The Works of Aristotle the Famous Philosopher, Aristotle [best fiction novels of all time .txt] 📗
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Anoint the loins also with sandalwood ointment, and once a week wash them with two parts of rose-water and one of white wine mixed together and warmed at the fire. This will assuage the heat of the loins, get rid of the oil of the plaster from the pores of the skin, and cause the fresh ointment or plaster to penetrate more easily, and to strengthen the womb. Some think that a load-stone laid upon the navel, keeps a woman from abortion. The same thing is also stated of the stone called aetites or eagle-stone, if it is hung round the neck. Samian stone has the same virtue.
CHAPTER XVDirections for Women when they are taken in Labour, to ensure their safe Delivery, and Directions for Midwives.
Having thus given the necessary directions to pregnant women, how to manage their health during their pregnancy, I will now add what is necessary for them to do, in order that they may be safely delivered.
When the time of birth draws near, the woman must be sure to send for a skilful midwife, and that rather too soon than too late. She must have a pallet bed ready to place it near the fire, so that the midwife and those who are to help her, may be able to pass round it, and give assistance on either side, as may be required. A change of linen must be in readiness, and a small stool to rest her feet against, as she will have more power when her legs are bent, than when they are straight.
When everything is thus ready, and when the woman feels the pains coming on, if the weather be not cold, she should walk about the room, rest on the bed occasionally, waiting for the breaking of the waters, which is a fluid contained in one of the outward membranes, and which flows out thence, when the membrane is broken by the struggles of the child. There is no special time for this discharge, though it generally takes place about two hours before the birth. Movements will also cause the womb to open and dilate, and when lying long in bed will be uncomfortable. If she be very weak she may take some mild cordial to give her strength, if her pain will permit her; and if the labour be tedious, she may be revived with chicken or mutton broth, or she may take a poached egg; but she must be very careful not to eat to excess.
There are many postures in which women are delivered; some sitting in a chair, supported by others, or resting on the bed; some again upon their knees and resting on their arms; but the safest and most commodious way, is in the bed, and then the midwife ought to observe the following rules:—Let her lay the woman upon her back, with her head a little raised by means of a pillow, with similar supports for her loins and buttocks, which latter should also be raised, for if she lies low, she cannot be delivered so easily. Then let her keep her knees and thighs as far apart as she can, her legs bent inward towards each other, and her buttocks, the soles of her feet and her heels being placed upon a small rest, placed for the purpose, so that she may be able to strain the stronger. In case her back should be very weak, a swathing band should be placed under it, the band being doubled four times and about four inches broad. This must be held by two persons who must raise her up a little every time her pains come on, with steady hands and in even time, but if they be not exact in their movements, they had better leave her alone. At the same time two women must hold her shoulders so that she may strain out the foetus more easily; and to facilitate this let one stroke or press the upper part of her stomach gently and by degrees. The woman herself must not be nervous or downhearted, but courageous, and forcing herself by straining and holding her breath.
When delivery is near, the midwife must wait patiently until the child's head, or some limb, bursts the membranes, for if the midwife through ignorance, or through haste to go to some other woman, as some have done, tears the membrane with her nails, she endangers both the woman and the child; for by lying dry and lacking that slipperiness which should make it easy, it comes forth with severe pains.
When the head appears, the midwife must hold it gently between her hands, and draw the child, whenever the woman's pains are upon her, but at no other times; slipping her forefingers under its armpits by degrees, and not using a rough hand in drawing it out, lest the tender infant might become deformed by such means. As soon as the child is taken out, which is usually with its face downwards,—it should be laid upon its back, that it may receive external respiration more freely; then cut the navel string about three inches from the body, tying the end which adheres to it with a silk string, as closely as you can; then cover the child's head and stomach well, allowing nothing to touch its face.
When the child has been thus brought forth, if it be healthy lay it aside, and let the midwife attend to the patient by drawing out the afterbirth; and this she may do by wagging and stirring it up and down, and afterwards drawing it out gently. And if the work be difficult, let the woman hold salt in her hands, close them tightly and breathe hard into them, and by that she will know whether the membranes are broken or not. It may also be known by making her strain or vomit; by putting her fingers down her throat, or by straining or moving her lower parts, but let all be done immediately. If this should fail, let her take a draught of elder water, or the yolk of a new laid egg, and smell a piece of asafoetida, especially if she is troubled with a windy colic. If she happen to take cold, it is a great obstruction to the afterbirth; in such cases the midwife ought to chafe the woman's stomach gently, so as to break, not only the wind, but also to force the secundine to come down. But if these should prove ineffectual, the midwife must insert her hand into the orifice of the womb and draw it out gently.
Having thus discussed common births, or such as are generally easy, I shall now give directions in cases of extremity.
CHAPTER XVIWhat ought to be done in cases of extremity, especially in women who, in labour, are attacked by a flux of blood, convulsions and fits of wind.
If the woman's labour be hard and difficult, greater care must be taken than at other times. And, first of all, the situation of the womb and her position in lying must be across the bed, and she must be held by strong persons to prevent her from slipping down or moving during the surgeon's operations. Her thighs must be put as far apart as possible, and held so, whilst her head must rest upon a bolster, and her loins be supported in the same manner. After her rump and buttocks have been raised, be careful to cover her stomach, belly and thighs with warm clothes, to keep them from the cold.
When the woman is in this position, let the operator put up his or her hand, if the neck of the womb be dilated, and remove the coagulated blood that obstructs the passage of the birth; and by degrees make way gently, let him remove the infant tenderly, having first anointed his hand with butter or some harmless salve. And if the waters have not come down, they may then be let out without difficulty. Then, if the infant should attempt to come out head foremost, or crosswise, he should turn it gently, to find the feet. Having done this, let him draw out one and fasten it with ribbon and then put it up again, and by degrees find the other, bringing them as close together and as even as possible, and between whiles let the woman breathe, and she should be urged to strain so as to help nature in the birth, that it may be brought forth. And to do this more easily, and that the hold may be surer, wrap a linen cloth round the child's thighs, taking care to bring it into the hand face downwards.
In case of flux of blood, if the neck of the womb be open, it must be considered whether the infant or the secundine, generally called the afterbirth, comes first, and as the latter happens to do so occasionally, it stops the mouth of the womb and hinders the birth, and endangers both the woman's and the child's life. In this case the afterbirth must be removed by a quick turn. They have deceived many people, who, feeling their softness, have supposed that the womb was not dilated, and by that means the woman and child, or at least the latter, have been lost. When the afterbirth has been removed, the child must be sought for and drawn out, as directed above; and if the woman or the child die in such a case, the midwife or the surgeon are blameless because they have used their best endeavours.
If it appears upon examination that the afterbirth comes first, let the woman be delivered as quickly as possible, because a great flow of blood will follow, for the veins are opened, and on this account two things have to be considered.
First:—The manner in which the afterbirth advances, whether it be much or little. If the former, and the head of the child appears first, it may be guided and directed towards the neck of the womb, as in the case of natural birth, but if there appears any difficulty in the delivery, the best way is to look for the feet, and draw it out by them; but if the latter, the afterbirth may be put back with a gentle hand, and the child taken out first. But if the afterbirth has come so far forward that it cannot be put back, and the child follows it closely, then the afterbirth must be removed very carefully, and as quickly as may be, and laid aside without cutting the entrail that is fastened to it; for you may be guided to the infant by it, which must be drawn out by the feet, whether it be alive or dead, as quickly as possible; though this is not to be done except in cases of great necessity, for in other cases the afterbirth ought to come last.
In drawing out a dead child, these directions should be carefully followed by the surgeon,
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