PARTURITION. 
women to the different pofitions and motions of the ute¬ 
rus ; of which laft, Plato, who lived immediately after 
Hippocrates, gives a very odd and romantic defcription, 
in his Timseus. After affirming “ that there is implanted 
in the genitals of man, an imperious headftrong inobe- 
dient power, that endeavours to fubje£l every thing to its 
furious lulls;” he fays, “ the vulva and matrix of women 
is alfo an animal ravenous after generation, which, being 
baulked of its defire for any length of time, is fo enraged 
at the difappointment and delay, that it wanders up and 
down through the body, obltrudting the circulation, Hop¬ 
ping the breath, producing fuffocations and all manner of 
difeafes.” 
Although there is a piece in Englilh, called “ Ariftotle’s 
Midwifery,” we find little or nothing of the practice in 
his works. He has written on the generation of animals ; 
and we find in him feveral hints, curious enough, even 
upon our fubjeft. He tells us, that women fuffer more 
than other animals from uterine geftation and labour ; 
that tliofe women who take mod exercife, endure both 
with the greateft eafe and fafety; and that the foetus in 
all animals naturally comes by the head, becaufe, there 
being more matter above than below the navel, the head 
neceffarily tilts downwards. For this reafon, he fays, 
every birth in which the head prefents is natural, and 
thofe unnatural in which the feet, or any other part of the 
body, come foremoft. 
We have nothing written on the fubjefl of parturition 
from his time to that of Celfus, who is fuppofed to have 
lived in the reign of the emperor Tiberius. This author 
has given a chapter on the delivery of dead children, and 
the placenta, in which he has copied from Hippocrates, 
though he is more full than his mailer, and mentions fe¬ 
veral improvements on his practice. After having given 
direflions with regard to the woman’s pofition, he advifes 
the operator to introduce one finger after another until 
the whole hand (hall gain admittance; he fays, that the 
largenefs of the uterus, and the ftrength and courage of 
the patient, are great advantages to the birth; that the 
woman’s abdomen and extremities mud be kept as warm 
as poffible ; that we mud not wait until an inflammation 
is produced, but aflift her without delay; becaufe, fliould 
her body be fwelled, we can neither introduce our hands, 
nor deliver the child, without great difficulty ; and vo¬ 
mitings, tremors, and convulfions, often enfue. 
Rufus Ephefius, who lived in the reign of Trajan, gives 
a. fhort account of the uterus and its appendages, and 
defcribes thofe tubes which are now called Fallopian, as 
opening into the cavity of the womb; though Galen ar¬ 
rogates this difcovery to himfelf, fo particularly, as to fay 
upon this fubjeft, that he was furprifed to find they had 
el'caped the notice of the common herd of anatomifts; 
but more efpecially amazed that a man of Kerophilus’s 
accuracy fliould be ignorant of them : yet Rufus has ex- 
prefsly mentioned the opinion of Herophilus on this par¬ 
ticular. 
Galen was born in the time of the emperor Adrian, 
A. D. 131. about fix hundred years after Hippocrates, 
upon whofe works he writes commentaries, and gives 
fome reafonable aphorifms relating to women and children. 
We have two books of his writing, de Semine (the third 
being accounted fpurious) ; one, De Uteri Diffeciione, de 
Fcetuum Formatione, De Septimejtri Partu, De Ufu Par- 
tium■ In his phyfiology he is prolix and inaccurate : his 
anatomy is pretty exa6t in many things; but, upon the 
whole, he contains little or nothing to our purpofe. 
In Oribafius, who was phyfician to Julian, we have 
a defcription of the parts, and in feveral places of his 
works, an account of the medicines ufed by the ancients 
in the difeafes of women and children: he has alfo a chap¬ 
ter on the choice of a nurfe, and another upon the milk ; 
but fays nothing of the operation. 
AEtius, who (according to Le Clerc) lived in the end 
of the fourth, but in the opinion of Dr. Freind in the end 
Vol. XVIII. No. 1273. 
665 
of the fifth, century, was likewife a colleflor from the 
ancients: for neither he nor Oribafius can be ftyled ori¬ 
ginal writers : the lad indeed, copied from none (almofl) 
but Galen, and was therefore called Simiu Galeni; where¬ 
as the other compiled from all the authors that went be¬ 
fore him, many of whom would have been loft in obli¬ 
vion, had not they been mentioned in his works ; he is 
very particular upon the difeafes and management of 
women ; his fourth Sermo of the 4th Tetrab being ex- 
prefsly written on this fubjeft, and containing almofl: 
every thing which had been faid before him. 
In his firft chapter, De Uteri Situ, Magnitudihe, ae 
Forma, he diftin< 5 lly divides the womb into a fundus and 
neck, and defcribes the os tinea; as ending in the finus 
muliebris, Jive pudendum, which plainly appears to be no 
other than what we now call the vagina; for, he fays, it 
is above fix inches in length ; but his defcription of the 
figure of the uterus is imperfeft. His feventh chapter 
treats of conception, from Soranus. In his twelfth and 
fifteenth chapters he gives a detail of Afpafia’s praflice 
in the care and management of women, during preg¬ 
nane}', and in time of labour; but the greateft part of 
thefe and the other chapters are taken from Hippocrates, 
to whom he has made a few infignificant additions, until 
we come to the twenty-fecond, in which there is a very 
full and diftincl account of difficult births. 
Among the caufes that produce difficult labours, he 
enumerates weaknefs of mind or body, or both, a con¬ 
fined uterus, a narrow paffage, natural fmallnefs of the 
parts, obliquity of the neck of the uterus, a flefhy fub- 
ftance adhering to the cervix or mouth of the womb, in¬ 
flammation, abfeefs, or induration of the parts, rigidity 
of the membranes, premature difeharge of the waters, 
which ought to be detained for moiftening and lubricating 
the parts, a ftone preffing againft the neck of the bladder, 
and extraordinary fatnefs ; an anchylofis of the ofl'a pu¬ 
bis at their junflure, by which they arediindered from fie- 
parating in time of parturition, too great preflu re of the 
uterus on the cavity of the loins, or too great quantity 
of faeces and urine retained in the reflum and bladder, an 
enfeebled conftitution, advanced age, flender make, and 
greennefs of years, attended with weaknefs and inexperi¬ 
ence. He obferves, that difficult labours likewife proceed 
from circumftances belonging to the child that is to be 
born ; from the extraordinary fize of the body, or any 
part of it; from its being unable (through weaknefs) to 
facilitate the birth by its leaping and motion: from the 
crowding of two or three feetufes : from twins prefenting 
together at the mouth of the womb : from the death of 
the child, as it can give no affiftance in promoting labour: 
from its tumefaflion after death, and wrong presentation. 
His twenty-third chapter contains the method of ex- 
trafiion and exfeflion of the feetus, from Philumenus. 
He fays, before the operator begins to deliver by exfec- 
tion, he ought to confider the ftrength of the patient, and 
determine with himfelf, whether or not there is a proba¬ 
bility of faving her life ; becaufe, if fhe is exhaufted, ener¬ 
vated, lethargic, or convulfed, with a difordered pulfe, it 
is better to decline the operation, than run the rifque of 
her periftiing under his hands; but, if he thinks her 
ftrength and courage fufficient for the occafion, let her be 
laid in bed, on her back, her head being low, and her legs 
held afunder by ftrong experienced women ; the may take, 
by way of cordial, two or three mouthfuls of bread dipped’ 
in wine, in order to prevent her fainting; for which pnr- 
pofe, her face may be alfo fprinkled with wine durin°- 
the operation. _ The chirurgeon, having opened the put 
denda with an inftrument, and obferved the fource of the 
difficulty, whether tumor, callus, or any of the caufes 
already mentioned, he mud take hold of it with a forceps, 
and amputate with a biftory: if a membrane obftrufls 
the mouth of the womb, it mud be divided : if the deli¬ 
very is prevented by the rigidity of the membranes that 
envelop the feetus, they mull be pinched up with a pair 
