The Works of Aristotle the Famous Philosopher Part 18

Though some may think it a natural labour when the child's head come first, yet, if the child's head present not the right way, even that is an unnatural labour; and therefore, though the head comes first, yet if it be the side of the head instead of the crown, it is very dangerous both to the mother and the child, for the child's neck would be broken, if born in that manner, and by how much the mother's pains continue to bear the child, which is impossible unless the head be rightly placed, the more the pa.s.sages are stopped. Therefore, as soon as the position of the child is known, the woman must be laid with all speed, lest the child should advance further than this vicious posture, and thereby render it more difficult to thrust it back, which must be done, in order to place the head right in the pa.s.sage, as it ought to be.

To this purpose, therefore, place the woman so that her b.u.t.tocks may be a little higher than her head and shoulders, causing her to lean a little to the opposite side to the child's ill posture; then let the operator slide up his hand, well anointed with oil, by the side of the child's head; to bring it right gently, with his fingers between the head and the womb; but if the head be so engaged that it cannot be done that way, he must then put up his hand to the shoulders, that by so thrusting them back a little into the womb, sometimes on the one side, and sometimes on the other, he may, little by little, give a natural position. I confess it would be better if the operator could put back the child by its shoulders with both hands, but the head takes up so much room, that he will find much ado to put up one, with which he must perform this operation, and, with the help of the finger-ends of the other hand put forward the child's birth as in natural labour.

Some children present their face first, having their hands turned back, in which posture it is extremely difficult for a child to be born; and if it continues so long, the face will be swelled and become black and blue, so that it will at first appear monstrous, which is occasioned as well by the compression of it in that place, as by the midwife's fingers in handling it, in order to place it in a better posture. But this blackness will wear away in three or four days' time, by anointing it often with oil of sweet almonds. To deliver the birth, the same operation must be used as in the former, when the child comes first with the side of the head; only let the midwife or operator work very gently to avoid as much as possible the bruising the face.

SECT. V.--_How to Deliver a Woman when the Child presents one or both Hands together with the Head._

Sometimes the infant will present some other part together with its head; which if it does, it is usually with one or both of its hands; and this hinders the birth, because the hands take up part of that pa.s.sage which is little enough for the head alone; besides that, when this happens, they generally cause the head to lean on one side; and therefore this position may be well styled unnatural. When the child presents thus, the first thing to be done after it is perceived, must be, to prevent it from coming down more, or engaging further in the pa.s.sage; and therefore, the operator having placed the woman on the bed, with her head lower than her b.u.t.tocks, must guide and put back the infant's hand with his own as much as may be, or both of them, if they both come down, to give way to the child's head; and this being done, if the head be on one side, it must be brought into its natural posture in the middle of the pa.s.sage, that it may come in a straight line, and then proceed as directed in the foregoing section.

SECT. VI.--_How a Woman ought to be delivered, when the Hands and Feet of the Infant come together._

There are none but will readily grant, that when the hands and feet of an infant present together, the labour must be unnatural, because it is impossible a child should be born in that manner. In this case, therefore, when the midwife guides her hand towards the orifice of the womb she will perceive only many fingers close together, and if it be not sufficiently dilated, it will be a good while before the hands and feet will be exactly distinguished; for they are sometimes so shut and pressed together, that they seem to be all of one and the same shape, but where the womb is open enough to introduce the hand into it, she will easily know which are the hands and which are the feet; and having taken particular notice thereof, let her slide up her hand and presently direct it towards the infant's breast, which she will find very near, and then let her gently thrust back the body towards the bottom of the womb, leaving the feet in the same place where she found them. And then, having placed the woman in a convenient posture, that is to say, her b.u.t.tocks a little raised above her breast (and which situation ought also to be observed when the child is to be put back into the womb), let the midwife afterwards take hold of the child by the feet, and draw it forth, as is directed in the second section.

This labour, though somewhat troublesome, yet is much better than when the child presents only its hands; for then the child must be quite turned about before it can be drawn forth; but in this they are ready, presenting themselves, and there is little to do, but to lift and thrust back the upper part of the body, which is almost done of itself, by drawing it by the feet alone.

I confess there are many authors that have written of labours, who would have all wrong births reduced to a natural figure, which is, to turn it that it may come with the head first. But those that have written thus, are such as never understood the practical part, for if they had the least experience therein, they would know that it is impossible; at least, if it were to be done, that violence must necessarily be used in doing it, that would probably be the death both of mother and child in the operation. I would, therefore, lay down as a general rule, that whenever a child presents itself wrong to the birth, in what posture so ever, from the shoulders to the feet, it is the way, and soonest done, to draw it out by the feet; and that it is better to search for them, if they do not present themselves, than to try and put them in their natural posture, and place the head foremost; for the great endeavours necessary to be used in turning the child in the womb, do so much weaken both the mother and the child, that there remains not afterwards strength enough to commit the operation to the work of nature; for, usually, the woman has no more throes or pains fit for labour after she has been so wrought upon; for which reason it would be difficult and tedious at best; and the child, by such an operation made very weak, would be in extreme danger of peris.h.i.+ng before it could be born. It is, therefore, much better in these cases to bring it away immediately by the feet, searching for them as I have already directed, when they do not present themselves; by which the mother will be prevented a tedious labour, and the child be often brought alive into the world, who otherwise could hardly escape death.

SECT. VII.--_How a Woman should be delivered that has twins, which present themselves in different postures._

We have already spoken something of the birth of twins in the chapter of natural labour, for it is not an unnatural labour barely to have twins, provided they come in the right position to the birth. But when they present themselves in different postures, they come properly under the denomination of unnatural labours; and if when one child presents itself in a wrong figure, it makes the labour dangerous and unnatural, it must needs make it much more so when there are several, and render it not only more painful to the mother and children, but to the operator also; for they often trouble each other and hinder both their births. Besides which the womb is so filled with them, that the operator can hardly introduce his hand without much violence, which he must do, if they are to be turned or thrust back, to give them a better position.

When a woman is pregnant with two children, they rarely present to the birth together, the one being generally more forward than the other; and that is the reason that but one is felt, and that many times the midwife knows not that there are twins until the first is born, and that she is going to fetch away the afterbirth. In the first chapter, wherein I treated of natural labour, I have showed how a woman should be delivered of twins, presenting themselves both right; and before I close the chapter of unnatural labour, it only remains that I show what ought to be done when they either both come wrong or one of them only, as for the most part it happens; the first generally coming right, and the second with the feet forward, or in some worse posture. In such a case, the birth of the first must be hastened as much as possible and to make way for the second, which is best brought away by the feet, without endeavouring to place it right, because it has been, as well as the mother, already tired and weakened by the birth of the first, and there would be greater danger to its death, than likelihood of its coming out of the womb that way.

But if, when the first is born naturally, the second should likewise offer its head to the birth, it would then be best to leave nature to finish what she has so well begun, and if nature should be too slow in her work, some of those things mentioned in the fourth chapter to accelerate the birth, may be properly enough applied, and if, after that, the second birth should be delayed, let a manual operation be delayed no longer, but the woman being properly placed, as has been before directed, let the operator direct his hand gently into the womb to find the feet, and so draw forth the second child, which will be the more easily effected, because there is a way made sufficiently by the birth of the first; and if the waters of the second child be not broke, as it often happens, yet, intending to bring it by its feet, he need not scruple to break the membranes with his fingers; for though, when the birth of a child is left to the operation of nature, it is necessary that the waters should break of themselves, yet when the child is brought out of the womb by art, there is no danger in breaking them, nay, on the contrary it becomes necessary; for without the waters are broken, it will be almost impossible to turn the child.

But herein princ.i.p.ally lies the care of the operator, that he be not deceived, when either the hands or feet of both children offer themselves together to the birth; in this case he ought well to consider the operation, of whether they be not joined together, or any way monstrous, and which part belongs to one child and which to the other; so that they may be fetched one after the other, and not both together, as may be, if it were not duly considered, taking the right foot of one and the left of the other, and so drawing them together, as if they both belonged to one body, because there is a left and a right, by which means it would be impossible to deliver them. But a skilful operator will easily prevent this, if, after having found two or three of several children presenting together in the pa.s.sage, and taking aside two of the forwardest, a right and a left, and sliding his arm along the legs and thighs up to the wrist, if forward, or to the b.u.t.tocks, if backwards, he finds they both belong to one body; of which being thus a.s.sured, he may begin to draw forth the nearest, without regarding which is the strongest or weakest, bigger or less, living or dead, having first put aside that part of the other child which offers to have the more way, and so dispatch the first as soon as may be, observing the same rules as if there were but one, that is keeping the breast and face downwards, with every circ.u.mstance directed in that section where the child comes with its feet first, and not fetch the burden till the second child is born. And therefore, when the operator hath drawn forth one child, he must separate it from the burden, having tied and cut the navel-string, and then fetch the other by the feet in the same manner, and afterwards bring away the after-burden with the two strings as hath been before showed. If the children present any other part but the feet, the operator may follow the same method as directed in the foregoing section, where the several unnatural positions are fully treated of.

CHAPTER VII

_Directions for Child-bearing Women in their Lying-in._

SECTION I.--_How a Woman newly Delivered ought to be ordered._

As soon as she is laid in her bed, let her be placed in it conveniently for ease and rest, which she stands in great need of to recover herself of the great fatigue she underwent during her travail, and that she may lie the more easily let her hands and body be a little raised, that she may breathe more freely, and cleanse the better, especially of that blood which then comes away, that so it may not clot, which being retained causeth great pain.

Having thus placed her in bed, let her take a draught of burnt white wine, having a drachm of spermaceti melted therein. The best vervain is also singularly good for a woman in this condition, boiling it in what she either eats or drinks, fortifying the womb so exceedingly that it will do it more good in two days, than any other thing does in double that time, having no offensive taste. And this is no more than what she stands in need of; for her lower parts being greatly distended until the birth of the infant, it is good to endeavour the prevention of an inflammation there. Let there also be outwardly applied, all over the bottom of her belly and privities, the following anodyne and cataplasm:--Take two ounces of oil of sweet almonds, and two or three new laid eggs, yolks and whites, stirring them together in an earthen pipkin over hot embers till they come to the consistence of a poultice; which being spread upon a cloth, must be applied to those parts indifferently warm, having first taken away the closures (which were put to her presently after her delivery), and likewise such clots of blood as were then left. Let this lie on for five or six hours, and then renew it again when you see cause.

Great care ought to be taken at first, that if her body be very weak, she be not kept too hot, for extremity of heat weakens nature and dissolves the strength; and whether she be weak or strong, be sure that no cold air comes near her at first; for cold is an enemy to the spermatic parts; if it get into the womb it increases the after pains, causes swelling in the womb and hurts the nerves. As to her diet, let it be hot, and let her eat but little at a time. Let her avoid the light for the first three days, and longer if she be weak, for her labour weakens her eyes exceedingly, by a harmony between the womb and them.

Let her also avoid great noise, sadness and trouble of mind.

If the womb be foul, which may easily be perceived by the impurity of the blood (which will then easily come away in clots or stinking, or if you suspect any of the after-burden to be left behind, which may sometimes happen), make her drink a feverfew, mugwort, pennyroyal and mother of thyme, boiled in white wine and sweetened with sugar.

Panado and new laid eggs are the best meat for her at first, of which she may eat often, but not too much at a time. And let her nurse use cinnamon in all her meats and drinks, for it generally strengthens the womb.

Let her stir as little as may be until after the fifth, sixth, or seventh day after her delivery, if she be weak; and let her talk as little as possible, for that weakens her very much.

If she goes not well to stool, give a clyster made only of the decoction of mallows and a little brown sugar.

When she hath lain in a week or more, let her use such things as close the womb, of which knot-gra.s.s and comfrey are very good, and to them you may add a little polypodium, for it will do her good, both leaves and root being bruised.

SECT. II.--_How to remedy those Accidents which a Lying-in Woman is subject to._

I. The first common and usual accident that troubles women in their lying-in is after-pains. They proceed from cold and wind contained in the bowels, with which they are easily filled after labour, because then they have more room to dilate than when the child was in the womb, by which they were compressed; and also, because nourishment and matter, contained as well in them as in the stomach, have been so confusedly agitated from side to side during the pains of labour, by the throes which always must compress the belly, that they could not be well digested, whence the wind is afterwards generated and, by consequence, the gripes which the woman feels running into her belly from side to side, according as the wind moves more or less, and sometimes likewise from the womb, because of the compression and commotion which the bowels make. This being generally the case, let us now apply a suitable remedy.

1. Boil an egg soft, and pour out the yolk of it, with which mix a spoonful of cinnamon water, and let her drink it; and if you mix in it two grains of ambergris, it will be better; and yet vervain taken in anything she drinks, will be as effectual as the other.

2. Give a lying-in woman, immediately after delivery, oil of sweet almonds and syrup of maiden-hair mixed together. Some prefer oil of walnuts, provided it be made of nuts that are very good; but it tastes worse than the other at best. This will lenify the inside of the intestines by its unctuousness, and by that means bring away that which is contained in them more easily.

3. Take and boil onions well in water, then stamp them with oil of cinnamon, spread them on a cloth, and apply them to the region of the womb.

4. Let her be careful to keep her belly warm, and not to drink what is too cold; and if the pain prove violent, hot cloths from time to time must be laid on her belly, or a pancake fried in walnut oil may be applied to it, without swathing her belly too strait. And for the better evacuating the wind out of the intestines, give her a clyster, which may be repeated as often as necessity requires.

5. Take bay-berries, beat them to a powder, put the powder upon a chafing-dish of coals, and let her receive the smoke of them up her privities.

6. Take tar and bear's grease, of each an equal quant.i.ty, boil them together, and whilst it is boiling, add a little pigeon's dung to it.

Spread some of this upon a linen cloth, and apply it to the veins of the back of her that is troubled with afterpains, and it will give her speedy ease.

Lastly, let her take half a drachm of bay-berries beaten into a powder, in a drachm of muscadel or teat.

II. Another accident to which women in child-bed are subject is haemorrhoids or piles, occasioned through the great straining in bringing the child into the world. To cure this,

1. Let her be let blood in the saphoena vein.

2. Let her use polypodium in her meat, and drink, bruised and boiled.

3. Take an onion, and having made a hole in the middle, of it, fill it full of oil, roast it and having bruised it all together, apply it to the fundament.

4. Take a dozen of snails without sh.e.l.ls, if you can get them, or else so many sh.e.l.l snails, and pull them out, and having bruised them with a little oil, apply them warm as before.

5. If she go not well to stool, let her take an ounce of ca.s.sia fistula drawn at night, going to bed; she needs no change of diet after.

III. Retention of the menses is another accident happening to women in child-bed, and which is of so dangerous a consequence, that, if not timely remedied, it proves mortal. When this happens,

1. Let the woman take such medicines as strongly provoke the terms, such as dittany, betony, pennyroyal, feverfew, centaury, juniper-berries, peony roots.