THE Extraordinary MIDWIFE, or Andro-Boethogynist (whether Physician or Surgeon practicing this Art) ought not only to be endued with all the Qualities and Qualifications mentioned in the Two preceding Chapters, but also to excel the Woman-Midwife in many special Particulars, and ingenious Points; which no ways belong to her Female Province.

FOR it is not enough that He knows how to relieve and lay the labouring Woman, however difficult or preternatural her Case may be; nor is it sufficient that he understands how to help and succour both the MOTHER and the INFANT after such a Delivery: No, so much of his Business might be easily learn’d and enhanced by old Women, were they but Docile, and not such obstinate Creatures.

BUT He ought farther also to know (first) how to prevent all preternatural Disasters incident to both the one and the other, in their respective States of Child-Bed and Infancy: And, Secondly, how to administer Relief and perform the Cure, in Case of any dismal Accident whatsoever to one or either of them in their dangerous Condition.

MOREOVER, his Knowledge ought neither to commence nor terminate in these Things; it being also his Duty over and above to know, how to conduct the Woman safely through all the Months of GESTATION, and to avert from her the Severity of their respective SYMPTOMS, to which she is so much expos’d, as mentioned in their proper Chapters, Sect. III. And not only so neither, but He ought also to understand well, how to guard against the Accesses of all Acute Diseases, so as at least to avert their ill Consequences; and especially (of course) to know thoroughly how to prevent ABORTION itself.

THESE are the Cases which most commonly require the ingenious Assistance of the Extraordinary MIDWIFE: And These are they which try his Skill and Knowledge most, as the Tempest or Storm best discovers the Judgment and Capacity of the Master-Mariner.

AND yet, neither ought even these Limits to be the narrow Boundary of his Studies: Since the more extensive his Art and Knowledge is, especially in what relates to the natural Constitution of Women, the fitter Man He is to take upon himself the Practice of this noble and most ingenious Profession.

NOT that I would be thought tacitely to insinuate in this place by the By, as if my own Knowledge was in any degree Superiour to other Men’s: No, I am too sensible of my own Weakness, to mean so, or to entertain any such vain selfish Thought; neither have I any fond Ambition to aim at standing in Competition with others in these Respects. For it shall suffice me, and sufficiently gratify my Highest Aim, if possibly a simple Word may drop from my Pen, which the more Ingenious may sometime improve to the common Good of Women, and the Welfare of their Children: And this I would desire the more, because I know no larger FIELD, that the Learned can launch out into; nor any profounder Study, that they can descant upon, than the Nature and Constitution of this tender Sex, which is so peculiarly different from all other Natural Works, and so singularly discrepant from all other Created Beings.

BUT more particularly in order, that the MAN-MIDWIFE or Andro-Boethogynist may be thus duly qualify’d and completely accomplished;

I. HE ought not only to be liberally instructed and generously educated, but also to be a Man of good Breeding and Conversation, as well as Courtesy and Complaisance.

II. HE ought not only to be a Man of diligent Study and sedulous Application of Mind, but also of great Humanity and Integrity, Temperance and Sobriety, endued with solid Resolution, quick Apprehension, and great Presence of Mind.

III. HE ought not only to be a Man of strict Virtue and Chastity, but also of unspotted Life and Conversation, Charity and Companion; delighting in Hospitality, and doing Good; acting the Christian as well as the Gentleman in all respects.

IV. HE ought not only to be a Man of known Discretion and Secresy, Sagacity and Judgment, but also of a pleasant Countenance; neat and clean in Person and Cloathes, Agreeable and Decent in Words and Actions, carefully adverting (at all times) to give no Occasion of Shame or Confusion to the Labouring Woman, or the By-standers.

V. HE ought, in fine, to handle Her decently, and treat her gently; considering Her as the weaker Vessel, whose elegant tender Body, will admit of no rough Usage: Wherefore upon this Account it is, that I would have all Practitioners whatsoever in this Art, debarr’d from the Use of INSTRUMENTS, which would secure many a Mother from being wounded or mangled, and many an Infant from being cut or torn to Pieces.

NOT that I would be thought for all that to imitate Mr. Mauriceau, saying of himself (in some Passages of his Book of MIDWIFERY) that he differs from all others: No, far from it; For I have the Indisputable Authority of the most Learned and Polite Practisers on my side, as mention’d before in Chap. 1. of this SECTION.

HOWEVER yet, I do not deny, but that INSTRUMENTS have been universally used, till of late Years; but the reason of That is Plain: Because in former Times, Men were only call’d upon extraordinary Occasions; some of which (however Skilful and Ingenious) had not the Opportunity of Laying a Woman perhaps in many Months. For which Reason it could not be otherways, but that they must have been at a loss in not understanding thoroughly the Practical Part, having so few Opportunities of improving manual Operation: Whereas since the Politer Part of the World has call’d them generally to the ordinary and common Practice of this ART; they have advanced their Dexterity by degrees, and are now come to the length of discharging that Office by Slight of Hand only, which formerly required so many frightful INSTRUMENTS.

I may well indeed say frightful; for what can be more inconsistent with the tender NATURE of Women, or more terrible to them, than to see Men come armed against Themselves and their tenderer INFANTS, with Knives, Hooks, Iron-Forceps, &c. thereby (as it were) to help them in time of their extremest Agony? For my part, I am Positive, that let who will use INSTRUMENTS, they kill many more INFANTS than they save, and ruin many more WOMEN than they deliver fairly: And this, I think, will be easily agreed to, by all those who have any Knowledge of the Parts of Generation in that Sex; as (I believe) it is also sufficiently evident even to Those who have no Judgment that way, by the notorious Fatalities and tragical Events they daily hear of in Fact.

HOWEVER I know, some Chirurgeon-Practitioners are too much acquainted with the Use of INSTRUMENTS, to lay them aside; no, they do not (it may be) think themselves in their Duty, or proper Office, if they have not their cruel Accoutrements in Hand: And what is most unaccountable and unbecoming a Christian, is that, when they have perhaps wounded the MOTHER, kill’d the INFANT, and with violent Torture and inexpressible Pain, drawn it out by Piece-meal, they think no Reward sufficient for such an extraordinary Piece of mangled Work.

BUT, in short, I would advise such to practise Butchery rather than MIDWIFERY; for in that Case, they could sell what they slay; but in this, by handling Man so, they only bring Infamy upon their Profession, and expose it to the Contempt and Hatred of Others.

COVETOUSNESS is the blackest of Vices, and in this Case (I am sure) it is an unpardonable Sin, to thirst after sordid Lucre for procuring the Health or preserving the Life of our Neighbour; as, I doubt, is but too common among some mercenary People: Who (as we have been creditably inform’d) have refus’d to take Women in Hand at the very Point of Extremity or Time of Need, before a certain Sum of Money was first deposited; tho’ perhaps borrow’d upon Pledge, or collected amongst their charitable Neighbours for God’ssake.

I do not say however, but that the Workman is worthy of his Reward, and That which ought to be paid according to the Merit and Dignity of his Performance; not according to the Time he spends about it, as hired Labourers are paid their Wages: No, that fruitless Labour would not be worth while; no Gentleman would undertake Midwifery upon such unprofitable Terms: For as it is in his Power to save the Life of the Mother, or the Infant, or Both, (which he often does effectually) He undoubtedly deserves an extraordinary Recompence worthy of so great and good a Piece of Service.

BUT notwithstanding all This, an extravagant Price is not to be arbitrarily demanded, nor ought the Reward to exceed the Ability of the PATIENT; neither are Those to be forsaken or left destitute of Help, and expos’d to imminent Danger, at all Hazards of Life, who cannot afford us Money: But rather (on the contrary) they are to be forthwith taken in Hand chearfully, attended by Night or Day diligently, and a trifle of Money given (by us) rather than taken from them, when our Fellow-Christian’s Circumstances so require it. For this is the right way to secure God’s Blessing to Ourselves, and Success to all our Endeavours.

AND, in short, I humbly pray, that He may (out of his infinite Goodness and Mercy) always enable Me, according to my best Inclinations, faithfully to perform these good Offices, which I know to be so much my indispensible and incumbent Duty, in that STATION, his All-wise Providence hath allotted me, as to the Affairs of Life.

WHENCE I come, in the next Place, by due Order, to treat particularly of the Contents of the preceding Chapter; and, First, to set forth an Anatomical Description of the several Parts of Generation in manner following.

THESE Parts are generally so well known, that I would not so much as mention them, out of Modesty, were it not, that, I presume, the young MIDWIFE may find something in the ensuing Description worth her singular Notice; which however, I shall not so much insist upon: But succinctly——

BEGINNING with the First, call’d the Vulva or Pudendum; we find it situated below the Os Pubis, having a great Chink or Fissure in the Middle, as it has the FrÆnulum and PerinÆum in the lower Part. And above the Chink there is a little Protuberance occasioned by Fat under the Skin, call’d Mons Veneris.

THE two Labia VulvÆ being a little separated, the NymphÆ appear, join’d one to each interior Side of them: They are two small Pieces of red Membranous Flesh, much resembling Pullet’s Gills: They encrease the Pleasure of Copulation, and direct the Course of the Urine.

IN the upper Part of the Chink, next to the Os Pubis, are several little round Substances; which the most ingenious Fallopius call’d the Clitoris, almost hid under the Skin denominated the PrÆputium.

A little deeper, or straight below the Clitoris, is the Urethra, or Orifice of the Neck of the Bladder; being a little Hole as big as a Goose-Quill; which discovers itself by a small Eminence, and is about two Inches long.

BETWIXT the Muscle, call’d Sphincter UrethrÆ, and the inner Membrane of the Vagina, are several small Glands; whose excretory Ducts are the Holes observable about the URETHRA, call’d^[153]LACUNÆ GRAFFI; which discharge a Liquor for lubricating or making the Vagina slippery, and encreasing the Venereal Titillation.

IN the Orifice of the Vagina, there is a slender subtile Membrane situated a-cross, which is call’d the Hymen, of a different Form in different Women; being sometimes Annular, and sometimes Semilunar: It is almost always to be found in young Girls, having a small Hole into the Vagina; which Hole in Adults is somewhat larger. In the first Act of COPULATION this Membrane is torn, which generally occasions an Effusion of a little Blood; but this may also happen by many other Procatarctick Causes^[154], and accidental Occasions.

THE GLANDULÆ or CARUNCULÆ Myrtiformes are constituted of the contracted Fibres of the dilacerated HYMEN; and are situated on the Side opposite to the URETHRA, next the ANUS, in the FOSSA Magna, or Navicularis; being the same Place where the HYMEN was at first established. These are small fleshy Eminences, and are sometimes Two or Three, and sometimes Four or Five in Number: They are deficient in GIRLS, and defaced in those WOMEN who have had CHILDREN.

THE VAGINA or Neck of the Womb, is a long and round Canal, reaching from these Caruncles to the Orifice of the Womb; not very unlike a strong small Gut: Its Orifice is narrow in Virgins, and in All Women much narrower than its other Parts: It’s Substance (according to Ruysche’s Observations) is membranous, nervous, papillary, and wrinkled Within; which consequently must be of an exquisitive Sense: In Virgins the WRINKLES are very Large, especially in the Fore-Part; but after frequent Embraces they are Less, and after repeated BIRTHS, they entirely disappear.

THE VAGINA lies betwixt the Bladder and the strait Gut, or Rectum; with which last it is wrapt up in the same common Membrane, from the PERITONÆUM, adhering to it, all its Length upwards, from its Orifice to that of the Womb, and quite round on the lower Side, as it does to the Neck of the BLADDER above.

IN Maids, the VAGINA is about Five Inches Long, and one and a half Wide: But in CHILD-BEARING-WOMEN, it cannot be determin’d; because it lengthens in the time of PREGNANCY, and dilates in time of BIRTH; having likewise (in all) some little Holes or Ducts in it, which discharge a mucous Liquor. The VAGINA Serves also, in fine, for a necessary Conduit to the MENSTRUA and LOCHIA, as it does for a proper Passage to the INFANT, &c.

THESE are, in short, all the external Parts of GENERATION in Women; and these have all their proper respective Functions assign’d them by Nature; contributing conjunctly and severally to the Charms of COPULATION: Which ACTION alters the very Course of the Blood, and Motion of the Animal SPIRITS; and consequently sets all the describ’d Parts in full AGITATION. Namely, thus

THE Labia dilate: the Orifice swells: the NymphÆ give way: the Clitoris (of exquisite Sensibility) erects: The Glands (by a Protuberancy of the Parts) yield their succous Contents: The Vagina draws close: The Fibres of the Womb complicate to open its Orifice: The Branches of the Spermatick Artery contract to draw the Extremities of the Tubes to the OVARIA, as they carry the Seed to them: The Seed circulating in the Veins, which open in the Cavity of the VAGINA and MATRIX, it ferments immediately with the Mass of Blood: This Fermentation swells the Membranes of the Tubes, opens the Cavity of the Womb, and disposes All perfectly for the right Reception of the impregnated Egg.

FROM hence we may plainly see, in what a miraculous Order and Manner, all These Parts minister, and are subservient unto that (yet more) admirable and wonderful Body the Womb. Which being thus in brief anatomically described, I come next in Course to

IN discoursing of These, I shall begin with the chief Part, to which the rest are but Subservients.

FIRST then, the MATRIX or Womb, is situated in the upper Part of the Cavity of the PELVIS, or Bason, between the Bladder and Streight Gut. It is placed there in the Middle of the HYPOGASTRIUM, for the Convenience of Copulation, and the more easy and ready Extrusion of the Infant.

SECONDLY, The Bones of the PELVIS (as described hereafter below) stand as a Rampart, fencing it against all external Injuries; That is to say, the OS PUBIS protects it before; the SACRUM behind; and the ILIUM on each Side: Like as the BLADDER and RECTUM on the other Hand defend this Noble Part again from the Rigidity of these Bones.

THIRDLY, the Figure of the Womb, from its internal Orifice to its Bottom, in a Natural State, resembles a large compress’d PEAR. Its Length is about three Inches; its Breadth two in the Hinder, and one in the Fore-Part; its Thickness half an Inch large: But I take the Dimensions of it, in general, to differ accord-to the Age and Constitution of the Body.

IN MAIDS however its Cavity is much less, and can scarcely contain the Bigness of a Bean: whereas in Women with Child, the Dimensions and Figure, as well as the Cavity itself differs, according to the different Times of GESTATION.

AS I have said before, its Anterior Part coheres above with the BLADDER, below with the RECTUM; the Hinder Part being free: But the lateral Parts are tied by Four Ligaments of different Sorts; whereof Two are placed Above, and Two Below; the Superiors are called Ligamenta Lata, or broad; the Inferiors Rotunda, or round Ligaments.

THE two broad Ligaments are Membranous, and call’d AlÆ Vespertilionum; which spring from the PeritonÆum, and join the Womb on each Side to the OSSA ILIA: So that the OVARIA are fasten’d to one End of them, and the TubÆ FallopianÆ lie along the Other.

THE two round Ligaments arise from the Fore and lateral Part of the Bottom of the Womb, and pass thro’ the Rings of the Muscles of the Abdomen, terminating in Fat near the Groins. They are of a hard Substance, pretty Big at the Bottom of the Womb; but smaller and flatter, as they approach the OS PUBIS. Now Those Four Ligaments serve to keep the Womb streight, steady, and firm in its proper Place before BIRTH, and to restore it to its natural Position, by the Help of Contraction, After.

THE Orifice of the Womb opening into the VAGINA, is of the same Figure with the Nut of the PENIS: This in VIRGINS is very small, scarcely admitting a Specillum or Probe; in Others it is much larger; but in Women with Child, several small Ducts or Vesicles open among the RugÆ, which discharge a Glutinous Liquor to close and seal up this Orifice, till the Time of BIRTH.

THE Substance of the Womb is Solid and Muscular, composed of a various Plexus, or Web of fleshy Fibres, woven like a Net, with the Interposition of innumerable Vessels, of ARTERIES, VEINS, NERVES, &c. Without, it is surrounded with a Thin and Smooth Membrane from the PeritonÆum; and within its Cavity, furnished with a Thick, Porous, and Nervous one, call’d the proper Membrane of the Womb.

THE Veins and Arteries of the Womb, proceed from the Spermatick Vessels, and Hypogastricks; which Vessels are all inserted in the proper Membrane. The Arteries convey the Blood for its Nourishment; which accumulating and abounding there in great Quantity, at Maturity of Years (when no more is requir’d for the Encrease or Growth of the Body) it distends the Vessels, and distills into the Bottom of the Womb: Whence proceeds the Blood which nourisheth the Foetus in the Pregnant Woman, and the Monthly Terms or Menstrua in the Woman not with Child; which Evacuation, Men Themselves are also subject to in a great Measure; (notwithstanding their inconsiderate Detractions and vain Talk on this Head) save only that in Them the Redundant Humour passes off a different Way by Urine, by the Nose, and sometimes by the Hemorrhoidal Veins, &c.

THE VEINS Serve only to reconduct to the Heart, the Blood which is neither wholly evacuated nor consum’d, as I observed more at large Before. But the Nerves arise from the Intercostals, and those of the Os Sacrum; remarkable Branches of which run along the Back of the Clitoris, from whence this Part is susceptible of the very slightest Impression.

THERE are moreover other small Vessels, springing one from another, which tend to this Orifice, and serve in Plethorick Women with CHILD, to carry off the Superfluity of the Humours. And, in short, prudent Nature, seems to have so ordered These to prevent ABORTION, which might easily happen, if the pregnant Womb was too much expos’d, or was to open itself for this Purpose.

THE Seminal or Spermatick Vessels are Four, like as they are computed to be also in Men, and differ only in being shorter. The Blood Vessels are very winding; and the Spermatick Arteries arising with a narrow Origin from the Aorta, form various Plexus’s, and Inosculations, as These do: And the Spermatick Veins (tho’ without Valves) have the like Inosculations with the Arteries, which however in These are more conspicuous.

THE OVARIA, or TESTICLES, are Two Bodies, on each Side One, annexed to the Bottom of the Womb, at about Two Fingers Distance, near the broad Ligaments: They are fixed to the PeritonÆum at the Ilia, nigh the Spermatick Vessels: Their Figure is almost Oval, a little depressed on the Upper Part, where the Spermaticks enter.

THEIR SIZE is generally about half as Big as MEN’s are; but this differs according to the Age and Constitution of Persons: Their Surface is smooth, and even in Virgins; but wrinkled, uneven, and dry in old Women: They are encompass’d with a proper strong Membrane, deriving its Original from the PERITONÆUM; which also covers all the Spermatick Vessels.

THEIR Substance is Membranous and Fibrous, interwoven with a vast Number of Vessels; among which are some round Vesicles, containing a viscous Humour, when boil’d, of the Colour, Consistence, and Taste of the boil’d White of an Egg: From whence they are call’d Eggs, because of this Analogy. These also differ in Size and Number, according to Age and Constitution, although (ordinarily) the Biggest of them scarcely equals a Pea; and there are in some Persons 10 or 12 of them, in others (perhaps) but One or Two discernible.

THE TubÆ FallopianÆ, are Two winding Canals, resembling Two Trumpets, situated on the Right and Left Side of the Womb, annexed close to its Bottom, by their double Membrane; which is only a Continuation of the exterior and interior Membranes of the Womb: They in SIZE equal a little Finger about the Middle; tho’ the Cavity opening into the Womb, will scarce admit a Hog’s Bristle; but the other Extremity, floating loose in the Abdomen, will admit the Point or Tip of a little Finger: They are of a Membranous and Cavernous Substance, about 5 or 6 Inches long, and have the same Veins, Arteries, and Nerves, as the OVARIA.

THESE Tubes, to be brief, (in time of COITION) are erected by a copious Influx of Blood and Spirits; which also, by the Assistance of their muscular Fringes, embrace the OVARIUM, transmit the prolifick Masculine Seed, afterwards receive the impregnated Egg, and at last convey it thence into the Womb. In fine, these are all the internal Parts, as I conceive, tending to GENERATION. But more particularly, to proceed to

THIS being that Cavity in which the Womb is placed, and through which the INFANT passes in time of BIRTH; it is my Opinion that a distinct Knowledge of it is highly necessary for all MIDWIVES to accomplish their Practice: For without that Qualification, they cannot help committing a great many Blunders, and being guilty of innumerable Mistakes; since they must proceed upon gross Uncertainties, and use their Hands like MEN groping in the Dark, as hereafter will more plainly appear.

THIS is that Cavity betwixt the Ossa Innominata and Os Sacrum; which join themselves in the Posterior Part of it on each side, by Cartilages and Ligaments: so that they, forming there a strong and firm Juncture, compose this Cavity of the PELVIS, which is vulgarly call’d the Bason of the Womb.

THE upper Part of the Ossa Pubis forms the Borders of this Cavity before, and the Hanging forwards or bending down of the Os Sacrum makes Those of it behind; as the Ossa Ilia compose the same on each side.

THESE Ossa Ilia are (by some) call’d the Wings and Bounds of the PELVIS; but they are mightily mistaken, who imagine that they surround or encompass the PELVIS: For they are only annexed to it on each side, and more extended towards the Back than the Forepart. As they are also very much in the wrong, who think that the Cavity of the PELVIS extends in its Length, according to the Length of the Back-Bone: since it rises from the Bottom obliquely, ascending Forwards, and so proceeds, as if a Person might, through its Passage, easily touch the Navel.

IN fine, it is here Remarkable also, that we do not always find the largest PELVIS in Women of the largest Size, but often the quite contrary; for it differs as the INFANT does in Bulk, exactly answering to the Bigness of its Head: And in some Women it is Deeper, in some Larger, in some Broader, in some Flatter, in some more Oval, and in some at last Rounder. From whence arise sundry Observations both useful and necessary, for the better Information of MIDWIVES.

I Doubt not in the least but This and the proceeding Chapter will seem needless, and appear superfluous to some Persons, in the Practice of MIDWIFERY; namely, to such as know not the New Improvements of this Art: But especially to such as are accustom’d to the Use of Instruments, they’ll appear altogether Useless and Vain; since such Practitioners can easily (upon any Occasion, without the curious Anatomical Knowledge of these Parts) first slay the INFANT, and then either deliver or kill the WOMAN, as Chance may direct their SHARPS.

BUT for my Part, because I have no Notion of such sort of Weapons, I shall endeavour to acquit my self more honourably, and teach my Followers another way, and That without Blood-shed; as I hope will hereafter more amply appear.

AND First therefore in speaking of the Bones of the PELVIS, I shall begin with the OSSA Innominata; which are two large Bones joined to the Sides of the OS SACRUM. They are compos’d of Three distinct Pieces, each of which has its respective Name: The First and superior is call’d Os Ilium; because the Guts Ilia lie upon it directly. It is Large and almost of a Semicircular Figure, a little Convex and Uneven on its External Side; as it is Concave and Smooth on the Internal. In short, it is join’d to the Sides of the three Superior VertebrÆ of the Os Sacrum, and is Larger in WOMEN than in MEN.

THE Second and Anterior is call’d Os Pubis; which is united in the Forepart to its Fellow-BONE of the other Side, by an intervening Cartilage: By the Extension of which Cartilage, the Ossa Pubis in Young Women, sometimes recede a little from One another, to facilitate a difficult Birth.

THE Third is the Inferiour and Posteriour, call’d Os Ischium, or Coxendix, which has a large Cavity call’d Acetabulum Coxendicis; and This receives the Head of the Os Femoris; the Supercilium or Top of which Cavity joins the Os Pubis.

THESE Three Bones, until the Age of Puberty, may be seen distinctly, tho’ afterwards they grow together, and become one BONE, without leaving any Mark of Division. They adhere on each side to the Os Sacrum by two Strong Ligaments; the Upper of which passes from the Posteriour Acute Process of the Ischium to the Sacrum; as the Lower joins the Tuberculum Ischii to the Sacrum.

THESE Bones in WOMEN are more distant or separated from One another, and are smaller than in MEN; especially the Os Pubis, to the end that the Cavity of the PELVIS, and the Angle betwixt the Os Pubis and Ischium, may be the Larger, for the more commodious Bearing of the Infant, and the more easy Exclusion of it in Birth. But from hence I would no ways infer, that the Ossa Pubis and Ilia sever themselves in time of LABOUR; (notwithstanding the Opinion of some Authors) for I am fully satisfied of the contrary: Because I have conducted more than one Woman in my Time, upon walking out of one Chamber into another, immediately after DELIVERY; which could never have happen’d in Case of such a distant or dislocated Separation.

THESE Bones call’d Innominata are of wonderful Use and Service: For besides that they form the PELVIS, and defend every Part of its Contents, they also give Connexion and Juncture of the rest of the Body, to the Thigh-Bones; as they likewise give Rise and Origin to many Muscles, and are the Basis of Support of the Spine of the Back, as well as of all the Superior Parts. Whence I come À propos to descant a little upon this particular Part, as far as concerns our present Purpose.

THE Spine then is that Bony Column or Ridge, which extends itself down the Back from the Head to the Fundament, containing the Spinal Marrow, and resembling the Letter S in figure.

IN This Spina therefore we must consider its Fivefold Division; namely, into Neck, Back, Loins, Os Sacrum, and Os Coccygis. The First Three consist of 24 VertebrÆ; whereof the Neck has 7, the Back 12, and 5 belong to the Loins. Those of the Neck bend inwards; those of the Back outwards, for enlarging the Cavity of the Thorax; Those of the Loins bend inwards again; and Those of the Os Sacrum outwards, to enlarge the Cavity of the PELVIS.

THE VertebrÆ of the two last concern us most in this Place; wherefore I shall say no more of the rest, save only by the By, or coincidently, as they fall in my way. Those of the Loins then are the Thickest and Broadest, and the Last of them is the Largest of all the VertebrÆ; as their Cartilages are thicker and stronger than any of the Others, and their Acute Processes are at a greater Distance from one another. From whence it comes to pass, that the greatest Motion of the Back is perform’d by the VertebrÆ of the Loins.

THE VertebrÆ of the Os Sacrum grow so close together in Adults, that they make but one large solid BONE, of a Triangular Figure; and yet not without the Mark of a four or five-fold Division: As in Children, it consists of many more Pieces or Divisions. However, its Basis is tyed to the last VertebrÆ of the Loins, and the Upper part of its Sides to the Ilia; as its Point is to the Os Coccygis.

THE Os Coccygis is also in Adults, for the most part, but one entire BONE; tho’ in younger Persons it is compos’d of 3 or 4 small Divisions; Of which the Lower is still less than the Upper; till the Last ends in a small Cartilage. It is join’d in its Glenoide Cavity to the Extremity of the Os Sacrum; being short and bent inwards: It supports the Intestinum Rectum, and yields to the Pressure of the INFANT in Travail: But MIDWIVES ought not to thrust it back or repel it with Violence; No, they should rather handle it gently, if they would prevent dangerous Consequences, as well as great Pain to the Woman in LABOUR.

FROM hence it is manifest, that they are mistaken who imagine that the Opening and Enlargement of the PELVIS, in making way for the INFANT, does depend upon the Separation of the Ossa Pubis: For it much more depends upon the yielding of the Os Sacrum, or its giving way naturally; especially This Part of it call’d Os Coccygis. Neither doth the Straitness of the Upper Part of the PELVIS so much occasion a difficult BIRTH, as the small Distance that is betwixt the Points of the Ossa Pubis, call’d Ossa Sedentaria or Seat-Bones, and the Os Coccygis: No indeed, neither of These can be any great Hindrance to the Passage of the Infant; since all Bones, never so closely knit together with Ligaments, may be moved extensively upon occasion, by carefully and gently stretching the said Ligaments. But, in short, it most commonly happens, that the Ill Position of the Infant itself, or the bad Condition and Situation of the Womb, or Both, occasion a difficult or preternatural Birth.

BUT I would here farther observe yet, that as these Bones differ frequently both in Form and Size, according to the different Constitution of the Body; so neither are they always of the same Substance: For in some Women, we find a great many Nervous and Cartilaginous Ligaments, which penetrate into the solid Substance of the Bones themselves; in which the Ligaments are so fast bound together, that it is hard to distinguish whether they are One or More Bones. From whence, however, it will hereafter appear, that One Woman is more easily delivered than Another; the Bones in One being more firm and immoveable, altogether resisting any Relaxation; which in Another are more loose and pliable, easily give way and yield freely to the Force of the Endeavouring and Struggling INFANT.

THE Contents of this Section will appear more evident, by looking curiously upon a Female SKELETON: In which (for Distinction’s-sake I recite This) that the lower Parts of the Seat-Bones, are generally more distant, and not so much bent inwards, down towards the Point of the Os Coccygis, as in a Male SKELETON. Which Difference, in short, the Omniscient Creator has so order’d, for preventing difficult BIRTHS; and yet, notwithstanding all this wise Provision of Nature, they happen too often in the World. However, having thus, in fine, described the Pelvis and its Bones, as far as is requisite for MIDWIVES, I come next, more particularly to describe that astonishing Piece of God’s Handy-work, to which all the afore-mention’d Parts are ordain’d to minister, and that both conjunctly and severally, without any Exception: viz.

I Say this is that Body, which the Learned Great Men of all Ages have esteem’d and look’d upon as the most wonderful Miracle of Nature, not only because of its singular Substance and Structure, but also of its peculiar Qualities and Faculties.

AS to the Substance and Structure, I have before observed in Chap. 6. of this Section, that it is singularly composed, of an innumerable Multitude of Fibrous Vessels and Muscular Parts; which being All most curiously interwoven, are admirably form’d together in its Constitution.

BUT how particular soever I have been on this Head, in Chap. 5, and 6. I must resume this Topick here, and add, that the Womb, and its Vagina or Neck, are closely join’d together: For it terminates in a Point near its Orifice, intrudes itself into the Vagina, and hangs so down, that in Women not with Child, and sometimes also in the first Months of Pregnancy, This sharp Point may be perceiv’d by the Touch.

AND how closely soever this Orifice of the Womb is shut after Conception or during Pregnancy; yet in a BIRTH it is so expanded, that the Womb and Vagina both seem to have but One and the same Cavity, like a Bag of equal Dimensions; there being then no Difference perceivable between that Orifice and the Vagina, excepting that the VAGINA is Softer and Thinner.

THE Womb may be otherwise aptly compar’d to the Earth; because the same Degree of Affinity that the Earth has to the Seed of Plants, the Womb bears to the Seed of Men: It being the very Secundary Cause in the Constitution of the Human Conception; not indeed the Instrumental only, but also the Active Cause: For whereas the Instrument takes Motion from, and operates by Virtue of Another, the Womb only acts of itself and operates by Virtue of its own Active Faculties.

BUT more particularly, the Womb has sundry proper Actions in this Constitution, which are peculiarly dependent of, and accordingly discharged by Itself only; and therefore it is not the sole or pure Instrumental Agent. But the Reason that I call it the Secundary or Disponent, not the Primary Cause, in constituting the Foetus, is, because the Actions of the Womb do not precisely terminate in this Constitution, but chiefly in disposing the Causes constituting the Man. And as (I think) there are Eight such Actions belonging to the Womb, I shall undertake to define them all particularly in a few Words. And,

I. THE FIRST Action of the Womb is, that by its attractive Faculty, it may allure the Masculine Seed infus’d by Coition into the Fund of its Capacity, after the same manner as a famishing Stomach snatches at the Victuals by the Gullet from the Mouth of the Eater.

II. THE SECOND is like unto the FIRST, and consists in attracting (after the same manner) the Muliebrian Seed from the Vessels of the Testicles, into the same Cavity.

III. THE THIRD Function of the Womb, is the Copulation and mutual Conjunction of the Seeds of both Parents; which it prepares and perfects by its innate Power, constricting itself in all Parts: And this Action, I do not (in this place) call a Permistion of these Seeds, as it is generally term’d, because a Mixture is properly perform’d only by the concording Qualities and mutual Actions of two or more miscible Copulatives, without any Assistance of the Thing Containing.

IV. THE FOURTH Office of the Womb, is an Effusion of the Menstruous Blood upon the aggregated Seed, from a Relaxation of the little Orifices of the Veins terminating in its interiour Surface.

V. THE FIFTH Action of the Womb, is, the Retention of those three conjoin’d Bodies; to effect which Work, the Womb contracts itself on all sides, and shuts up all its Orifices, even to the sensible Animadversion of the Woman.

VI. THE SIXTH Function of the Womb, is to excite the Virtue of the Torpent Lifeless Seed, and rouze it up from Idleness to Activity; as the latent Virtue of Physick in the Body is excited to Operation by the natural Heat of the Viscera.

VII. THE SEVENTH Office of the Womb, is (after the Foetus is Form’d and Organiz’d) the Attraction of the Blood from the Maternal Veins, into the Umbilical Vessels, for its Nutrication and Growth.

VIII. THE EIGHTH and last Function of the Womb, is Birth, which I shall remember to speak more particularly of in its proper Place.

FROM all which we may easily collect the sundry proper Uses of the Womb, and readily comprehend that it is not only destin’d by Nature to admit the Seed, and receive the impregnated Egg from the Ovarium and the Fallopian Tube; but also to contain the Organizing Matter, and all necessary Principles (Active and Passive) for constituting the Conception; fomenting the receiv’d Seeds, by its natural Calidity, preserving the same, and preparing the Maternal Blood by its inherent Temperament, for the Use of the Foetus: Which Foetus it surrounds and defends from external Accidents, by its Substantial Corpulency; containing and nourishing the Infant, about the Space of 9 or 10 Months, by its Faculties of Extension and Attraction; and at last forcing it into the World, by that of Expulsion.

UPON which Occasion, that the MIDWIFE may the better discharge her Duty, and assist the Labouring Woman more effectually, without Fear or Danger, and without committing any Blunder or Mistake; as I have already taught her in what Place the Womb is seated, to what Parts it tends, and how it is annexed, &c; so I shall now proceed to describe its Qualities and Faculties, so far as is necessary, and absolutely requisite in the Practice of MIDWIFERY. And, First, then——

NATURE has endued the Womb with this Faculty, to the end that it may (in Pregnancy) extend and dilate itself Day by Day, in Proportion to the Growth of the Infant, Secundine, and Humours.

NOW the Womb in its lower Part being straitly tied to the Intestinum Rectum and Bladder; it is to be understood that the Distention happens mostly in its superiour Part or Bottom: Which is not only most Free and at greatest Liberty, but also Thickest and aptest for Dilatation.

THIS will appear more evident, when we consider how the Infant adheres to that Part, the Bottom, by means of the Secundine: How the Infant also as it grows, begins to separate the Humours in the Secundine, which (of consequence) encrease as the Infant does: And how again the Encrease of the Humours fill up the Chinks and Vacuums, as I may call them, which the Infant cannot possess. From hence it is that the Womb extends itself in the Form of a Pear, only a little Plainer at Both Ends.

THUS the Secundine adhering^[155] to the Bottom of the Womb, by its thicker Part (call’d the Placenta,) thence it is that the Womb encreases and extends itself more in its Bottom, than in any inferiour Part.

WHEREFORE the Womb being most extended in its upper Part, call’d the Bottom; and both the Bladder and Rectum below being soft loose Parts, it necessarily follows, that the Womb may freely ascend and descend upon Occasion, as we often find it in the Cavity of the Belly; which, however, does not happen to All Women alike.

BUT, in short, these extensive and ascensive Faculties of the Womb, chiefly residing in its Bottom; I would have it laid down for a certain Maxim of Truth, that These exert themselves, without any the least Extenuation to the Uterine Substance: Which Position leads me directly to consider——

TOUCHING the Thickness of the Pregnant Womb, Authors have differ’d extremely: Some thinking, that as the Womb grows Larger, it grows Thicker; and Others the Reverse, that as it extends, it grows Thinner.

NOW these Opinions being both diametrically opposite One to the Other, as Both (perhaps) may be contrary to Truth, I shall freely and ingenuously offer my Sentiments in a few Words; not that I vainly desire to engage myself in any Controversy: Save only, because the true Knowledge of this Point, is so Material and Consequential for all MIDWIVES, especially in Cases of difficult and preternatural Births, that I cannot well excuse myself, should I pass it by with Silence in this Place.

Mr. MAURICEAU, in his Book of the Diseases of Women, contradicting the Authority of Riolanus, Bartholinus, and the whole Body of the most Renown’d and Ingenious Anatomists, both Ancient and Modern, is at great Pains to make us believe, that the impregnated Womb is (like the Bladder) in this Case; the more it is extended, the thinner it grows.

BUT as his quoted Authority of Galen and Carol. Stephanus cannot be sufficient against so many good Authors of the contrary Opinion; so neither will his Demonstrations of Wax, nor Comparisons with the Wombs of Animals, be sufficient to make out his Argument, against confirm’d Experience, common Sense, and current Reason. Which Point of Experience I judge this Author to have been deficient in, otherwise he would certainly have given us some particular Instance or other of it, and not had Recourse to Inconsistencies for supporting his new-fashion’d unreceiv’d Notion. For what Comparison can there be betwixt an Animate and Inanimate Body? Or what Affinity betwixt the WOMB of Animals and that of Women, who are form’d after the Image of God, and (by a Prerogative above all other Creatures) are furnished with a WOMB very different from them?

I ingenuously acknowledge, when I first met with this Author’s Works, not daring then to be too Positive in this Point, I was put into some Suspence of Judgment; which made me not only consult with the best of Authors and Professors of Anatomy, but also induc’d me to embrace every Opportunity of satisfying myself otherways to a full Conviction.

WHEREFORE at all Dissections of pregnant Women, where I have been present, I carefully observed and took notice of this particular Point; upon which I must needs affirm, that I always found the WOMB (however Big or Little) of its natural Thickness, and rather thicker than thinner: For tho’ It is expanded by the growing Infant, &c. yet it may (most probably) be equally condensed, by the Imbibition of the fluent Humours, which consolidate into itself by the Pores of its Plexus Body. Nay, I have not only satisfy’d myself in dead, but also in living Bodies, with respect to this Matter; for by passing One Hand into the WOMB to take away the Secundine, when the Other laid upon the Belly, I clearly discerned the Truth by Sense, and have sometimes found the WOMB not only incredibly Thick, but also Rigid withal: And in this Matter, I have not been singular; for I find the ingenious Daventer writes to the same purpose, upon this Head, in his Book of Midwifery. Having therefore thus, in short, perceiv’d the Thickness of the WOMB, both with my Hands and Eyes, I must trust my Senses, and prefer my Experience before any Man’s bare Conjecture; for tho’ I often see not those Things which I believe, yet I must still believe those Things which I see.

WHENCE I conclude, that the WOMB, tho’ of a different Bigness from the Conception to the Birth, is always, at least, of one Thickness with the unconceiv’d Womb: Which the Divine Wisdom (no doubt) has so ordered for the Preservation of the Mother and Infant; for if the WOMB in Time of Pregnancy did grow Thinner, according to its Extension, it must of Consequence grow Weaker, and, in that Case the Infant would be liable to perforate it with Foot or Hand, which would infallibly terminate in the Loss of both their Lives.

BUT besides, if the WOMB was so Thin and Weak as Mr. Mauriceau imagines; as the Pregnant Woman would be liable to imminent Danger every Moment Before, as well as In Time of Labour; so the Midwife would be expos’d to the greatest of Difficulties: For who then durst, without Horror, offer to turn the Infant, so closely compress’d in those thin Membranes of the WOMB? Or who could have Resolution enough to separate and pull away the After-Birth?

HOWEVER, I could produce innumerable Instances of most Learned and Ingenious Men to support my above-mentioned Opinion; but I shall content myself now with One, who (I think) is of sufficient Authority: For hearing lately that Mr. Mauriceau’s mention’d Book (which I had only read before in its Original French) was translated by Dr. Chamberlain, I doubted not but I should fully discover that Eminent Translator’s Sentiment upon this single Point; whereupon this most famous Physician and Boethogynist marks by way of Observation or a Bene Notandum, that his Charity for his Author makes him believe that French-Women differ in this Point from Our English, with whom it is apparently otherwise order’d. And in the farther Explication of his Author’s Opinion on this Head, he adds, That Experience will convince any inquisitive Person of the Contrary.

TO which I reply, in short, with all due Submission, that the French-Women do not differ one Jot in this respect from Ours, nor Ours from any Others: Which (no doubt) the worthy Doctor was very sensible of, notwithstanding his great Complaisance to his Author.

ALTHOUGH the Ligaments are fixed to the WOMB on each side, under the Tubes, near the Bottom, on purpose to keep it duly in the Middle, from falling to either Side; yet we may easily perceive, First, That the Pregnant WOMB, as it dilates and extends itself most (in the Bottom) above the Ligaments, so it rises Highest and becomes Heaviest in that Part; by which means it cannot always be contained in the narrow Compass of the Pelvis, and the Larger the INFANT is, the Higher the WOMB rises (above the Ligaments) in the Belly. Insomuch that when the Cavity of the Pelvis is not sufficient to contain a large WOMB, fill’d with One or more well-grown INFANTS, together with the Secundines and Humours, it must (of necessity) ascend into the Cavity of the Belly; as is evident from Chap. 10.

SECONDLY, The WOMB being in Form of a Pear, much larger above than below the Ligaments, and that superiour Bulk being only sustain’d at the lower Part by subtile Ligaments apt to extend, as well as supported near the Orifice by the Bladder and Rectum, which are soft, loose, and extensive Parts: Hence, I say, we may easily conceive, that as These are not sufficient to hinder a large Womb from ascending above the Borders of the Pelvis into the Cavity of the Belly; so neither are they able to keep it from leaning or inclining this or that way, by reason of its Weight in the Bottom, which is always the farther distant from the Ligaments, the more it is extended: And the extended Womb being not of the same Firmness and Solidity with That in a natural State, is the more apt and ready to move aside, either on the Right or the Left Hand.

NOW this various Motion of the Womb, in short, will appear more manifestly Probable, when we consider how variously Women with Child move their Bodies, bending them every way for Relief, when oppress’d with Pain; both sitting and lying in different Postures: All which may easily give the Womb a Tendency this or that way, sliding either Forwards or Backwards, to the right or the left Side of the Person.

I Doubt not in the least but among the Many, some will reject this Thesis as False or New-fangled; but They who are Ignorant of it, are meer blind Novices in the Art of Midwifery: For repeated Experience has taught Myself and many Others the Certainty of this Truth; as will more amply appear from the following Discourse.

THE Womb having then ascended into the Cavity of the Belly, if its pointed Parts tend perpendicularly into the Pelvis, so as that its Orifice may be easily touch’d on every Side with the Fingers, its Bottom is placed about the Navel; and This I call a right or natural Situation: But when otherways, the Posture is changed, inclining this or that way, and the Orifice suspended so High, that it can scarce or not at all be touch’d, I call That a wrong and preternatural Position, or oblique Situation of the Womb; which may not only be occasion’d (as is said) by the Weight and Bulk of its Bottom, above the extended and relaxed Ligaments, but also by many other different Causes; such as an obdurated Gland, a Cicatrix, an Ulcer, an Obstruction of the Vessels in the Ligaments or adjacent Parts, &c.

HENCE it is that the wrong Positions of the WOMB are manifold, which would be very tedious to enumerate exactly here; but only, that I may not pass by what is so material, I shall reduce them to a Four-fold Difference; as the Ancients did the Winds, because of the Four Regions or Limits of the Heavens. And Those Four will (I hope) comprehend all other wrong Situations of the WOMB, not very improperly or mal-À-propos, as Ovid^[156] has comprehended These in the following elegant Verses, viz.

THE first bad Position of which is, when the Bottom of the WOMB is placed on the left Side of the Woman, a little raised or depress’d; the Orifice being turn’d towards the Spine of the right Os Ilium or Os Pubis, against which the Infant in time of Birth commonly pushes its Head, beats out its Brains, and sticks there to Death: Or else passing the said Spine, it lies a-thwart the Pelvis.

THE Second ill Position of the WOMB is, when the Bottom is seated on the right Side; the Orifice being turn’d towards the left Part of the Pelvis, directly opposite to the other Position, and attended with the same Inconveniencies.

THE Third is, when, in Women having large Bellies, the WOMB hangs too much Forwards; the Orifice being turn’d towards the Os Sacrum: So that the Infant falls down by the Head into the Bent, or crooked Cavity of the Os Coccygis, where it fatally sticks fast.

THE fourth Oblique Situation of the WOMB is, when its Bottom is press’d too near the Diaphragma, and its Body too near the VertebrÆ of the Loins; the Orifice being elevated, is thereby turned too near the OS PUBIS, where the Infant striking its Head against these Bones, remains immoveable and perishes: Or, (which is worse) sliding with its Head upon the OSSA PUBIS, it is turn’d on one or other Side or Backwards; when (commonly with Hand or Arm out of the Body) it lies a-thwart the Passage, and infallibly occasions its Own or its Mother’s Death, or Both; unless (as in the three preceding Cases) it be in due time prevented by the Assistance of some very skilful Hand.

THOSE are the Four most difficult and principal wrong, or chief preternatural Situations, of the WOMB; from whence we may easily frame a competent Conjecture of the Rest; to wit, when the Bottom of the WOMB is more or less turn’d to the right, or the left Side, or forwards, or backwards: Since as that differs more or less from the natural Position, so the Birth in like manner is (of consequence) the more or less Difficult, as will hereafter manifestly appear.