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When the difficulty of labour arises from a dead child, it is a great danger to a mother and great care ought to be taken therein; but before anything be done, the midwife ought to be well assured that the child is dead indeed, which may be known by these signs.
(1) The breast suddenly slacks, or falls flat, or bags down. (2) A great coldness possesses the belly of the mother, especially about the navel. (3) Her urine is thick, with a filthy stinking settling at the bottom. (4) No motion of the child can be perceived; for the trial whereof, let the midwife put her hand into warm water, and lay it upon the belly, for that, if it is alive, will make it stir. (5) She is very subject to dreams of dead men, and affrighted therewith. (6) She has extraordinary longings to eat such things as are contrary to nature. (7) Her breath stinks, though not used so to do. (8) When she turns herself in her bed, the child sways that way like a lump of lead.
These things being carefully observed, the midwife may make a judgment whether the child be alive or dead, especially if the woman take the following prescription:—"Take half a pint of white wine and burn it, and add thereto half an ounce of cinnamon, but no other spices whatever, and when she has drunk it, if her travailing pains come upon her, the child is certainly dead; but if not, the child may possibly be either weak or sick, but not dead. This will bring her pains upon her if it be dead, and will refresh the child and give her ease if it be living; for cinnamon refresheth and strengtheneth the child.
Now, if upon trial it be found the child is dead, let the mother do all she can to forward the delivery, because a dead child can in no wise be helpful therein. It will be necessary, therefore, that she take some comfortable things to prevent her fainting, by reason of the putrid vapours arising from the dead child. And in order to her delivery let her take the following herbs boiled in white wine (or at least as many of them as you can get), viz., dittany, betony, pennyroyal, sage, feverfew, centaury, ivy leaves and berries. Let her also take sweet basil in powder, and half a drachm at a time in white wine; let her privities also be anointed with the juice of the garden tansey. Or take the tansey in the summer when it can most plentifully be had, and before it runs up to flower, and having bruised it well, boil it in oil until the juice of it be consumed. If you set it in the sun, after you have mixed it with oil, it will be more effectual. This, an industrious midwife, who would be prepared against all events, ought to have always by her. As to the manner of her delivery, the same methods must be used as are mentioned in the section of natural labour. And here again, I cannot but commend the stone aetites, held near the privities, whose magnetic virtue renders it exceedingly necessary on this occasion, for it draws the child any way with the same facility that the load-stone draws iron.
Let the midwife also make a strong decoction of hyssop with water, and let the woman drink it very hot, and it will in a little time bring away the dead child.
If, as soon as she is delivered of the dead child, you are in doubt that part of the afterbirth is left behind in the body (for in such cases as these many times it rots, and comes away piece-meal), let her continue drinking the same decoction until her body be cleansed.
A decoction made of herbs, muster-wort, used as you did the decoction of hyssop, works the effect. Let the midwife also take the roots of pollodum and stamp them well; warm them a little and bind them on the sides of her feet, and it will soon bring away the child either dead or alive.
The following medicines also are such as stir up the expulsive faculty, but in this case they must be stronger, because the motion of the child ceases.
Take savine, round birthwort, trochisks of myrrh, castor, cinnamon and saffron, each half a drachm; make a powder, give a drachm.
Or she may purge first, and then apply an emollient, anointing her about the womb with oil of lilies, sweet almonds, camomiles, hen and goose-grease. Also foment to get out the child, with a decoction of mercury, orris, wild cucumbers, saecus, broom flowers. Then anoint the privities and loins with ointment of sow-bread. Or, take coloquintida, agaric, birthwort, of each a drachm; make a powder, add ammoniacum dissolved in wine, ox-gall, each two drachms. Or make a fume with an ass's hoof burnt, or gallianum, or castor, and let it be taken in with a funnel.
To take away pains and strengthen the parts, foment with the decoction of mugwort, mallows, rosemary, with wood myrtle, St. John's wort, each half an ounce, spermaceti two drachms, deer's suet, an ounce; with wax make an ointment. Or take wax six ounces, spermaceti an ounce; melt them, dip flux therein, and lay it all over her belly.
If none of these things will do, the last remedy is to try surgery, and then the midwife ought without delay to send for an expert and able man-midwife, to deliver her by manual operation, of which I shall treat more at large in the next chapter.
FOOTNOTES:
[10]Horse-parsley.
Of Unnatural Labour.
In showing the duty of a midwife, when the child-bearing woman's labour is unnatural, it will be requisite to show, in the first place, what I mean by unnatural labour, for that women do bring forth in pain and sorrow is natural and common to all. Therefore, that which I call unnatural is, when the child comes to the birth in a contrary posture to that which nature ordained, and in which the generality of the children come into the world.
The right and natural birth is when the child comes with its head first; and yet this is too short a definition of a natural birth; for if any part of the head but the crown comes first, so that the body follows not in a straight line, it is a wrong and difficult birth, even though the head comes first. Therefore, if the child comes with its feet first, or with the side across, it is quite contrary to nature, or to speak more plainly, that which I call unnatural.
Now, there are four general ways a child may come wrong. (1) When any of the foreparts of the body first present themselves. (2) When by an unhappy transposition, any of the hinder parts of the body first present themselves. (3) When either of the sides, or, (4) the feet present themselves first. To these, the different wrong postures that a child can present itself in, may be reduced.
When manual operation is necessary, let the operator acquaint the woman of the absolute necessity there is for such an operation; and that, as the child has already lost its life, there is no other way left for the saving hers. Let him also inform her, for her encouragement, that he doubts not, with the divine blessing, to deliver her safely, and that the pains arising therefrom will not be so great as she fears. Then let him stir up the woman's pains by giving her some sharp clyster, to excite her throes to bear down, and bring forth the child. And if this prevails not, let him proceed with the manual operation.
First, therefore, let her be placed across the bed that he may operate the easier; and let her lie on her back, with her hips a little higher than her head, or at least the body equally placed, when it is necessary to put back or turn the infant to give it a better posture. Being thus situated, she must fold her legs so as her heels be towards her buttocks, and her thighs spread, and so held by a couple of strong persons, there must be others also to support her under her arms, that the body may not slide down when the child is drawn forth; for which sometimes great strength is required. Let the sheets and blankets cover her thighs for decency's sake, and with respect to the assistants, and also to prevent her catching cold; the operator herein governing himself as well with respect to his convenience, and the facility and surety of the operation, as to other things. Then let him anoint the entrance to the womb with oil or fresh butter, if necessary, that with so more ease he may introduce his hand, which must also be anointed, and having by the signs above mentioned, received satisfaction that the child is dead, he must do his endeavours to fetch it away as soon as he possibly can. If the child offer the head first, he must gently put it back until he hath liberty to introduce his hand quite into the womb; then sliding it along, under the belly, to find the feet, let him draw it forth by them, being very careful to keep the head from being locked into the passage; and that it be not separated from the body; which may be effected the more easily, because the child being very rotten and putrefied, the operator need not be so mindful to keep the breast and face downwards as he is in living births. But if notwithstanding all these precautions, by reason of the child's putrefaction, the head should be separated and left behind in the womb, it must be drawn forth according to the directions which have been given in the third section of this chapter. But when the head, coming first, is so far advanced that it cannot well be put back, it is better to draw it forth so, than to torment the woman too much by putting it back to turn it, and bring it by the feet; but the head being a part round and slippery, it may also happen that the operator cannot take hold of it with his fingers by reason of its moisture, nor put them up to the side of it, because the passage is filled with its bigness; he must, therefore, take a proper instrument, and put it up as far as he can without violence, between the womb and the child's head (for the child being dead before, there can be no danger in the operation), and let him fasten it there, giving it hold upon one of the bones of the skull, that it may not slide, and after it is well fixed in the head, he may therewith draw it forth, keeping the ends of the fingers of his left hand flat upon the opposite side, the better to help to disengage it, and by wagging it a little, to conduct it directly out of the passage, until the head be quite born; and then, taking hold of it with his hands only, the shoulders being drawn into the passage, and so sliding the fingers of both hands under the armpits, the child may be quite delivered, and then the after-burden fetched, to finish the operation, being careful not to pluck the navel-string too hard lest it break, as often happens when it is corrupt.
