

WHEREFORE the only necessary Relief of this Malady, consists chiefly in the Woman’s abstaining from too much Walking, and all other extravagant Exercises; upon indulging her inferiour Limbs, by keeping them rais’d upon a Couch or Stool, that the Blood may not settle too much to these lower Parts: Or (which is far better) let her prudently keep her Bed; in which Posture, the Blood can meet with no such Difficulty in returning by these Veins to the Heart, as it will find when it must ascend by the Woman’s SITTING or STANDING upright; so that consequently it must needs circulate the more readily and with more Ease. 107Hence in short, it is, that from this more Free and Easy Circulation in Bed, such Women are always more easy, or better dispos’d, and far less pain’d or troubled in the Mornings, than at Nights, in This Condition.

BUT if, after All, the PATIENT’s Convenience will not permit such Indulgences, Then a proper Swathe of three or four Fingers Breadth, is most adviseable; beginning to swathe this Varicose, or Swelling Part, from the Bottom upwards, as far as the Varices or Tumours extend. But in Case of more Plethorick Marks, at last, in the other Parts of the Body, Phlebotomy may be most safely made Use of.

CHAP. XXV. Of the INFLATIONS and TUMOURS of the LEGS.

THESE bloating Symptoms not only happen to some Women before, but also after BIRTH; especially when the Lochia, or Child-bed Cleansings, do not flow in a regular Measure or sufficient Quantity.

THE Cause of the present disorder’d Case, proceeds either from the Suppression of some Aqueous Flux of the Womb; or from some such watery serous Blood descending to the Legs; or from the Abundance of retain’d Menstruous Blood, more than the Infant can dispense with: which, being of no Service either to MOTHER or CHILD, settles downwards to these aggriev’d Parts. But these Things are to be considered with this Distinction and Difference, that if the LIVER be debilitated, and the Blood becom’s Pituitous or Aqueous, the Woman’s Legs are so Oedematous or Tumid, that when pressed with the Finger, it leaves the Impression of a Dent and Hollowness: But if the Blood grows corrupted and bilous, her Legs are inflam’d, and sometimes occasionally exulcerated, as in Scorbutick Cases: And if none of These happen, then a gross thick Blood only abounds, tending vitiously 108downwards. Upon which there are only some Livid or Blueish Marks^[81] to be discover’d with those Tumours, such as the VARICES or Swellings occasion in the preceeding Case.

IN fine, the Woman troubled with these Symptoms, commonly bears a Female; as all Women, having sickly times of GESTATION, generally do. However yet, tho’ this swelling Affection is very troublesome, its Danger is not great; because it ordinarily ceases of it self with good Care after the BIRTH. Wherefore in this Condition a CURE is not always to be attempted, lest the Humours recoiling upwards, affect some nobler Part. Nevertheless, if the SWELLING be too considerably Painful or Troublesome, proper Digerents and Discutients may be apply’d, and the Legs fomented with a convenient Lixivy, Decoction, or Cataplasm.

CHAP. XXVI. Of FISSURES or CHOPS of the BELLY.

THIS Symptom only happens to Women bearing their first or second CHILD; whole lower BELLIES have not yet been sufficiently extended by frequent CONCEPTION.

THE Cause proceeds only from the natural Lenitude and Constriction of the Skin of the ABDOMEN or lower Belly; which (in proportion to the Growth of the INFANT) must dilate and distend itself: So far as that towards the latter Months, it gives way to such a large degree, that it appears not otherways than as if the SKIN was to be divided, and almost crack or break by its thin Attenuation.

HOWEVER it occasions also very often great Pain, as well as a permanent wrinkled Deformity 109of that Part. Wherefore Laxative Liniments, and proper Unguents, are pertinently to be made use of by way of Precaution, from the fourth Month, until the Time of Delivery.

CHAP. XXVII. Of WATER-FLUXES.

THE Water which is gather’d in the Time of GESTATION, between the Membranes involving the INFANT, is at last upon the approaching BIRTH effus’d: For the CHILD having broke the Amnion, feels these WATERS troublesome, and consequently obliges the Chorion also to give way. From whence proceeds naturally a copious Effusion of the same Waters.

BUT of this natural Flooding, I am not properly to treat in this Place; only of that preposterous Flux, which happens before the due time of BIRTH, the immediate Cause of which proceeds from some Procatarctick Accident: Such as a Perturbation of Mind, an unlucky Fall, a Leap, a Stroke, or any other Violence.

THIS Symptom happens Two ways, either by a Disruption, or Dilatation of the MEMBRANES: the first by external, the other commonly by internal Causes. In the first Case, the Flux comes suddenly, irregularly, and in a great Quantity; in the second, by little and little, or by degrees, and less in Quantity.

THE first Case is most dangerous, being the infallible PROGNOSTICK of instant Abortion, if not timely and judiciously prevented. The second Case is of the following bad Consequence, that this Water, which has hitherto defended the Infant from the Rigidity of the circumjacent Parts, being at last (how leisurely soever) exhausted and spent; the Child is soon sensible of its Loss, and finding its wonted Seat become uneasy, it thereupon being restless or discontented, endeavours to 110move and seek for a Better: By which means (if Abortion does not presently ensue) it falls into a preternatural Situation, which (of course) occasions a preternatural BIRTH. But abstracting from This, the bare Deficiency of the Waters, for moistening the Passages in time of LABOUR, is enough to effect the same Unhappiness.

HOWEVER, the Cure of this SYMPTOM depends chiefly upon a good Regimen of DIET, and external, as well as internal Corroboratives.

IN short, having thus discuss’d the several SYMPTOMS of the Nine Months, and such as are most common and familiar to the Woman during her Foetura, or the whole Time of her CHILD-BEARING; I shall proceed now in the next Place with all due Method and peculiar Regard for her Good.

CHAP. XXVIII. Of Acute DISEASES incident to the CHILD-BEARING WOMAN.

IT sometimes, and more than too often, happens, that besides the common SYMPTOMS of the Months, the conceiv’d Woman is also suddenly taken with some acute DISEASE or other; upon which I shall offer my sincere Opinion, and according to the best of my Judgment, give a brief Account of Those several Maladies, with their Definition and Cause, Nature and Quality, Danger and Cure.

FIRST then, the great Galen defines acute DISEASES to be such, whose Motion is swift, attended with sudden and immediate Danger.

THE learned Brassavole calls such DISEASES Acute, as come suddenly, continue a short Time, and have very severe or violent SYMPTOMS.

THE ingenious Blancard calls those DISEASES Acute, which are over in a little Time, but not without 111imminent Danger. Now Those are deem’d either very Acute, or most Acute; the latter is meant when the Distemper is over the 4th Day; but the former is that which continues till the 7th Day: For the more acute the DISEASE is, the sooner follows its Determination, either for Life or Death. Again, a Disease is call’d simply acute, when it lasts 14 or 21 Days; or lastly, it is term’d Acute ex decidentiâ, which lasts 42 Days at least.

AND according to the diligent Dr. Sydenham^[82], the Despumation of Acute DISEASES happens in 336 Hours; which he also justly applies to intermitting FEVERS, reckoning 5 Hours and a half for a Paroxysm: Because what we call Days in Acute Fevers, are so many Periods in intermitting Fevers: The only difference of Those consisting in that the one perfects its Fermentation at once, which the other accomplishes at reiterated Times, and divers Turns, by the same Duct of Nature. He farther still, observes that Autumnal Quartan Fevers continue six Months; in which Time, if the Number of the recurrent Paroxysms be summed up, they will exactly amount to the aforesaid 336 Hours, or 14 Days, which is the Term or End of the regular and continual Fevers of that Season.

AND the wise Hippocrates observes^[83] that as an exquisite continual Fever ceases within the 7th Day, so an exquisite Tertian has seven periodical Circuits; because every Access in the latter, makes up a Day in the former Case. Hence it is manifest that all Epidemick Diseases have their due and regular Times^[84] of encreasing, continuing, and decreasing; and that These Laws of Nature are so constant and permanent, that however Fevers differ in other Circumstances, they are equal as to the Duration of Time; counting according to the 112Periods or Fits of the intermitting, and the continued Number of Days of the never intermitting Fever.

GALEN^[85] further explains Acute DISEASES, and calls them Two-fold: The one attended with a continual Fever; such as are burning Fevers, Frenzies, Lethargies, Pleurisies, Squincies, Inflammations, &c. The other without any Fever, such as Epilepsies, Apoplexies, Convulsions, Palsies, Contraction of LIMBS, JOINTS, &c. Now the^[86] Accesses and Crises of all These proceed from the Influence of the Moon; which in over-ruling terrestrial Things, surpasses all the other Planets and Stars, not so much because of her Power, as by her Approximation or Vicinity.

THE Cause of both the one and the other seems to be the same; tho’ it affecteth differently, according to the various Regimen and Disposition of the Woman: And it most probably proceeds either from the vitious Humours, which have abounded in the Body before Conception; or from such Humours as have been congested afterwards by the suppressed Menses, or Months: Which being irritated by improper or depraved Food, by bad or negligent Regimen, either before or after Conception; those Humours (like Yest in Ale) ferment the Blood, to such a Degree, that (all on a sudden) the Patient is violently taken with one or other of those Acute Diseases, which are determined by a certain Lunary Crisis; that is to say, by a certain Motion of Nature, accelerated by the Power of the Moon, to a gradual Expulsion of the peccant Matter thro’ the Pores of the Body. But this Crisis, in short, happens always with most Ease and Safety upon the New or Full-Moon, because the ambient Air does not at that time so much affect the Superficies of the Body, nor so violently repress the Motion of the Fluids.

HOWEVER, this melancholy Accident can never happen worse than to the Conceiv’d Woman; and the 113farther she is gone in her Time, the more Danger still. And that because of the Scarcity or Want of pure Blood, which ought to be imbibed by the Infant, either in part or in whole, according to its Age and Strength: Or, because of the Plenty of vitious Blood, which tends to no other end, than to imbecilitate the Woman, and render her incapable of suffering the Insults of such acute Diseases. For Nature may (perhaps) be able to bear up against one simple Effect, but when it is joined and aggravated by another, the Patient is too often obliged to succumb, and yield herself up to be overpower’d in the Struggle of Life.

BUT, after all yet, acute Diseases are not always mortal to the Conceived Woman; for, as Experience teaches, Some have the good Fortune to escape, tho’ indeed the Odds^[87] are very great on the other Side. But of such sharp Maladies, those without any Fever are reckoned most dangerous; because they are not only Acute, but also most Acute: And by those the Mother is more immediately endangered than the Infant; whereas by those which come with a Fever, the tender Infant is first and chiefly endangered, because of the Mother’s internal Calidity and Depravation, which easily affects, and soon suffocates or stifles it in a short time.

HOWEVER, it is very observable, that a Woman^[88], bearing a Female, is more readily seized, and more easily freed or cured of acute Diseases, than she who bears a Male: And that because Females are naturally more obnoxious to Distempers, proceeding from the Retention of the Menstrua, and consequently more favourably affected, because of the natural Affinity and Familiarity of the Case.

AND this is the Reason that Females, after the first Months, do bear and sustain more Pains than the 114Males; as daily Experience confirms, in that a Female Miscarriage^[89] seldom happens after the first Months: whereas the Male Abortion is most of all to be feared, after the Time of Motion or Animation, because the Acetabula, or Cavities, being then more siccid, are the more easily broken by its stronger Motion.

IN Cases of Acute Diseases, the worst is, that the necessary Helps, which such incident Distempers otherways absolutely require, are not always safe and convenient for the Child-bearing Woman: which Condition, (with respect to the Cure) renders the Case one of the nicest Points in the Art of Physick. Wherefore I would, with Submission, advise, that none but the ablest and well-qualified Physician should undertake either the Care or the Cure of such a Patient. To whom I am not to prescribe Rules, and therefore I shall only refer him to his own more Acute Judgment, and the Curious Solutions of (that most learned Physician) Daniel Senertus^[90], upon the six following Questions, thus stated by himself, viz.

I. HOW far slender Diet is convenient for the Child-bearing Woman, labouring under an acute Disease?

II. HOW far it is convenient to open a Vein or bleed this Woman upon such an Occasion?

III. HOW far it may be proper to purge her on the same Occasion?

IV. WHETHER Venæ-Sections or Purges are most dangerous in such a Case?

V. WHETHER it is practicable (in such a dangerous Case) to excite Abortion, for the Woman’s Health and Recovery?

VI. HOW far Clysters, Diureticks, and Diaphoreticks are convenient on such Occasions?

HAVING, thus, now, in fine, briefly hinted upon the sundry Heads of this Chapter, I shall, in the next Place, offer a few Words upon That, which (I think) 115is the most common Consequence of the foregoing Effects, viz.

CHAP. XXIX. Of the DEBILITY and WEAKNESS of the Fœtus.

BESIDES all the enumerated Symptoms, Acute and Chronical Distempers, to which the Child-bearing Woman is subject; it also happens over and above (too frequently) that the Infant becomes Weak and Sick in the Womb.

THE Cause of which unhappy Accident I take to be fourfold: As it proceeds, either from a Debility and Insufficiency of the Parental Seed, or from a Scarcity or Want of requisite Sustenance, or from a certain Depravation of that Sustenance, or from some immediate Procatarctick Cause of the Mother; which may all be thus rationally distinguished, and severally accounted for; viz.

THE Cause certainly lies in the Seed, if the Woman has continued always healthy, eating, drinking, and living regularly.

IT may be imputed to the Scarcity of Aliment, if she has often laboured under Diseases, or been exposed to Hunger, Want, Penury, or any such like manifest retrenching Cause.

IT may be adjudged to a Depravity of Aliment, when the Woman (by a vitiated Constitution of Body) is subject to some certain Distempers; and, besides, in short, any Procatarctick Cause is discoverable from the Relation of the Patient.

BUT whatever the Cause may be, the Diagnostick Signs of this unhappy Affection, are commonly One or more of the following Six; viz.

1161. THE turgid swell’d Breasts of the Pregnant Woman, all on a sudden^[91], fall and extenuate into a Flabbiness.

2.^[92]THEY diffuse copiously a thin Waterish Milk, not half digested to its due Perfection.

3. THE Menstrua return at an uncommon Rate, and in an irregular Manner.

4. THE Woman personally is either very frequently Sick, or long expos’d to a lasting Sickness. Or,

5. SHE is either subject to a very frequent, or long continu’d Looseness, and constant Diarrhæa.

6. THE Infant which used (as it ought) to move briskly, is now but very seldom, and more faintly perceiv’d in Motion.

ON the other hand, the Prognosticks of this Case, are briefly Two: For either Abortion follows, or (which is worse) the Infant dies; if not timely prevented, by removing the Efficient Cause of it, upon comforting and strengthening both the Woman and the Child.

IN a Word, the Latter of these tragical Events I shall refer to Sect. V. Chap. last. But the Former leads me more immediately to consider it in the proper Method of my Discourse.

CHAP. XXX. Of ABORTION.

WOMEN miscarry so frequently, that if any curious Persons will diligently observe and examine that Matter, they will find the Number of Miscarriages to exceed That of timely Births: Wherefore 117I have reason to think, that this Head deserves to be handled more at large, and to be more particularly insisted upon, in the following manner.

THE Modern Practisers in MIDWIFERY, distinguish Miscarriages, by four different Appellations; according to the four different Times of the Constitution of the CONCEPTION. viz.

A Miscarriage happening in the Time of Spumification, is call’d an Effluxion of the GENITURA: That which happeneth in the Vegetation, or Time of Ramification, or (as some will have it) before the 40th Day, is call’d a Deperdition of the Embryo: That which falls out in the sensitive Progression, or Time of Carnification, or (as others will have it) before the 90th Day from CONCEPTION, they call an Abortion of the Foetus. But what so happens afterwards preceding the 7th Month, is properly call’d an entire Abortion of the Infant.

HOWEVER, Others will have a fifth Distinction made; namely, what so happens in the 7th, 8th, and preceding the 20th Day of the 9th Month, to be call’d an untimely BIRTH; because tho’ born with Life, they alledge it to be very seldom, or never really Vital, or likely to Live: Upon which I shall, in good Time, introduce my own Sentiment in the subsequent Chapters of this Section.

NOTWITHSTANDING, this Definition signifies but little to the Purpose; let the MISCARRIAGE happen when it will, and under whatsoever Name or Denomination, It is nothing else in general, than an untimely Exclusion of an imperfect and immature Birth; which unhappy Accident may proceed from a vast Variety of Causes, stimulating Nature to such a violent Expulsion.

IN treating therefore of this Accidental BIRTH, I shall make use of none of those Distinctions; but rather (to prevent Mistakes) shall call all its several Species, of whatsoever Time, by the general (and most common) Name of ABORTION.

118AND of this ABORTION, happen when it will, the proximous Cause is always the Expulsive Faculty of the Womb; which being hurt, or violently disorder’d in any respect, irritates and debilitates the Retentive Power: And then again, on the other hand, this Retentive Faculty (tho’ not the proximous Cause) is sometimes first hurt or injur’d, and by that means incapacitated to retain the INFANT; which (in that Case) offends and provokes the Expulsive Power^[93], which is the proper proximous Cause of all ABORTIONS.

BUT most commonly the Expulsive receives the First Hurt; from whence the Retentive is oblig’d to Sympathize, and yield to its over-ruling Motions. And, according to Galen^[94], the Expulsive Faculty may be injur’d and irritated by Three different Causes; viz. 1. By the Bulk of the Infant, when the Womb cannot distend itself far enough to contain it: 2. By its Weight, when heavier than the Womb and Ligaments can bear: And, 3. By the Humours (when the Membranes break) flowing into the Womb; occasioning a Mordacious Itching there, or putrefying the Infant in its Place.

TO which three Efficients, some Modern Authors have thought it sufficient to add the similar, organical, and common Diseases of the Womb; together with some Procatarctick Causes.

HOWEVER, because I have generally observ’d Those, to be very promiscuously and confusedly treated of, I shall (according to my best Ability) endeavour to reduce the many different Causes of ABORTION to such plain Heads, and set them in such a clear Light, that they shall prove evident and manifest to the meanest Capacity: That Women (whose peculiar Good I have only at Heart in the Performance of this Work) may readily conceive them, and thereby be enabled (in most Cases) to prevent their greatest Misfortunes. And that whether the Cause happens proximously and immediately 119from a stimulated Expulsive, or mediately from a læs’d and injur’d Retentive Faculty.

WHEREFORE I shall now reduce those Causes to the following Four general Heads; namely, 1. To the Constitution of the Mother: 2. The Constitution of the Infant: 3. The Symptoms of the Months: And, 4. To the various Procatarctick Causes of this Tragical Case.

FIRST the Causes of ABORTION, proceeding from the Constitution of the Mother, are Three-fold, and respect either her whole Body, her Womb only, or its neighbouring Parts. Those respecting her whole Body, are,

I. THE four Intemperatures of the Body; as the Calid, which, by its Hot Quality, exhausts the Humours (that are naturally necessary) to the Prejudice and Loss of the Infant.

II. THE Frigid; which, by its Cold Quality, vitiates and attenuates the Infant’s Aliment, to a starving Condition.

III. THE Siccid; which, by its adust dry Quality, scorches and consumes the Ligaments, that they break, like so many Strings that snap before the Sun: Upon which the Infant (being deprived of those Mediums, through which Nature has appointed its Sustenance) corrupts and decays, like a PLANT in Arid Sandy Ground.

IV. THE Humid Intemperature; which, by its moist Quality, debilitates the Retentive Faculty, hinders the Ligaments to consolidate and close firmly, and opens the shut Orifice of the Womb. But besides all This also, by filling the ACETABULA with superfluous Humours, it may suffocate and stifle the INFANT.

V. A nimious and too great an Obesity or Fatness, and too great a Gracility or Leanness of the Woman’s Body: For the One converts the CHILD’s Nourishment to itself; and the Other starves the INFANT for want of its natural Requisites.

120VI. A PLETHORY, or too great a Repletion of Blood in her Body; which frequently choaks and suffocates the INFANT.

VII. ALL Corporeal Causes, exagitating the Spirits and Humours; which have the same Effect and Force to irritate the Expulsive Faculty.

VIII. ALL Diseases incident to the Body, whether they be Acute, Remiss, or Diuturnal; which may easily effect ABORTION. But

SECONDLY, The Causes on the part of the Womb, are not to be lightly or slightly considered; because if it be not both naturally well constituted, and carefully well dispos’d, it can neither foment, cherish, nor retain the Infant. For the least Flaw of its morbifick Causes, stimulates to a great Degree the expulsive Faculty: which Causes are, in my Opinion, as follow; viz.

I. THE Womb’s Præternatural SIZE, either in Magnitude, or Exiguity: The one giving room for the Infant’s too much tumbling or too frequent Motion; and the other restraining the CHILD too much, even to the suppressing and stifling of it.

II. ITS præternatural CONSTRICTION or Coarctation; which may resist its necessary due Extension, for containing the growing Infant.

III. ITS præternatural DENSITY; which may not only hinder the requisite Distention, but also prevent the Secundine^[95] from being firmly connected to the Vessels.

IV. ITS LAXITY of the Orifice, or Lavity of the interiour Surface; proceeding from pituitous^[96] or viscous Humours, which slacken the Ligaments, and give way to the Foetus.

121V. THE Womb’s too frigid and siccid Intemperature; which Qualities are the greatest Enemies to Nature and all the Actions of Female LIFE.

VI. ITS frigid and humid Intemperature; which (abounding with Mucosities or slimy Humours) so relaxes the Ligaments, that they cannot hold or detain the INFANT.

VII. ALL obdurated and confirmed Tumours and Ulcers, all Erysipelas and Inflammations of the Womb: Which often prove the Causes of the same Effect.

VIII. A præternatural Situation, or an oblique Position may become the 8th and last Cause of ABORTION, which I shall mention on part of the Womb.

FROM hence I come, Thirdly, in a due Method, to Those Causes respecting the neighbouring Parts; which I humbly conceive to be as follow.

I. ALL Diseases, Pains, and what Causes soever of those Parts, may tend much to deject or affect the Spirits, and stir up the Humours with unusual Alteration.

II. ALL Causes and bad Affections compressing the lower Belly, and exagitating or straining its Muscles.

III. A præternatural Site and inapt CONFORMATION^[97] of the Umbilical Vessels, for their due Operation.

BUT then again, Secondly, It also often happens that, tho’ the pregnant Woman labours under no Disease or Misfortune, either in Body, Womb, or neighbouring Parts, yet notwithstanding the Expulsive Faculty is irritated to Ejection by several Causes of the Constitution of the INFANT itself, as follow; viz.

I. ITS præternatural Bulk, or vitious Conformation, oppressing and straining the Womb, either in Whole or in Part.

II. ITS Debility and Weakness, or contracted, infirm, feeble Constitution, as mentioned in the preceding Chapter.

122III. THE Death of the INFANT, emitting nauseous Vapours and putrefy’d Matter, stimulates the Womb sooner or later to Expulsion: And (in this tragical Case) the sooner the Better; as will hereafter appear.

AND moreover, Thirdly, the SYMPTOMS of the Months, frequently prove Causes of ABORTION; of which SYMPTOMS, having already treated particularly, I shall in this place repeat little or nothing, only refer the Reader to their respective Chapters in the preceding Part of this Section: And yet under this present Head, may be also comprehended all Acute Diseases, which (too often) prove of the same bad Consequence; as is evident from Chap. 28.

FOURTHLY, There is a great Variety of Procatarctick Causes, distinct from all those above-mentioned, which most frequently occasion ABORTION: And Those are Two-fold, INTERNAL and EXTERNAL. Of which the Internal are as follow, in my Judgment.

I. THE Passions of the Mind (mentioned in Sect. I. Chap. 5.) because such immoderate Affections too much excite the Humours, and incense the Spirits.

II. VICTUALS; if taken too much at a time, suffocate the INFANT; if too little, it is starved, and the MOTHER brought to a very low Condition of Life; and if improper, or of ill Concoction, the CHILD is thereby either much weaken’d, or (which is worse) it dies of course.

III. DRINKING immoderately, extinguisheth the natural Calidity of the Womb and the INFANT; as certainly strong or hot Liquors impress a vitious Intemperature upon Both.

IV. WATCHINGS a-Nights, too much exhaust and dissipate the Spirits; as too much Sleep, on the other hand, dulls, lessens, and obtunds the natural Heat.

V. ALL inward disorderly Causes dissolving the Uterine Acetabula, Ligaments, or Vessels, by which the INFANT attracts its Nourishment.

123VI. ALL Venenated, Cathartick, and Diaphoretick MEDICINES, Acrimonious Clysters, Venæ-Sections, Baths, &c: Which partly by exagitating the Spirits and Humours, and partly by diminishing the Aliment, occasion frequent ABORTIONS. Again

THE external Procatarctick Causes are These, which ensue in their due Order.

I. ALL inclement Constitutions or bad Influences of the Weather, Winds,^[98]and Air; such as Cold, which pinches; or as Heat, which intercepts the Breath, and stifles the INFANT, &c.

II. SMELLING or Touching, Sitting, or Treading upon some Sorts of pernicious Herbs.

III. ALL violent Motions, immoderate Exercises, &c. such as Running, Leaping, Dancing, Riding, or Coaching, Lifting, or Carrying a heavy Weight, also long Fasting, strait Lacing, a Fall, a Blow on the Back or the Belly, &c. as I hinted before occasionally.

IV. ALL frightful Objects, and sudden Surprizes by hasty News, Fire, or such like terrifying Accidents.

V. ALL astonishing and terrible affecting NOISES; such as sudden Claps of Thunder, Cannons, Guns &c.

VI. ALL nauseous Stinks, on the one hand, and odoriferous Smells, &c. on the other, being both disagreeable and dangerous.

THOSE, and many other trifling Matters, such as the Smell of an extinguished Light, or Candle, are known (too often) to be the Reason and Cause of ABORTION: which made (that great Naturalist) Pliny^[99] justly take occasion to deplore the Frailty of Man.

“HE bewails and is asham’d (as he expresseth it) to think how frivolous the ORIGIN of the proudest of Creatures is; such a mere Trifle (as is mentioned) being frequently the Cause of his FATALITY. And the Philosopher most pertinently adds, that He who 124now glories in so many VANITIES, trusting in the Strength of his Body, vaunting in the Riches of his Possessions, and upon every Smile of Fortune, believes himself to be a God, &c. little considers how many ways he might have miscarried in coming into the World, or how many ways he may yet, even to-day, go out of it, and come to his last GASP, as Anacreon, the wanton Lyrick Poet, did, who was suddenly choak’d with the Stone of a Grape; or as Fabius (that noble Dictator of Rome) dy’d, who was immediately strangl’d by a HAIR in a Draught of Milk.”

I say, He little considers, how many Trials and Hardships he was expos’d to, before he had Being: or, how many ways he might have been stifled before he had Breath, and have been dead even before he was Born.

WHICH Consideration leads me to the Thought of another Cause of ABORTION, mentioned by the holy Prophet^[100]Hosea, where he says: “Because they have deeply corrupted themselves, and separated themselves unto that Shame at Baalpeor, (i. e. defiled themselves at the Statues of Priapus) their Glory shall fly away like a Bird, from the Womb, from the Conception, and from the Birth; dry Breasts, and a miscarrying Womb shall be given them, &c.”

AND having thus far briefly defin’d and descanted upon ABORTION, and the Nature of its Efficients, I come now, in the next place, to shew by what DIAGNOSTICK SIGNS, every Woman may infallibly know an approaching or instant MISCARRIAGE, either in herself or another: As also to set forth, by what PROGNOSTICK SIGNS, she may know the Danger she is threatned with upon that Occasion.

WHICH Undertaking, I hope, may prove conducive to the Welfare of that tender Sex; it being too common for Women to neglect the proper Means, through a supine Ignorance of the Nature, and Danger of their 125CONDITION. But This, however, is generally owing to indiscreet Old Women about them; (as I have often observ’d, and oft’ner had Occasion to hear) who either keep the PATIENT in Suspence, wheedling and telling her idle Stories, that the Case is not so dangerous, the Pains, Floodings, &c. will go off in good Time, and the like: Or afterwards (upon appearance of more severe growing Symptoms) they extenuate the Danger, telling her to submit with Patience, the common Misfortune cannot possibly be prevented, &c.

TO which usual Suggestions, I answer; that as the one is an ignorant and imprudent Insinuation, the other is a downright Falsity: For in the first CASE, the Woman is diverted by foolish Hopes from applying for proper Advice, until perhaps it is past all Remedy; and in the second, she is misled very often to her utter RUIN: Since whatever hath not yet happen’d, may peradventure be happily prevented; and even upon the last Extremity of the most violent Occasion, the Severity of the Case may possibly be averted by good Management, and the Danger entirely compounded for by proper Conduct.

WHEREFORE, I cannot but think, it is worth any Woman’s while to know the Marks of an approaching and instant ABORTION: Whereof the DIAGNOSTICKS are as follow, viz.

I. A sudden Extenuation and Falling of the Breasts^[101]; sometimes only of One, but more commonly of Both: That of One denoting the Woman to bear Twins, of which she is about to lose One; and which, if the right Breast falls, is a Male; but if the left, a Female.

II. A Watery Milk flows^[102] in Abundance from those FALLEN BREASTS, discovering the future Danger.

126III. PALPITATIONS of the Heart, frequently accompany’d with a Coarctation of the Sides and Upper Belly, very much incommoding the Patient.

IV. A GRAVITY or Heaviness of the Loins, and Thighs; Gnawing of the Stomach, Pains of the Head and Eyes.

V. A TREMOR, or Trembling and Quaking FITS, attended with a Frigidity of the exteriour Limbs.

VI. A Rigor and Stiffness, or a Vibration and Concussion of the SKIN and MUSCLES of the whole Body, with a concomitant Chilness.

VII. HORROUR, Fevers, Faintings, Swoonings, and sometimes Convulsions, Cramps, &c. all foreboding the coming Malady. These are the usual and principal Marks of an approaching ABORTION: Which when Instant, and the Time at Hand, then the

VIII^th DIAGNOSTICK plainly appears; which is a corrupt WATER flowing first, next a bloody WATER, then pure Blood, after that small Clods of Blood, and at length, the Infant itself (form’d or inform’d) follows of Course.

HENCE I proceed to the usual Prognosticks of ABORTION; which take as follow in their proper Order, viz.

I. ALL Women are more endanger’d in a Miscarriage, than in a Natural Birth: because That happening at a preternatural Time, is of greater Violence than This. For like as ripe Fruit, whose Stalk is so loose in its Season from the Tree, that the Fruit falls of its own Accord: So it is in a Natural Birth, for the Vessels and Ligaments, by which the Infant adheres to the Womb, easily loose and break spontaneously; which in an Abortion, must needs happen by a more dangerous painful Force and Violence.

II. THO’ Women (in this Case) may frequently escape with their Lives, yet their Natural Constitution is thereby too often broke at least, and debilitated, or 127thereupon subjected to one or other heavy SYMPTOM or DISEASE; if not also rendred quite BARREN.

FOR sometimes, because of the Pains, Flux, or Putrefaction of the retain’d Blood, Fevers, and other Distempers generally ensue: Sometimes by the violent Disruption of the Vessels, great Floodings and Loss of Blood happen; upon which Faintings, Swoonings, Convulsions, and at length Death it self follows: But, in fine, Convulsions happening^[103] either at the Time, or after ABORTION, the Case is most dangerous; for then the Patient seldom escapes.

III. THE first MISCARRIAGE is most dangerous to all; because the Genital Parts are more streight or constricted, and less acquainted with such severe distending Pains: And besides the Orifices of the Vessels being so violently dilacerated, the Party often continues afterwards Sterile or Barren the rest of her Life^[104].

IV. LEAN and tender Women are much endanger’d in ABORTION, by Reason of their Debility and Infirmity: As Women too fat are, on the other Hand; because of the great Astriction and Narrowness of the Passages.

V. THE younger the Abortive Production happens to be, the less the Woman is endanger’d; because the larger the Infant is, it gives the greater Pains and Ruption of the Vessels.

VI. WHATEVER happens in the 7th or 9th Month, may be reckon’d a safe BIRTH, provided the Child be Alive: Whereas if Dead, it is extremely dangerous. But above All, the Eighth Month is to be most dreaded, not only because of the Largeness of the INFANT, but also because of the pernicious Quality of that Month; as will hereafter more amply appear in Chap. 34.

128WHICH Consideration leads me farther to observe; That, from the Beginning of the 5th, until the Middle of the 6th Month, the INFANT is least liable to Danger^[105]: So next in the 4th, and from the Middle of the 6th, until the Close of the 7th Month: Then of course it is safer in the 3d and 2d Months, than in the 1st or 9th. For the least Cause may expell the Embryo in the First, and break the Mature Ligaments of the INFANT in the Ninth. But of all the whole Time, as I said before, the 8th Month is the most^[106] dangerous, both to MOTHER and INFANT: according to which Consideration and Order of Time, the prudent Physician may, with more or less either Fear on the one hand, or Assurance on the other, exhibit or prescribe proper REMEDIES for the Preservation or Recovery of his Patients.

FROM whence I come in the next place to offer my serious Sentiments upon the Cure of this Malady, and the Prevention of ABORTION: Which difficult Work depends chiefly upon the Preservation of both MOTHER and INFANT; for when the Miscarriage is once over, the Cure then does not much differ from the Case of a natural BIRTH.

HOWEVER in all Cases of this nature, it is an infallible Maxim, that it is more easy to prevent Miscarriage, than to relieve or rectify the Miscarrying Woman; and more proper to begin that Prevention Before, than After Conception: Because the most proper Remedies for obviating many Causes of ABORTION, cannot so well be adhibited to the Woman after she is Pregnant. And besides, as those Causes are very Different and various (as more fully appears from what has been said); so the Manner and Method of Prevention cannot be altogether exactly Uniform; every Cause requiring its respective Cure, before a Prevention can be effected.

129WHEREFORE, in my humble Opinion, the first Step towards this Prevention is to weigh well and consider carefully the CONSTITUTION of the yet unimpregnated Woman; in order to know and discover the Cause or Causes either of Body, or Womb, which may or can occasion any future ABORTION. Now in this Case, Women having once miscarry’d, or oftner, methinks they may easily find out the Cause Themselves, by the Help of their Midwives; which being done, they should endeavour to have it remov’d, and effectually cur’d, before they conceive any more. However, if it chance to be neglected at that time, it may be more prudently undertaken afterwards, with such Precaution, as the Nature of the CAUSE and CONSTITUTION of the Woman require: Always remembring, but especially before or about the usual Time of ABORTION, to make use of proper Corroboratives for strengthening both the INFANT and WOMB; since Women, miscarrying from any one internal Cause, commonly bear their Conceptions to a certain Time, which they cannot exceed, unless that Cause be judiciously removed beforehand.

I ONCE had an accidental Opportunity of being fully satisfied of the Veracity of this Case, in a Woman of good Note in the City of Dresden; who miscarried fourteen Times in less than eight Years; being never able to go beyond the tenth Day of the fourth Month, and commonly losing the Foetus about the last of the Third.