In Flanders, between Antwerp and Mechlin, in a village called Uthaton, a child was born which had two heads and four arms, seeming like two girls joined together, having two of her arms lifted up between and above their heads: the thighs being placed as it were across one another, according to the following figure. How long they lived is not known; but, probably, life would not be sustained for any length of time; for, even supposing the vital organs were unaffected, by the curious junction of the two bodies, the singularposition of the limbs would, to some extent, interfere with the free actions of life, as well as produce misery to the creature all its days. These vagaries of nature happily seldom occur, and when they do, the friendly stroke of death gives relief.
The following figure shows that though some of the members of the body may be wanting, yet they are commonly supplied by others—by members which serve the same purpose as those which are deficient.
Without doubt some of the stories of monsters are fabulous, but we hesitate not to state that we believe many of them to be true. Nearly every accoucheur has, at some time or other, had cases when they have had to assist in bringinginto the world specimens of the freaks of nature, either deficient of their natural properties, or a superabundance of them. It frequently happens that these prodigies exist but for a short time—death speedily putting an end to what must otherwise be a miserable existence, and little is said about them. The surgical museums in our country contain sufficient proof of the birth of monsters: and there is no denying the fact, that there are cases in which people are born into the world, and from certain peculiarities in their structure have been exhibited to the public as monsters.
Herein I propose to treat of the womb, and the various maladies to which it is subject. By the Grecians it is called metra, the mother; adelphos, says Priscian, because it makes us all brothers.
It is placed in the hypogastrium, or lower part of the body, in the cavity called pelvis, having the strait gut on one side, to keep it from the other side of the backbone, and the bladder on the other side to defend it from blows.
It is divided into the neck and the body. The neck consists of a hard fleshy substance, much like cartilage, at the end whereof is a membrane transversely placed, called hymen, or engion. Near to the neck there is a prominent pinnacle,which is called by Montinus the door of the womb, because it preserves the matrix from cold and dust; by the Grecians it is called clytoris; by the Latins, præputium muliebre.
The body of the womb is that wherein the child is conceived; and this is not altogether round, but dilates itself into two angles, the outward part of it nervous and full of sinews, which are the cause of its motion, but inwardly it is fleshy. In the cavity of the womb there are two cells or receptacles for the seed, divided by a line running through the midst of it. In the right side of the cavity, by reason of the heat of the liver, males are conceived; and in the left side, by the coldness of the spleen, females. Most of our moderns hold the above as an infallible truth, yet Hippocrates holds it but in general: “For in whom (saith he) the spermatic vessels on the right side come from the reins, and the spermatic vessels on the left side from the hollow vein, in them males are conceived in the left side, and females in the right.” Empedocles, in giving his opinion, says, “Such sometimes is in the power of the seed, that the male may be conceived in the left side, as well as in the right.” In the bottom of the cavity, there are little holes called the cotiledones, which are the ends of certain veins and arteries, serving in breeding women to convey substance to the child which is received by the umbilical veins; and others to carry their courses into the matrix.
The menstruals are a monthly flux of excrementitious blood, which is to be understood of the surplus or redundance of it. For it is an excrement in quality, its quality being poor and corrupt, like unto the blood in the veins. Thisis proved two ways; first, from the final cause of the blood, which is the propagation and conservation of mankind, that man might be conceived; and being begotten, he might be comforted and preserved both in the womb and out of the womb. And all will grant it for a truth, that a child, in the matrix, is nourished with the blood. And being out of the womb, it is still nourished with the same; for the milk is nothing but the menstruous blood made white in the breast. Secondly, it is proved to be true, from the generation of it, it being the superfluity of the last aliment of the fleshy part.
The natural end of man and woman’s being is to propagate; and this injunction was imposed upon them by God at their first creation, and again after the deluge. Now, in the act of conception, there must be an agent and patient; for if they be both every way of one constitution, they cannot propagate: man therefore is hot and dry, woman cold and moist; he is the agent, she the patient or weaker vessel, that she should be subject to the office of the man. It is necessary the woman should be of a cold constitution, because in her is required a redundancy of nature for the infant depending upon her; for otherwise, if there were not a surplus of nourishment for the child, more than is convenient for the mother, then would the infant detract and weaken the principal parts of the mother, and like unto the viper, the generating of the infant would be the destruction of the parent.
The monthly purgations continue from the 15th year to the 46th or 50th; yet often there happens a suppression, which is either natural or morbical: they are naturally suppressed in breeding women, and such as give suck.
CHAPTER VII.OF THE RETENTION OF THE MENSES.
The suppression of the terms is an interception of that accustomed evacuation of blood which every month comes from the matrix, proceeding from the instrument or matter vitiated. The part affected is the womb, and that of itself or by consent.
Cause.—The cause of this suppression is either external or internal. The external cause may be heat, or dryness of air, immoderate watching, great labour, vehement motion, &c. whereby the matter is so consumed and the body so exhausted, that there is not a surplus remaining to be expelled. Or it may be caused by cold, making the blood vicious and gross, condensing and binding up the passages, that it cannot flow forth.
The internal cause is either instrumental or material, in the womb or in the blood. In the womb it may be divers ways; by imposthumes, humours, ulcers, by the narrowness of the veins and passages, or by the omentum, in fat bodies, pressing the neck of the matrix, but then they must have hernia, zirthilis, for in mankind the caul reacheth not so low; by overmuch cold or heat, the one vitiating the action, the other consuming the matter by an evil composition of the uterine parts, by the neck of the womb being turned aside, and sometimes, though rarely, by a membrane or excrescence of the flesh growing about the mouth or neck of the womb. The blood may be in fault two ways, in quantity or quality: in quantity, when it is so consumedthat there is not a superplus left, as in viragos, or virile women, who, through their heat and strength of nature, digest and consume all in their last nourishment. The blood likewise may be consumed, and consequently the terms staid, by bleeding at the nose, by a flux of the hemorrhoids, by a dysentery, or bloody flux, by many other evacuations, and by continual and chronical diseases. Secondly, the matter may be vicious in quality; and suppose it to be sanguineous, phlegmatical, bilious, or melancholic; every one of these, if they offend in grossness, will cause an obstruction in the veins.
Signs.—Pains in the head, neck, back, and loins; weariness of the whole body, (but especially of the hips and legs, trembling of the heart.) If the suppression proceed from cold, she is heavy, sluggish, of a pale colour, and has a slow pulse; the urine curdles, the blood becomes waterish and much in quantity, and the excrements are retained. If of heat, the signs are contrary to those now recited. If the retention come of conception, this may be known by drinking of water and honey, after supper, going to bed, by the effect which it worketh; for if, after taking of it, she feels a beating pain upon the stomach, and the lower part of the belly, it is a sign she hath conceived, and that the suppression is natural; if not, then it is vicious, and ought medicinally to be taken away.
Prognostics.—With the evil quality of the womb, the whole body stands charged, but especially the heart, the liver, and the brain; and betwixt the womb and these three principal parts there is a singular concert: First, the womb communicates to the heart by those arterieswhich come from the aorta. Hence, the terms being suppressed, will ensue faintings, swoonings, intermission of pulse, cessation of breath. Secondly, it communicates to the liver by the veins derived from the hollow vein. Hence will follow obstructions, jaundice, dropsies, hardness of spleen. Thirdly, it communicates to the brain by the nervous membrane of the back: hence will arise epilepsies, frenzies, melancholy passion, pain in the after parts of the head, fearfulness, and inability of speaking. Hippocrates says, if the months be suppressed, many dangerous diseases will follow.
Cure.—The suppression is a plethoric effect, and must be taken away by evacuation; and therefore we begin with the phlebotomy. In the midst of the menstrual period open the liver vein; and for the reservation of the humour, two days before the evacuation, open the saphena in both feet; if the repletion be not great, apply cupping-glasses to the legs and thighs, although there should be no hopes of removing the suppression. As in some the cotiledones are so closed, it will be convenient, as much as may be, to ease nature of her burden, by opening the hemorrhoid veins with a leech. After bleeding, let the humours be prepared and made flexible with syrup of calamint, betony, hyssop, mugwort, horehound, fumitory, maiden-hair. Bathe with camomile, pennyroyal, savin, bay-leaves, juniper-berries, rue, marjoram, feverfew. Take of the leaves of maiden-hair, succory, and betony, of each a handful, make a decoction; take thereof three ounces. Syrup of maiden-hair, mugwort, and succory; mix of each half an ounce. Aftershe comes out of the bath, let her drink it off. Purge with pill de agarice, fley-bang, corb, feriæ. Galen commends pilulæ de caberica, coloquintida; as they purge the humour of offending, and open the womb, and strengthen the faculty by their aromatical quality.
If the stomach be overcharged, let her take a vomit, such a one as may work both ways, lest working only upward, it should too much turn back the humour.
After the humour hath been purged, proceed to more proper and forcible remedies. Take of troschisk of myrrh one drachm and a half; of musk ten grains with the juice of smallage; make twelve pills; take six every morning, or after supper going to bed. Take of cinnamon half an ounce, smirutium, valerian aristolochia, of each two drachms; roots of astrumone, drachm saffron, of each two scruples; spec. diambia, two drachms; troschisk of myrrh, four scruples; make half into a powder; with mugwort water and sugar a sufficient quantity, make lozenges, take one drachm of them every morning; or mingle one drachm of the powder with one drachm of the sugar, and take it in white wine. Take of prepared steel, spec. hair, of each two drachms; borax, spec. of myrrh, of each one scruple, with the juice of savin; make it up with the lozenges, and take three every other day before dinner. Take of castor one scruple, wild carrot seed half a drachm, with syrup of mugwort, make four pills; take them in a morning fasting, for three days together, before the wonted time of the purgation. Take of juice of horehound, of each five drachms; rhubarb, spikenard, aniseed, galbanum, asafœtida,marrow root, gentian, with honey, make an electuary, take of it three drachms for a dose. In phlegmatic bodies nothing can be better given than the decoction of the wood guiacum, taken in the morning fasting, and so for twelve days together, without provoking of sweat.
Administer to the lower parts by suffumigations, pessaries, unctions, injections: make suffumigations of cinnamon, nutmeg, cloves, bay berries, mugwort, galbanum, molanthium, amber, &c. Make pessaries of figs, and the leaves of mercury bruised, and rolled up with lint. Make injections of the decoction of origane, mugwort, betony, and eggs; inject it into the womb by an instrument for that purpose. Take of oil of almonds, lilies, capers, camomile, of each an ounce; laudani, oil of myrrh, of each two drachms; with wax make an unguent, with which let the place be anointed; make infusions of fenugreek, camomile, melilot, dill, marjoram, pennyroyal, feverfew, juniper-berries, and calamint; but if the suppression comes by a defect of matter, then ought not the menses to be provoked until the spirits be animated, and the blood again increased; or, by proper effects of the womb, as dropsies, inflammations, &c. then must particular care be used.
If the retention comes from repulsion or fulness, if the air be hot or dry, use moderate exercise before meals, and your meat and drink attenuating; use with your meat garden savory, thyme, origane, and cyche peason: if from emptiness or defect of matter, if the air be moist and moderately hot, shun exercise and watching; let your meat be nourishing and of light digestion, as raw eggs, lamb, chickens, almonds, milk.
CHAPTER VIII.OF THE OVERFLOWING OF THE MENSES.
I shall now treat on the overflowing of the menses, an effect no less dangerous than the former. This immoderate flux is a sanguineous excrement, proceeding from the womb, exceeding both in quantity and time. First, it is sanguineous: the matter of the flux being only blood, wherein it differs from that which is commonly called the false menses, or the whites. Secondly, it proceeds from the womb: for there are two ways from which the blood flows; one by the internal veins of the body of the womb,—and this is called the monthly flux; the other is by those veins which are terminated in the neck of the matrix,—and this is called the hemorrhoids of the womb. Lastly, it is said to exceed both in quantity and time. In quantity, saith Hippocrates, when they flow about eighteen ounces: in time, when they flow about three days: but it is inordinate flowing, when the faculties of the body are thereby weakened. In bodies abounding with gross humours, this immoderate flux sometimes unburdens nature of her load, and ought not to be staid without the counsel of a physician.
Cause.—The cause is internal or external. The internal cause is threefold; in the matter, instrument, or faculty. The matter, which is the blood, may be vicious, by the heat of constitution, climate, or season, heating the blood, whereby the passages are dilated, and the faculty weakened, that it cannot retain the blood; and, byfalls, blows, violent motion, breaking of the veins, &c. The external cause may be lifting, carrying of heavy burdens, unnatural child-birth, &c.
Signs.—The appetite is decayed, the conception is depraved, and the actions weakened; the feet are swelled, the colour of the face is changed, and a general feebleness of the body. If the flux comes by the breaking of a vein, the body is sometimes cold, the blood flows forth in heaps, and that suddenly, with great pain. If it comes through heat, the orifice of the vein being dilated, then there is little or no pain, yet the blood flows faster than it doth in an erosion, and not so fast as it doth in a rupture. If by erosion, or sharpness of blood, she feels a great heat scalding the passage; it differs from the other two, in that it flows not so suddenly, nor so copiously as they do. Lastly, if it proceeds from bad blood drop some of it on a cloth, and when it is dry, you may judge of the quality by the colour. If it be choleric, it will be yellow; if melancholy, black; if phlegmatic, waterish and whitish.
Prognostics.—If with the flux be joined a convulsion, it is dangerous, because it intimates the more noble parts are vitiated: and a convulsion caused by emptiness is deadly. If it continues long, it will be cured with great difficulty: for it was one of the miracles which our Saviour, Christ, wrought, to cure this disease, when it had continued twelve years. If the flux be inordinate, many diseases will ensue, and without remedy; the blood, with the native heat, being consumed, either cachetical, hydropical, or paralytical diseases will follow.
Cure.—The cure is, first, in repelling and carrying away the blood: Secondly, in correcting and taking away the fluxibility of the matter: Thirdly, in incorporating the veins and faculties. For the first, open a vein in the arm, and draw out so much blood as the strength of the patient will permit; and at several times, for thereby the spirits are less weakened, and the refraction so much the greater.
Apply cupping-glasses to the breasts, and also the liver, that the reversion may be in the fountain.
To correct the fluxibility of the matter, cathartical means, moderated with the astrictories, may be used.
If it be caused by erosion, or sharpness of blood, prepare with syrup of violets, wormwood, roses, citron-pill, succory, &c.
If by adust choler, prepare the body with syrup of roses, myrtles, sorrel, and purslain, mixed with water of plantain, knot-grass, and endive. Then purge with rhubarb, one drachm, cinnamon fifteen grains; infuse them one night in endive water; add to the straining, pulp of tamarind, cassia, of each half an ounce; make a potion. If the blood be waterish as it is in hydropical bodies, and flows forth by reason of thinness, to draw off the water it will be profitable to purge with agaric, coloquintida: sweating is proper, for thereby the matter offending is taken away, and the blood carried to the other parts. To procure sweat, use cardus water, with mithridate, or the decoction of guaiacum, and sarsaparilla. The pills of sarsaparilla are commended.
Take of bole ammoniac one scruple, London treacle one drachm, old conserve of roses half an ounce, with syrup of myrtle make an electuary: or, if the flux hath continued long, take of mastic two drachms, olibani troch de carbara, of each one drachm; balustium, one scruple; make a powder;—with syrup of quinces make it into pills; take one before meals. Take the juice of knot-grass, comfrey, and quinces, of each one ounce, camphor, one drachm; dip silk or cotton therein, and apply it to the place. Take of oil of mastic, myrtles, quinces, of each half an ounce; fine bole, trock, decarda, of each one drachm; sanguis draconis a sufficient quantity; make an unguent, and apply it before and behind. Take the plantain, shepherd’s purse, red rose leaves, of each one ounce:—boil all these in plantain water, and make of it two plasters; apply one before and one behind. If the blood flow from those veins which terminated in the neck of the matrix, then it is not the overflowing of the terms, but the hemorrhoids of the womb; yet the same cure will serve both, only the instrumental cure will a little differ: for, in the uterine hemorrhoids, the ends of the veins hang over like teats or bushes, which must be taken away by incision, and then the veins closed up with aloes, fine bole, burnt alum, troch de terrs fiall; myrrh, mastic, with the juice of comfrey and knot-grass, laid plaster-ways thereto.
The air must be cold and dry. All motion of the body must be forbidden. Let her meat be pheasant, partridge, mountain birds, coneys, calf-feet, &c.
CHAPTER IX.OF THE WEEPING OF THE WOMB.
The weeping of the womb is a flux of blood, unnaturally coming from thence by drops, after the manner of tears, causing violent pains, keeping neither period nor time. By some it is referred unto the immoderate evacuation of the menses, yet they are distinguished in the quantity and manner of overflowing, in that they flow copiously and free; this is continual, by little and little, and with great pain and difficulty.
The cause is in the faculty, by being enfeebled that it cannot expel the blood resting there, makes that part of the womb grow hard, and stretcheth the vessels; from whence proceeds the pain of the womb. It may be the matter of the blood which may offend in too great a quantity; or it may be so gross and thick as to flow by drops. The signs will be pains in the head, stomach, and back, with inflammations, suffocations, and excoriations of the matrix. If the strength of the patient will permit, first open a vein in the arm, rub the upper parts, and let her arm be corded, that the force of the blood may be carried backwards: then apply such things as may laxate and mollify the strengthening of the womb, and assuage the sharpness of the blood, as cataplasms made of bran, linseed, and mallows. If the blood be vicious and gross, add thereto mugwort, calamint, dictam, and betony; and let her take of Venice treacle the size of a nutmeg, and the syrup of mugwort everymorning; make an injection of the decoction of mallows, linseed, groundsel, mugwort, with oil of sweet almonds.
Sometimes it is caused by the wind, and then phlebotomy is to be omitted, and instead, take syrup of feverfew one ounce; honey, roses, syrup of roses, of each half an ounce; water of calamint, mugwort, betony, and hyssop, of each an ounce; make a julep. If the pain continues, employ this purgation: take of hieræ one drachm; syrup of roses and luxative one ounce; with the decoction of mugwort make a potion. If it come through the weakness of the faculty, let that be corroborated. If through the grossness and sharpness of the blood, let the quality of it be altered, as I have shown in the foregoing chapter. Lastly, if the excrements be retained, provoke them by a clyster of the decoction of camomile, betony, feverfew, mallows, linseed, juniper berries, aniseed, adding thereto of diacatholicon, half an ounce; hiera picra, two drachms; honey and oil, of each one ounce; nitre a drachm and a half.
From the womb proceed not only menstruous blood, but a distillation of a variety of corrupt humours through the womb, keeping neither courses nor colour, but varying in both.
Cause.—The cause is either promiscuously in the whole body, by a cocochymia, or weakness ofthe same, or in some of the parts, as in the liver, which causeth a generation of corrupt blood, and then the matter is reddish; sometimes the gall being sluggish in its office, not drawing away those choleric superfluities engendered in the liver, the matter is yellowish; sometimes in the spleen, not deficiating and cleansing the blood of the excrementitious parts. It may also come from the catarrh in the head, or from any other corrupt member; but if the matter of the flux be white, the cause is in the stomach by a crude matter there, and vitiated through grief and melancholy, for, otherwise, if the matter were only pituitous, crude phlegm, it might be converted into blood; for phlegm in the ventrical is called nourishment half digested; but being corrupt, though sent into the liver, yet it cannot be turned into nutriment; for the second decoction cannot correct that which the first hath corrupted; and therefore the liver sends it to the womb, which can neither digest nor repel it, and so it is voided out with the same colour it had in the ventricle. The cause also may be in the reins being over-heated, whereby the spermatical causes may be moistness of air, eating of corrupt meats, anger, grief, slothfulness, immoderate sleeping, costiveness.
The signs are, extenuation of the body, shortness and stinking of the breath, loathing of meat, pain in the head, swelling of the eyes and feet, and melancholy: humidity from the womb of divers colours, as red, black, green, yellow, and white. It differs from the menses, in that it keeps no certain period, and is of many colours, all of which generate from blood.
Prognostics.—If the flux be phlegmatical, itwill continue long and be difficult to cure, yet if vomiting or diarrhœa happeneth, it diverts the humour and cures the disease. If it be choleric, it is not so permanent, yet more perilous, for it will cause a cliff in the neck of the womb, and sometimes make an excoriation of the matrix; if melancholic, it must be dangerous and contumacious. Yet the flux of the hemorrhoids administer cure.
If the matter flowing forth be reddish, open a vein in the arm; if not, apply ligatures to the arms and shoulders. Galen cured the wife of Brutus, by rubbing the upper part with crude honey.
If it be caused by a distillation from the brain, take syrup of betony, and marjoram; with sugar and betony water make lozenges, to be taken every morning and evening; Auri Alexandria, half a drachm at night going to bed. If these things help not, use the suffumigation and plaster, as they are prescribed.
If the flux be melancholic, prepare with syrup of maiden-hair, borage, buglos. Purges for melancholy are stamped prunes, two oz.; senna, one drachm; fumitory, a drachm; sour dates, one ounce; with endive water, make a decoction; take of it four ounces, add unto it confections, hamesech three drachms, manna three drachms. Take conserves of borage, violets, buglos, of each a drachm; citron peel candied one drachm; sugar, seven ounces; with rose-water make lozenges.
Lastly, let the womb be cleansed from the corrupt matter. Make injections of the decoction of betony, feverfew, spikenard, bistort, mercury, and sage, adding thereto sugar, oil of sweet almonds, of each two ounces; pessaries also maybe made of silk or cotton, mollified in the juice of the aforesaid herbs.
A dry diet is commended as the best, because in this effect the body most commonly abounds with phlegmatical and crude humours. For this cause Hippocrates counsels the patient to go to bed supperless. Let her meat be partridge, pheasant, and mountain birds, rather roasted than boiled. Immoderate sleep is forbidden, moderate exercise is commended.
This is called in English, “the suffocation of the mother;” because it causeth the womb to be choked. It is a retraction of the womb towards the midriff and the stomach, which so presseth and crusheth up the same, that the instrumental cause of respiration, the midriff, is suffocated, and causes the animating faculty, the efficient cause of respiration, also to be intercepted, while the body being refrigerated, and the action depraved, she falls to the ground as one dead. Many instances are recorded of those who have been considered dead, even by the medical men, in this disorder.
To distinguish the living from the dead the ancients prescribe three experiments: the first is, to lay a light feather to the mouth, and by its motion you may judge whether the patient be living or dead: the second is to place, a glass of water on the breast, and if you perceive it tomove, it betokeneth life: third, to hold a looking-glass to the mouth and nose; and if the glass appears thick, with a little dew upon it, it betokens life. You ought not to depend upon these; for the motion of the lungs, by which the respiration is made, may be taken away so that she cannot breathe, yet the internal transpiration of the heat may remain; which is not manifest by the motion of the breast or lungs, but lies occult in the heart and inward arteries: examples whereof we have in the fly and swallow, who, in cold winters, seem dead, and breathe not at all; yet they live by the transpiration of that heat which is reserved in the heart and inward arteries: therefore, when the summer approacheth, the internal heat being revocated to the outer parts, they revive out of their sleepy ecstacy.
Those women therefore, who seem to die suddenly, let them not be committed unto the earth until the end of three days, lest the living be buried for the dead.
Cause.—The part affected is the womb, of which there is a twofold motion—natural and symptomatical. The natural motion is, when the womb attracteth the seed, or excludeth the infant or secundine. The symptomatical motion, of which we are to speak, is a convulsive drawing up of the womb.
The cause is the retention of the seed, or the suppression of the menses, causing a repletion of the corrupt humours in the womb, from whence proceeds a flatuous refrigeration, causing a convulsion of the ligaments of the womb. And as it may come from humidity or repletion, being a convulsion, it may be caused by emptinessor dryness. And by abortion, or difficult child-birth.
Signs.—At the approaching of the suffocation, there is a paleness in the face, weakness of the legs, shortness of breath, frigidity of the whole body, with a working in the throat, and then she falls down as one void of sense and motion; the mouth of the womb is closed up, and being touched with the fingers feels hard. The paroxysm of the fit being past, she openeth her eyes, and feeling her stomach oppressed, she offers to vomit.
It differs from apoplexy, by reason it comes without shrieking out; also in the hysterical passion the sense of feeling is not altogether destroyed and lost, as it is in the apoplectic disease: and it differs from the epilepsies in that the eyes are not wrested, neither doth any spongy froth come from the mouth; and that convulsive motion, which sometimes, is joined to suffocations, is not universal, and it is in the epilepsies, only this or that matter is convulsed without vehement agitation. In the syncope, both respiration and pulse are taken away, and she swoons away suddenly; but in the hysterical passion, there is both respiration and pulse, though it cannot be well perceived; her face looks red, and she hath a fore-warning of her fit. Lastly, it is distinguished from the lethargy by the pulse, which in one is great, and the other little.
Prognostics.—If the disease arises from the corruption of the seed, it foretells more danger than if it proceed from the suppression of the menses, because the seed is concocted, and of a purer quality than the menstruous blood; and the more pure being corrupted becomes the morefoul. If it be accompanied with a syncope, it shows nature is weak, and that the spirits are almost exhausted; but if sneezing follows, it shows that the heat begins to return, and that nature will subdue the disease.
Cure.—In the cure observe: first, that during the paroxysm, nature must be provoked to expel those malignant vapours which stupify the senses, that she may be called out of that sleepy ecstacy. Secondly, that in the intermission of the fit, proper medicines may be applied to take away the cause.
To stir up nature, fasten cupping-glasses to the hips and navel, apply ligatures unto the thigh, rub the extreme parts with salt, vinegar, and mustard: cause loud clamours and thundering in the ears. Apply to the nose asafœtida, castor, and sal volatile; provoke her to sneeze by blowing up into her nostrils the powder of castor, white pepper, and hellebore; hold under her nose partridge feathers, hair, and burnt leather. The brain is sometimes so oppressed, that there is a necessity for burning the outward skin of the head with hot oil, or with a hot iron. Sharp clysters are available. Take of sage, calamint, horehound, feverfew, marjoram, betony, hyssop, of each one handful; aniseed, half an ounce; coloquintida, white hellebore, of each two drachms; boil in two pounds of water to the half; add the straining oil of castor two ounces, hiera picra two drachms, and make a clyster of it. Hippocrates writes of an hysterical woman, who could not be freed from the paroxysm but by pouring cold water upon her; yet this cure is singular, and ought to be administered only in the heat of summer.
If it be caused by the retention and corruption of the seed, let the midwife take oil of lilies, marjoram, and bays, dissolving in the same two grains of civet, and musk; let her dip her finger therein, and put into the neck of the womb, tickling and rubbing the same.
If it arise from the suppression of the menses look to the cure in chap.XVI.If from the retention of the seed, use such things as will dry up and diminish the seed, as diacimina, diacalaminhes, &c. Amongst potions, the seed of agnus is well esteemed, whether taken inwardly, applied outwardly, or received as suffumigation. Make an issue on the inside of her leg, a hand-breadth below the knee. Make trochisks of agaric, two scruples, wild carrot seed, lign-aloes, of each half a scruple; washed turpentine, three drachms; with conserve of anthos make a bolus. Castor is of excellent use in this case, eight drachms of it taken in white wine: or make pills of it with mithridate, and take them going to bed. Take of white briony root, dried and cut after the manner of carrots, one ounce put in a draught of wine, placing it by the fire, and when it is warm, drink it. Take myrrh, castor, and asafœtida, of each one scruple; saffron and rue-seed, of each four grains; make eight pills, and take two every night going to bed.
Galen, by his own example, commends unto us agaric pulverized one scruple in white wine. Lay to the navel, at bed-time, a head of garlic bruised, fastening it with a swathed band. Make a girdle of galbanum for the waist, and also a plaster for the belly, placing in one part of it civet and musk, which must be laid upon the navel. Take pulveris, benedict, trochisk ofagaric, of each two drachms; of mithridate a sufficient quantity; and so make two pessaries, and it will purge the matrix of wind and phlegm; foment the natural part with salad oil, in which hath been boiled rue, feverfew, and camomile. Take of rose leaves a handful, cloves two scruples; quilt them in a little cloth, and boil them in malmsey the eighth part of an hour, and apply them to the mouth of the womb, as hot as may be endured, but let not the smell get to her nose. A dry diet must still be observed. Let her bread be aniseed biscuit, and her flesh meat roasted.
The falling down of the womb is a relaxation of the ligature, whereby the matrix is carried backward, and in some hangs out the size of an egg. The falling of the womb is, when it sinks down to the entrance of the privities, and appears to the eye either very little or not at all. The precipitation is, when the womb, like a purse is turned inside outward, and hangs betwixt the thighs in the size of a cupping-glass.
Cause.—The external cause is difficult child-birth, violent pulling away of the secundine, rashness and inexperience in drawing away the child, violent coughing, sneezing, falls, blows, and carrying heavy burdens. The internal cause is overmuch humidity flowing into these parts, hindering the operations of the womb, whereby the ligaments by which the womb is supported arerelaxed. The cause in particular is referred to be in the retention of the seed, or in the suppression of the monthly terms.
Signs.—The intestines and bladder are oftentimes so crushed, that the passage of the excrements is hindered; if the urine flows forth white and thick, and the midriff moistened, the loins are grieved, the privities pained, and the womb sinks down to the private parts, or else comes clean out.
Prognostics.—In an old woman it is cured with great difficulty; because it weakens the faculty of the womb, and therefore, though it be reduced to its proper place, yet upon very little illness it returns; and so it is with the younger sort, if the disease be inveterate. If it be caused by a putrefaction of the nerves, it is incurable.
Cures.—The womb being naturally placed between the strait gut and the bladder, and now fallen down, ought not to be put up again, until the faculty, both of the gut and of the bladder, be stirred up. Nature being unloaded of her burden, let the woman be laid on her back, her legs higher than her head; let her feet be drawn up to her hinder parts, with her knees spread; then mollify the swelling with oil of lilies and sweet almonds, or with the decoction of mallows, beets, fenugreek, and linseed; when the inflammation is dissipated, let the midwife anoint her hand with oil of mastic, and reduce the womb into its place. The matrix being up, the situation of the patient must be changed, let her legs be put out at length, and laid together; six cupping-glasses to her breast and navel; boil mugwort, feverfew, red roses, and comfrey in red wine; make a suffumigation for the matrix; andat her coming out of the bath, give her syrup of feverfew one ounce, with a drachm of mithridate. Take laudani, mastic, of each three drachms, make a plaster of it for the navel; then make pessaries of asafœtida, saffron, comfrey, and mastic, adding thereto a little castor.
The matrix seated in its natural abode, the remote cause must be removed. If the body be plethoric, open a vein; prepare with syrup of betony, calamint, hyssop, and feverfew. Purge with pil. hierac, agaric, pil. de colocin. If the stomach be oppressed with crudities, unburden it by vomiting; sudorifical decoctions of lignum sanctum, and sassafras, taken twenty days together, dry up the superfluous moisture, and consequently suppress the cause of the disease.
Let the air be hot and dry, your diet hot and attenuating; abstain from all motion, both of body and mind; eat sparingly, drink little, sleep moderately.
The inflammation of the matrix, is a humour possessing the whole of the womb, accompanied with unnatural heat, by obstructing, and gathering of corrupt blood.
Cause.—The cause of this effect is suppression of the menses, repletion of the whole body, difficult child-birth, vehement agitation of the body, falls, blows, &c.
Signs.—Anguish, pain in the head and stomach; vomiting, coldness of the knees, convulsionof the neck, trembling of the heart; a straitness of breath, by reason of the heat which is communicated to the midriff, the breasts sympathising with the womb, pained and swelled. If the fore part of the matrix be inflamed, the privities are grieved, the urine is suppressed, or flows forth with difficulty. If the after part, the loin and back suffer, the excrements are retained on the right side, the right hip suffers, the right leg is heavy and slow to motion; and so if the left side of the womb be inflamed, the left hip is pained, and the left leg is weaker than the right. If the neck of the womb be refreshed, the midwife shall feel the mouth of it retracted, and closed up with a hardness about it.
Prognostics.—All inflammations of the womb are dangerous, if not deadly; and especially if the total substance of the matrix be inflamed; but they are very perilous if in the neck of the womb.
Cure.—Let the humours flowing to the womb be repelled, for effecting which, after cooling clysters, open a vein in the arm, if she be not enceinte; the day after strike the saphena on both feet, fasten ligatures and cupping-glasses to the arm, and rub the upper part. Purge gently with cassia, rhubarb, and senna two drachms, aniseed one scruple, barley-water a sufficient quantity; make a decoction. At the beginning of the disease anoint the privities and reins with oil of roses and quinces; make plasters of plantain, linseed, barley-meal, white of eggs, and, if the pain be vehement, a little opium; ferment the genitals with the decoction of poppy heads. In the declining of the disease, use incisions of sage, linseed, mugwort, pennyroyal, horehound,and fenugreek; anoint the lower part of the belly with the oil of camomile and violets.
Take lily roots and mallow-roots, of each four ounces; mercury one handful; mugwort, and feverfew, camomile flowers, and melilot, of each a handful and a half; bruise the herbs and fruits, and boil them in a sufficient quantity of milk; then add fresh butter, oil of camomile, and lilies, of each two ounces; bean meal a sufficient quantity; make two plasters,—one before, the other behind.
If the tumour cannot be removed, but tends to suppuration, take fenugreek, mallow-roots, decocted figs, linseed, barley-meal, turpentine, of each three drachms; deer’s suet, half a drachm, opium half a scruple; with wax make a plaster.
Take wormwood and betony of each half a handful; white wine and milk, of each half a pound; boil them until one part be confirmed; then take of this decoction four ounces, honey of roses two ounces, and make an injection. Yet beware that the humours are not brought down to the womb. Take roasted figs and mercury bruised, of each three drachms; turpentine and duck’s grease, of each three drachms; opium, two grains; with wax make a pessary.
Of phlegm neglected, or not perfectly cured, is generated a schirrus of the matrix, which is a hard unnatural swelling, insensibly hindering theoperation of the womb, and disposing the whole body to slothfulness.
Cause.—One cause of this disease may be ascribed to want of judgment in the physician; as many empyrics ministering to an inflammation of the womb, do overmuch refrigerate the humour, that it can neither pass forward nor backward; hence the matter being condensed, degenerates into a hard substance. Other causes may be the suppression or the menstruous retention of the lochi, or after purging; eating of corrupt meats, &c. It may proceed also from obstructions and ulcers in the matrix, or from evil effects in the liver and spleen.
Signs.—If the bottom of the womb be affected, she feels a heavy burden representing a mole; yet differing in that the breasts are attenuated, and that the whole body becomes less. If the neck of the womb be affected, no outward humours will appear; the mouth of it is retracted, and feels hard.
Prognostics.—Schirrus confirmed is incurable, and will turn into a cancer, or incurable dropsy, and ending in a cancer, proves deadly.
Cure.—Where there is a repletion, bleeding is advisable; open the medina on both arms, and the saphena on both feet, more especially if the menses be suppressed. Prepare the humour with syrup of borage, succory, and clarified whey: then take of the following pills according to the strength of the patient:
Take of hiera picra six drachms, black helebore, polybody, of each two drachms and a half; agaric, lapis lazuli, abluti salindiæ, coloquintida, of each one drachm and a half; mix them and make pills. The body being purged, proceed to mollifythe hardness as follows: the privities and neck of the womb with unguent, decalthea, and agrippa; or take opapanax, bdellium, ammoniac, and myrrh, of each two drachms, saffron half a drachm; dissolve the gum in oil of lilies and sweet almonds; with wax and turpentine make an unguent; apply below the navel diacoon, ferelina; make infusion of figs, mugwort, mallows, pennyroyal, althea, fennel roots, melilot, fenugreek, boiled in water. Make an injection of calamint, linseed, melilot, fenugreek, and the four mollifying herbs, with oil of dill, camomile, and lilies dissolved in the same. Three drachms of the gum bdellium; cast the stone pyrites on the coals, and let her receive the fume into the womb. Foment the secret parts with the decoction of the roots and leaves of danewort. Take gum galbanum, opapanax, of each one drachm, juice of danewort, mucilage, fenugreek, of each one drachm; calf’s marrow an ounce, wax a sufficient quantity; make a pessary.
The air must be temperate; use no salt meats.
The uterine dropsy is an unnatural swelling, by the gathering of the wind and phlegm in the cavity, membranes, or substance of the womb, by reason of the debility of the native heat and aliment received.
The causes are overmuch cold or moistness ofthe milt and liver, immoderate drinking, eating of crude meats; all which, causing a repletion, do suffocate the natural heat. It may be caused by the overflowing of the menses, or by any other immoderate evacuation, and by abortions, phlegmons and schirrosities of the womb.
Signs.—The lower parts of the belly, with the genitals, are puffed up, and pained; the feet swell, the natural colour of the face decays, and the appetite is depraved. If she turns herself in the bed, a noise like the flowing of water is heard. Water sometimes comes from the matrix. If the swelling be caused by wind, the belly sounds like a drum; and the wind breaks through the neck of the womb with a murmuring noise. It is distinguished from a general dropsy, in that the lower parts of the belly are most swelled.
Prognostics.—This effect foretells the ruin of the natural functions, by that singular consent the womb hath with the liver, and that therefore general dropsy will follow.
Cure.—Mitigate the pain with fomentation of melilot, mercury, mallows, linseed, camomile, and althea; then let the womb be prepared with hyssop, calamint, mugwort, with the decoction of elder, marjoram, sage, pennyroyal, betony; purge with senna, agaric, and rhubarb. Take rhubarb, and trochisks of agaric, of each one scruple: with juice of iros make pills.
In diseases which have their rise from moisture, purge with pills. And in these effects which are caused by emptiness or dryness, purge with a potion. Fasten a cupping-glass to the belly, with a great fume, and also the navel, especially if the swelling be flatulent: make an issue on theinside of each leg, a hand-breadth below the knee. Apply to the bottom of the belly, as hot as may be endured, a little bag of camomile, cummin, and melilot, boiled in oil of rue; anoint the belly and secret parts with unguent agrippa and unguent aragons; mingle therewith oil of iros: cover the lower parts of the belly with the plaster of bay-berries, or a cataplasm made of cummin, camomile, and briony roots.
Our moderns ascribe great virtues to tobacco-water distilled, and poured into the womb by a metrenchyta. Take balm, southernwood, origen, wormwood, calamint, bay-leaves, marjoram, of each one handful: juniper-berries four drachms; with water make a decoction: of this may be made fomentations and infusions: make pessaries of storax, aloes, with the roots of dictau, aristolochia, and gentian.
The air must be hot and dry; moderate exercise. She may eat the flesh of partridges, larks, chickens, mountain birds. Let her drink be thin wine.
This disease is called by the Greeks mole; and is taken from the load or heavy weight of it, it being a mole or great lump of hard flesh burdening the womb.
It is an inarticulate piece of flesh without form,begotten in the matrix as if it were a true conception. Note two things: first, a mole is said to be inarticulate and without form, it differs from monsters, which are both formate and articulate: secondly, it puts a difference between a true conception and a mole; first, in the genus, in that a mole cannot be said to be an animal: secondly, in the species, because it hath no human figure, and bears not the character of a man: thirdly, in the individual, for it hath no affinity with the parent, either in the whole body or any particular part.
Cause.—The true cause of this fleshy mole proceeds from both the man and from the woman, from corrupt and barren seed in man, and from the menstruous blood in the woman, both emitted together in the womb, where nature finding herself weak, labours to bring forth a vicious conception rather than none; and instead of a living creature, generates a lump of flesh.
Signs.—The menses are suppressed, the appetite is depraved, the breasts swell, and the belly is suddenly puffed up, and waxeth hard. Thus the signs of a breeding woman, and one that breedeth a mole, are one. The first sign of difference is in the motion of the mole; it may be felt to move in the womb before the third month, which an infant cannot; yet the motion cannot be understood of any intelligent power in the mole, but the faculty of the womb and the animal spirits diffused through the substance of the mole; for it hath not an animal but a vegetative source of life, in manner of a plant: secondly, if a mole, the belly is suddenly puffed up; butif a true conception, the belly is suddenly retracted; and then riseth up by degrees: thirdly, the belly being pressed with the hand, the mole gives way; and the hand being taken away, it returns to the place again; but a child in the womb, though pressed with the hand, moves not presently; and being removed, returns slowly, or not at all: lastly, the child continues in the womb not above ten months, but a mole continues sometimes four or five years, more or less, according as it is fastened in the matrix. I have known a mole to fall away in four or five months. If it remain until the eleventh month, the legs wax feeble, and the whole body consumes.
Prognostics.—If, at the delivery of a mole, the flux of the blood be great, it shows the more danger, because nutrition, having been violated by the flowing back of the superfluous humours, where the natural heat is consumed; and parting with so much of her blood, the woman is so weakened in all her faculties, that she cannot subsist without difficulty.
Cause.—We are taught by Hippocrates, that phlebotomy causeth abortion by taking all that nourishment which should preserve the life of the child: wherefore, open the liver vein and saphena in both feet, fasten cupping-glasses to the loins and sides of the belly, let the uterine parts be first mollified, and then the expulsive faculty provoked to expel the burden.
To laxate the ligature of the mole, take mallows with the roots, three handfuls; camomile, melilot, pelitory of the wall, violet leaves, mercury, root of fennel, parsley, of each two handfuls; linseed, fenugreek, each one pound; boilthem in water, and let her sit therein up to the navel. At her going out of the bath, anoint the privities and reins with the following unguent. Take mercury and althea roots, of each half a handful: flos, bracho, ursini, half a handful; linseed, barley-meal, of each six ounces; boil all these with water and honey, and make a plaster; make pessaries of the gum galbanum, bdellium, antimoniacum, figs, hog’s suet, and honey.
After the ligaments of the moles are loosed, let the expulsive faculty be stirred up to expel the moles. Take troch de myrrh, one ounce; castor astrolochia, gentian, dictam, of each an ounce; make a powder; take one drachm in four ounces of mugwort water. Take of hypericon, calamint, pennyroyal, betony, hyssop, sage, horehound, valeria, madder, savine: with water make a decoction; take three ounces of it, with one ounce and a half of feverfew.
But if these things prove not available, then must the mole be drawn away with an instrument put up into the womb, which may be performed by a skilful surgeon. After the delivery of the mole let the flux of blood be stayed as soon as may be. Fasten cupping-glasses to the shoulders and ligatures of the arms. If this help not, open the liver vein in the right arm.