Part 29

III. AND the same is the Method of _Cure_, in _Case_ of an _Intestinal_ RUPTURE, otherwise call’d ENTEROCELE, i. e. HERNIA; only, That a _Truss_ is now more convenient than a SWATH: However in this Place I would observe that all _Tumours_ of the SCROTUM, are not to be mistaken for the present _Bursten Case_; because the same may also happen from a _Watry Humour_ collected in that Part, which is more properly call’d an HYDROCELE, and is easily distinguish’d from the ENTEROCELE: Insomuch, that, in this _Condition_ the _Tumour_ is most commonly, in one part of the SCROTUM, I mean in its _Right_ or _Left Side_; when also the fallen _Intestines_ may be perceiv’d by the _Touch_; as the RUPTURE or _Hole_ through which the _Intestines_ are fallen, may be by the _Finger_: Whereas in the _Case_ of an HYDROCELE, the _Tumour_ is commonly in _both Sides_, and the SCROTUM is more puffed up, neither is there any _Hole_ of a RUPTURE to be found in the PERITONÆUM. The _Cure_ of which _Case_ depends entirely upon proper _Absorbents_, or _Discutients_, for resolving and drying up the WATER, or dissipating the WIND, and afterwards upon _Corroboratives_ for confirming the _Parts_. But after All, in the mean Time this _Tumour_ is also sometimes, upon occasion, properly open’d by a LANCET to evacuate its _preternatural Contents_.

IV. AN _Inflammation_ or _Exulceration_ of the NAVEL may happen to the CHILD, by the _String’s_ falling off too soon, or before it be fully clos’d and _cicatriz’d_; which may proceed from any violent Agitation of the BELLY, by continual _Crying_, vehement _Coughing_, &c. as it also may from an unskilful _Ligature_ of the STRING, or from cold AIR; upon which sometimes follows a great loss of _Blood_, and even DEATH itself, if not timely prevented.

THIS _Inflammation_ is known by the NAVEL’S swelling-up, being red and hard with _Heat_ and _Pulsation_; In which _Case_ after appeasing the INFANT’S _Coughs_, or _Cries_, &c.—I would apply to it the _Unguentum refrigerans Galeni & Populeon_, each one half mix’d; or a small _Bolster_ dip’d in the _Oil of Roses_ with a little _Vinegar_.

BUT, and if the NAVEL continues _Ulcer’d_ after the falling of the STRING from it; in that _Case_ proper _Desiccative_ and _Astringent Medicines_ are to be apply’d, such as small _Rags_ dipp’d in _Lime-Water_, but not too strong; or in _Plantane-Water_, wherein a little ALUM has been dissolved. If the ULCER be but small, a _Pledget_ of _Dry Lint_ will be sufficient; observing always to keep a good _Linnen Compress_ on the _Top_ of whatsoever _Remedy_ is us’d, with a SWATH to keep all fast, until the NAVEL be perfectly heal’d and _cicatriz’d_; lest at the same time it should also force itself _outwards_, as in the ’foregoing _Case_.

V. THE _Child_ is also very frequently troubled with the APHTHÆ, or _Ulcers of the Mouth_; commonly call’d the THRUSH: Proceeding either from vitious _Milk_, or from its _Corruption_, in the STOMACH; emitting sharp _Vapours_, which readily affect the tender Skin and Superfice of the INFANT’S _Mouth_, and _that_ the more easily, because the same _Tunick_, or _Skin_, which invests the _Mouth_, is common to the _Gullet_, which naturally communicates the _Affections_ of the VENTRICLE to the _Jaws_. Hence it is that the _Nice Taste_ of the _delicate_ TONGUE so readily distinguishes all _Relishes_; and hence it is that the Ingenious _Physician_, by looking upon the TONGUE only, is able to judge of the prevailing _Intemperament_ of the whole Body.

THE _Cure_ of these THRUSHES, proceeding as aforesaid from the _acid Vapours_ of bad MILK, or from its ill _Digestion_, depends properly and entirely upon defeating and obtunding the ACRIMONY, by _proper Absorbents_, and gentle _Purgatives_.

VI. ANOTHER _Symptom_ not only familiar, but even _Natural_, to all CHILDREN, is their _Teething_; which tho’ _This_ be the mere Work of NATURE, yet because of the various _Distempers_ and _Symptoms_, which commonly attend and conjoin this DENTITION, it is not improperly reckon’d in the CATEGORY of the _Diseases_ of INFANTS: Which however is to be understood, not of the _Simple_ DENTITION, but of the difficult _Breeding of Teeth_; Not but that the CHILD is furnished with _Teeth_ even before BIRTH, tho’ they lurk so long in their proper _Sockets_, being cover’d with the GUMS, until their due Time of _Eruption_[189]. Tho’ in the _Interim_, it has been observed that some CHILDREN have brought eminent TEETH with them into the World[190], as it is also for _Instance_, particularly reported of LEWIS the XIV of _France_.

BUT however the TEETH most commonly break out about the _Seventh Month_, and first those call’d _Dentes Incisores_, or the _four_ fore-TEETH; which after a short _Interval_, are followed by the _two_ _Dog-Teeth_, commonly call’d the EYE-TEETH; and at last succeeded by the eight _Cheek-Teeth_ or GRINDERS, in each Jaw; the two last of the _Molares_, properly called _Dentes Sapientiæ_, springing only out about, or after the one and twentieth Year. Now as this _Eruption_, particularly _that_ of the DOG-TEETH, because of their very deep _Root_ and small _Nerve_, cannot happen without an _exquisite Sense_, and _intense Pain_ to the INFANT; so, from the continual _Solution_ of the GUMS, many præternatural _Affections_ seize the CHILD, according to _Hippocrates’s_ Catalogue[191]; to which, in short, I must only refer: Because if I was to enter upon the particular _Detail_ of all _These_, I should extend the _Limits_ of this WORK beyond all measure; wherefore I shall endeavour to comprehend them all under the _one following general Head_; viz.——

CHAP. XII. _Of the Acute Diseases of_ INFANTS.

THE very tender _Nature_ and infirm _Constitution_ of CHILDREN, subject them to many various and grievous _Symptoms_, besides those to which they are expos’d by a vast variety of _Procatarctick Causes_. But as I am not in this place to enter upon the _Detail_ of these particular _Symptoms_, neither shall I enumerate their respective _Causes_: Which however is the less requisite, considering the _Regimen_ and _Nursement_ of the CHILD already prescribed in the foregoing _Chapters_; since the _least step_, degenerating from what is there inculcated, may prove an effectual _mediate Cause_; for all that indeed, according to the most Learned and Excellent Dr. _Harris_, the only _immediate Cause_ of all CHILDREN’S _Diseases_ is, an _Active_ and _prevailing_ ACID[192].

THIS _Doctrine_, in as much as the _Constitution_ of INFANTS is undeniably most _Humid_, appears also evident from _Hippocrates_’s his own Words, saying, _the Rise of all Diseases is one and the same, the Place only makes the Difference_[193]. Hence we may justly conclude, FIRST, _That_, however the _Symptoms_ may differ in _degree_, the _Diseases_ of the INFANT-_State_ are but very _few_: SECONDLY, That the _Cure_ of _these_ is far more Safe and Easy, than _those_ of full _grown Persons_: THIRDLY, That the _Younger_ the _Sick_ CHILD is, the more easy still is the _Cure_: Because its tender Body, abounding with _Natural_ and _acquired Moisture_, is soft and flexile, and consequently apt to receive any _Alteration_: And FOURTHLY, I observe that the INFANT easily falls into _Sickness_, or may be suddenly taken Ill, and as readily restored to _Health_, if but carefully and ingenuously _treated_: Because any _Impression_ whatsoever, good or bad, is sooner received by a _Soft_, than by a _Hard Body_; tho’, I confess, the same is more _Lasting_, if once strongly impressed upon the _Hard adult Constitution_.

NOW as to the _Diagnosticks_ of CHILDREN’S _Diseases_, These depend chiefly upon the _Relation_ of the NURSES; since all _Sentiments_ taken from their unruly PULSES, or their (naturally) thick URINES, prove most _Uncertain_. However, as the STOMACH is always affected with an _Acid Distemper_, (whatever the reigning _Disease_ may be, or howsoever it may be intitled by ingenious _Authors_) so it most commonly produces _Fastidy_ or _Loathing_ of VICTUALS, _Vomiting_ of a thick GELLY, or a viscid and coagulated PHLEGM, sour _Belchings_, and EXCREMENTS of a sourish _Smell_, and a greenish _Colour_, especially in the Beginning. As afterwards——

IF the _Distemper_ continues, the PATIENT turns gradually _Pale_, and its discoloured FACE is tinged a little _Green_ or _Yellowish_; The BELLY swells with _Wind_, which breaks frequently _upwards_; one or more red _Pustules_ (a certain sign of _Acidity_) commonly rise in the FACE, or upon some other _upper Part_ of the Body; and the INFANT growing daily worse, _breathes high_, and _smells sour_ or ACID.

AGAIN, As to the _Prognosticks_ of these _Distempers_, of what kind soever they be, which afflict the INFANT; I cannot in short, but readily agree with the most Ingenious _Doctor_ before-mentioned, who plainly tells us, that _These_ depend chiefly upon the Method of _Cure_, and the _Conduct_ of the NURSE; Wherefore I proceed to the CURE.

AS to this point then of the _Cure_ of CHILDREN’S _Diseases_, I shall FIRST observe that, how _many_ soever these _Distempers_ are accounted, according to the REGISTERS of _Polite Authors_, by what Name soever they are denominated, and how learnedly soever defin’d, as they all proceed from one immediate _efficient Cause_, (which has been already hinted at) so the _Cure_ of them all is the same, and depends, in like manner, upon _One only regular Method_.

SECONDLY, I observe that as this _Cause_ is nothing else than an _Acid Humour_, abounding in the _Stomach_, and coagulating the _imbib’d Nourishment_ of the INFANT, (as is evident from all the given _Diagnosticks_) so the proper _Method of Cure_, depends entirely upon obtunding that _Acidity_, dissolving those _Coagulations_, and eliminating the _peccant Matter_. But more particularly,

HAVING always a great and due regard to the _natural Debility_, and _tender Constitution_ of the _Young_ PATIENT, the _Acid_ ought first to be prepared by prudent means, and then to be carried off by proper _Medicines_. I say _prepared_ by prudent Means, because _this_ is no indifferent Matter; For if we should take the same Method with these tender _Creatures_ in this _Case_, that we do with more _adult Persons_ we would certainly _miscarry_ in our Attempts; or if we should attempt this Preparation, by _Alexipharmacks_, _Cordials_, (improperly so call’d) _Causticks_, or _Sudorificks_; these Things being most prejudicial to the Nature of _young_ ONES, would rather promote the _Crudity_, than the _Concoction_ of the HUMOURS.

THEREFORE the ingenious Doctrine of the Excellent Doctor HARRIS, must certainly take place here, namely[194],that _the most temperate Things most securely absorb the prevailing Acidity, and that the more Simple and Gentle the Remedies are, the more Safe and Certain the Cure is._

HENCE the simple _Testaceous Medicines_ mentioned by him, are not to be paralleled in the present _Case_; since they effectually mitigate all _Ebullitions_, and gradually become the most safe and powerful _Anodines_: Insomuch, that they, in a word, as certainly asswage all the _Pains_, _Gripes_, _Disquiets_, _Watchings_, &c. of CHILDREN; as _Narcoticks_, or _Opiats_, do allay those of older People.

THE Body being then alter’d by these means, and the _Humours_ duly prepared, they are to be forthwith ejected, or timely purged off, even from the _youngest_ INFANTS, as well as from those of riper Years: The _Doses_ and _Quantities_ of all sorts, being discreetly adapted to the _Age_ and _Strength_ of the CHILD, under what _Form_ soever they may be given.

UPON this Head, I might indeed pretend to expatiate, but because, whatever _I_, or any _other ingenuous Person_, understanding the Matter in Hand, may attempt to offer, will only terminate in, and be consentaneous to, what my last quoted _Author_ has plainly laid down, and concisely comprehended in a few _emphatick Words_; I shall here also, for Brevity’s-sake, set Bounds to my _Progress_. And thus, in short, having at large, and in every particular Respect, faithfully discharged my _Duty_, both as _Physician_ and MIDWIFE, to the CHILD as well as to the MOTHER; I now take leave of both the _one_ and the _other_, and in the next place, come briefly to touch upon the _Reverse Cases_.

SECT. VII.

CHAP. I. _Of Præternatural_ CONCEPTIONS.

HAVING particularly defin’d the _Natural Conception_, in Chap. I. Sect. III. and hitherto treated of its various different _Consequences_, both in GESTATION, BIRTH and CHILD-BED; I come in the next place (conformable to my promise before-mentioned) to treat of the opposite and _reverse Case_, commonly call’d (by the _Authors_) a vitious or depravated CONCEPTION: Which however, I shall distinguish by the general TITLE of _præternatural_, as I have one _Set_ of BIRTHS under the same Denomination, contained in Sect. V. But——

NOW, because I judge all such CONCEPTIONS as well as BIRTHS, to be _præternatural_, which, tho’ not according to the _ordinary Institution_ of NATURE, are yet however not _repugnant_ to NATURE: And because such CONCEPTIONS, as well as the _Præternatural_ BIRTHS already defin’d, happen after many different ways and manners; I shall also reduce and divide them into _two_ CLASSES, _viz._——

FIRST, _Præternatural_ CONCEPTIONS in respect of the _Number_; to which belong all _Superfætations_, and other Numerous CONCEPTIONS; And SECONDLY, _Præternatural_ CONCEPTIONS in respect to the _Form_ or _Substance_; to which belong all _false_ CONCEPTIONS, MOLES, MONSTERS, _&c._ Of all which particularly and briefly in their due Order, and FIRST——

CHAP. II. _Of_ SUPERFÆTATIONS.

A SUPERFÆTATION is nothing else than a _Second_ (after a _First_) CONCEPTION: Since if divers INFANTS may be _conceiv’d_ at one _Embrace_, as will evidently appear from the following _Chapter_, we may easily believe, that _two_, _three_, or _more Embraces_, may most probably have the same _Effect_: Which is sufficiently confirm’d by the Experience of _Hippocrates_[195] himself, as well as by many other most Learned _Authors_[196].

WHEREFORE I shall spend no time in reciting here any _Instances_ I have met with of this _Nature_; only I refer the _Curious_ to a very famous collected _History_ of such BIRTHS, as in the _Margin_[197]. Whence the Certainty of _Superfætation_ is not to be doubted, and much less to be disputed: And according to _Aristotle_ the same may happen, after the _Second_ or _Third Day_, from first Conception, as well as after so many _Months_[198]. But farther,——

THE _Cause_ of all _Superfætations_ is only an _Apertion_ of the _Orifice_ of the WOMB, at the Effusion of the _Virile_ SEED. Which however (according to _Avicen_) only happens to such _Women_, as have plenty of BLOOD, or a _Calid_ WOMB, desirous of _Copulation_, or to such as have their MENSTRUA after the _first_ CONCEPTION.

SUPERFÆTATIONS however are not easily discover’d before BIRTH; at which time, _Avicen_ advises to take Notice of the NAVEL-STRING; _For_ (says He) _if it be without folds or wrinkles, there is but one_ CHILD; _if otherways, there’s a Child for every Wrinkle_: But I think the expert MIDWIFE using her _Hand_, as I have not unadvisedly inculcated[199], will have but small Occasion for such _Observations_, and far less _Need_ to trust to them.

BUT when more than _one_ CHILD is found, they are distinguishable, (I mean _Superfætations_) from _These_ conceiv’d at one time; _those_ having each a _peculiar_ SECUNDINE; _these_ ONE only in Commune: As the _one_ is also less vital and more imperfect, than the _other_; according to the interval of Time betwixt their CONCEPTIONS.

THE _Cure_ or Prevention of this _Case_ is much the same with the following, _viz._

CHAP. III. _Of a Numerous_ CONCEPTION.

A _Numerous_ CONCEPTION may happen either with, or without SUPERFÆTATION: And _that without_, may be truly call’d _Monstrous_; as all BIRTHS, exceeding the Number of the _Woman’s Breasts_, or the SINUS’S of her WOMB, may be justly accounted.

I could also give many Instances of this sort of BIRTHS, where 3, 4, 5, and more CHILDREN have been _born at once_, but shall satisfy myself with _This_, which I think is one of the most remarkable, _viz._ _That_ of the _Countess Margaret_,[200] Daughter to _Florent_ IV. _Earl of Holland_, and SPOUSE to _Count Herman of Heneberg_; who, on _Good-Friday_, in the Year of our LORD 1276, and of her _Age_ 42, brought forth at one BIRTH 365 INFANTS; whereof 182, are said to have been _Males_, as many _Females_, and the odd one an HERMAPHRODITE: who were all _baptized_, _those_ by the Name of JOHN, _these_ by that of ELIZABETH, in two _Brazen Dishes_, by _Don William, Suffragan Bishop of Treves_. The BASONS are still to be seen in the _Village Church_ of _Losdun_, where all _Strangers_ go (on purpose) from the _Hague_, being reckon’d among the great CURIOSITIES of _Holland_. For farther and more instances of this Nature, I refer the Curious to a large collected _History_ of such, by the _Author_ mentioned in the _Margin_[201] From whence the Certainty of _Numerous_ CONCEPTIONS will evidently appear.

AGAIN the _Cause_ of such _Numerous_ CONCEPTIONS is (according to _Avicenna_’s just Opinion) the _Division_ of the SEED in numerous _Portions_, or _Proportions_; which may happen, either because of the WOMB, or because of the INJECTOR: Because of the WOMB, when its _Cavity_ is larger than ordinary; or when it too greedily _attracts_ to all its Parts; or when the divided SEED adheres separately to the singular _Uterine Veins_: Insomuch, that if what has been recorded of the abovesaid _Countess_ be true, it is not improbable that, there may be a CONCEPTION for every _Orifice_ of the _Uterine Veins_, and that every _Vessel_ may attract its own distinct _share_ of the SEMINAL _Matter_, and thereupon initiate a respective CONCEPTION, tho’ it cannot possibly bring it to _Perfection_.

MOREOVER the same may also happen, because of an irregular INJECTION, namely, when _that_ is perform’d by _stops_ and _intervals_; then the WOMB attracting accordingly, may occasion different CONCEPTIONS, according to the different _Immissions_ or _Divisions_ of the SEED.

BUT these CONCEPTIONS, whether _two_, _three_, or _more_, are always annexed to, and contained in one common SECUNDINE. And tho’ the _Woman_, by reason of her good Constitution of _Body_ and WOMB, may do well in the time of _Gestation_, yet her _Præternatural Condition_ in the BIRTH, always threatens _Danger_, as is already made out more manifestly[202].

NOW as to the _Cure_ or Prevention of both _this_ and the _preceding Case_, I know but one only grateful Method of performing it; _viz._ by refrigerating and reducing the too _calid_ WOMB to a convenient _Temperature_, and using a proper _Regimen_ of _Health_ and DIET; and _that_ both before and after CONCEPTION.

CHAP. IV. _Of False_ CONCEPTIONS.

HAVING already also particularly defin’d the _real_ or _true_ CONCEPTION in _Sect._ III. Chap. I. I come now in like manner to the REVERSE of that _Case_, properly call’d a _false_ CONCEPTION. But that I may, in this Point, be well understood,——

A _False_ CONCEPTION, in my Opinion, is nothing else, but a _Protuberancy_ of the _Woman_’s BELLY, attended with some, if not with most, of the _Symptoms_ of the Months of GESTATION: which however, is no ways occasion’d by a humane FOETUS, but (on the contrary) either by _Water_ and _Winds_, or _Wind_ and _Water_ vitiously mixed; which is also pertinently call’d a _Dropsy_ of the WOMB: Or then, by a corrupted _Viscid_, or _pituitous Matter_ collected in the WOMB; and that either proceeding from weak and vitious SEED, or from some extraordinary _Intemperature_ of the WOMB, which may hinder the _Elaboration_ of the SEED and BLOOD, and consequently the _Accomplishment_ of the CONCEPTION: Or the same may also finally proceed from the _Impurity_ of the MENSTRUA, which may corrupt the SEED, and convert it to _Aqueous_, _purulent_, or _other_ HUMOURS.

THIS _false_ CONCEPTION is attended (besides the common _Symptoms_ of a _true_ CONCEPTION) with inordinate FEVERS, PAINS of the _Head_, _Neck_, _Loins_, _Groins_, _Back_, and _Belly_: Which BELLY swells sooner than in the _Condition_ of _real_ CONCEPTION; and which, if struck with the _Hand_, gives a _Sound_ like a DRUM whence ’tis also call’d a TYMPANY: The whole _Body_ is hence discoloured; the _Feet_, and sometimes the _Face_ swells; and only a little (if any) _watery_ MILK is found in the _Breasts_. THE _Cure_ of the _Case_ depends entirely upon proper _Evacuations_, peculiar to the _Quality_ of what is to be evacuated. Whence I come to treat of the _Conception_ of MOLES.

CHAP. V. _Of_ MOLES.

A MOLE is properly nothing else, than a _fleshy Mass_ (instead of a FOETUS) engender’d, of an _imperfect_ CONCEPTION, in the WOMB. And is so call’d, because (_quasi Lapis Molaris_) like a MILL-STONE, its _weight_ infests the _Woman_.

THERE are two immediate _Causes_ of this CONCEPTION of MOLES, _viz._ the _Superfluity_ of Matter, and the _infirmity_ of the _forming Faculty_. Which, I think, is agreeable to _Hippocrates_ his meaning, saying, that _too much Menstruous Blood, or too little, weak, or insufficient_ SEED, _is the only Cause of a_ MOLE[203].

I know, that besides these, there are many other various _Causes_ given by diverse _Authors_; yea I know that the MOLE it self is variously accepted among them: But as I am not to insist upon the _quibbling_ Notions of other Men, so I shall only here observe,——

FIRST, that there is a vast Variety and Difference in the _Substance_, as well as in the _Form_ of MOLES: SECONDLY, That there is sometimes but _one_, _and_ sometimes _two_, _three_, or _more_ MOLES, contain’d in _One_ WOMB; and _that_, sometimes with, and sometimes without the _Natural_ FOETUS as also sometimes separately, and sometimes adhering the _One_ to the _Other_: THIRDLY, That in this _Case_, if the FOETUS be not directly kill’d by the _Compression_ of its tender Body, it is at least in _Danger_ of being _misshaped_, or perhaps _monstrously formed_, according to the _Bulk_, _Weight_, and _Solidity_ of what is contain’d with it in the WOMB.

HOWEVER in regard to the FOETUS, when we are certain of its _Existence_; tho’ in the WOMB, with _one_ or _more_ MOLES, it may perhaps be very safe; Therefore I again observe, that, in this _Case_, as long as the _Woman_ is no ways endangered, the _Exclusion_ of BOTH ought to be _Natural_, and accordingly the _appointed Time_ waited for: When according to all _Authors_, the MOLE comes sometimes before, sometimes with, sometimes immediately after, and sometimes a few Days, or perhaps Weeks, after the FOETUS. But such MIDWIVES as follow my _Method_, already plainly laid down[204], will scarce trust their WOMAN with the Charge of a MOLE, one moment after the _Birth_ of the INFANT and _Secundine_: Because by such means, yea, even by a small _Clod_ of BLOOD, which is a far less matter, retain’d after the BIRTH, _Millions_ of Women have lost their pretious _Lives_.

IN the mean time, as MOLES are most commonly generated _alone_, without any FOETUS; I come now to indicate their peculiar _Diagnosticks_, which the _Reader_ may take as follows, _viz._ FIRST, the _Woman_’s BELLY swells equally in all its _Dimensions_; whereas in _Case_ of a _Natural_ CONCEPTION, it is raised, and as it were acuminated or pointed towards the NAVEL, and a little compressed on _both sides_.

SECONDLY, The _Orifice_ of the WOMB never shuts in _this_, as it does in the _Natural_, CONCEPTION: And the MOLE may be distinctly felt by the _Touch_, like a _Globular Mass_, in the _Region_ of the WOMB and LOINS.