flux, or any other great distemper. Also, excrements retained cause
great difficulty, and so does a stone in the bladder: or when the
bladder is full of urine, without being able to void it, or when the
woman is troubled with great and painful piles. It may also be from the
passages, when the membranes are thick, the orifice too narrow, and the
neck of the womb not sufficiently open, the passages strained and
pressed by tumours in the adjacent parts, or when the bones are too
firm, and will not open, which very much endangers the mother and the
child; or when the passages are not slippery, by reason of the waters
having broken too soon, or membranes being too thin. The womb may also
be out of order with regard to its bad situation or conformation, having
its neck too narrow, hard and callous, which may easily be so naturally,
or may come by accident, being many times caused by a tumour, an
imposthume, ulcer or superfluous flesh.

As to hard labour occasioned by the child, it is when the child happens
to stick to a mole, or when it is so weak it cannot break the membranes;
or if it be too big all over, or in the head only; or if the natural
vessels are twisted about its neck; when the belly is hydropsical; or
when it is monstrous, having two heads, or joined to another child,
also, when the child is dead or so weak that it can contribute nothing
to its birth; likewise when it comes wrong, or there are two or more.
And to all these various difficulties there is oftentimes one more, and
that is, the ignorance of the midwife, who for want of understanding in
her business, hinders nature in her work instead of helping her.

Having thus looked into the cause of hard labour, I will now show the
industrious midwife how she may minister some relief to the labouring
woman under these difficult circumstances. But it will require judgment
and understanding in the midwife, when she finds a woman in difficult
labour, to know the particular obstruction, or cause thereof, that so a
suitable remedy may be applied; as for instance, when it happens by the
mother's being too young and too narrow, she must be gently treated, and
the passages anointed with oil, hog's lard, or fresh butter, to relax
and dilate them the easier, lest there should happen a rupture of any
part when the child is born; for sometimes the peritoneum breaks, with
the skin from the privities to the fundament.

But if the woman be in years with her first child, let her