The Works of Aristotle - THE DISEASES OF THE WOMB.

THE DISEASES OF THE WOMB.

 

I HAVE already said, that the womb is the field of generation; and if this field be corrupted it is in vain to expect any fruit though it be ever so well sown; it is, therefore, not without reason, that I intend in this chapter to set down the several distempers to which the womb is obnoxious, and proper and safe remedies against them.

 

SECT. I. Of the Hot Distempers of the Womb.

THIS distemper consists in the excess of heat; for the heat of the womb is necessary for conception but if it be too much, it nourisheth not the seed, but disperseth its head, and hinders the conception: this preternatural heat is sometimes from the birth, and makes them barren; but if it be accidental, it is from hot causes that bring the heat and the blood to the womb: it arises also from internal and external medicines, and from too much hot meat, drink, and exercise. Those that are troubled with this distemper have but few courses; and those yellow, black, burnt, or sharp, have hair betimes on their privities; they are very prone to lust, and are subject to the headache, and abound with choler. And when the distemper is strong upon them, they have but few terms, and out of order, being bad and hard to flow, and in time they become hypochondriacs, and for the most part barren, having sometimes a frenzy of the womb.

The remedy is to use coolers, so that they offend not the vessels that must be open for the flux of the terms. Therefore inwardly use coolers, such as succory, endive, violets, water-lilies, sorrel, lettuce, saunders, and syrups, and conserves made thereof. Also take conserve of succory, violets, water-lilies, burrage, each an ounce; conserve of roses half an ounce, diamargation friged diatriascantal each half a dram; and with syrup of violets, or juice of citrons, make an electuary. For outward applications make use of ointment of roses, violets, water-lilies, gourds, Venus-narvel, applied to the back and loins.

Let the air be cool, her garments thin, and her meat endive, lettuce, succory, and barley. Give her no hot meats, nor strong wine, unless mixed with water. Rest is good for her, but she must abstain from copulation, though she may sleep as long as she will.

SECT. III. Of the cold Distempers of the Womb.

THIS distemper is the reverse of the foregoing, and equally an enemy to generation, being caused by a cold quality abounding to excess, and proceeds from a too cold air, rest, idleness, and cooling medicines. It may be known by an aversion to venery. and taking no pleasure in the act of copulation when they spend their seed. Their terms are phlegmatic, thick, and slimy, and do not flow as they should. The womb is windy, and the seed crude and waterish, it is the cause of obstructions and barrenness, and hard to be cured.

For the cure of this distemper use this water: take galangal, cinnamon, nutmeg, mace, cloves, each two drams; ginger, cubebs, zedoary, cardamom, each an ounce; grains of paradise, long pepper, each half an ounce; beat them, and put them into six quarts of wine for eight days; then add sage, mint, balm, motherwort, each three handfuls. Let them stand eight days more, then pour off the wine, and beat the herbs and the spices, and then pour on the wine again, and distil them. Or you may use this: take cinnamon, nutmegs, doves, mace, ginger, cubebs, cardamoms, grains of Paradise, each an ounce and a half; galangal six drams, long pepper half an ounce, zedoary five drams; bruise them and add six quarts of wine; put them into a cellar nine days, daily stirring them; then add of mint two handfuls, and let them stand fourteen days, pour off the wine and bruise them, and then pour on the wine again, and distil them. Also anoint with oil of lilies, rue, angelica, bays, cinnamon, cloves, mace, and nutmeg. Let her diet and air be warm, her meat of easier concoction, seasoned with aniseed, fennel, and thyme, and let her avoid raw fruits and milk diets.

SECT. IV. Of the Inflation of The Womb.

THE inflation of the womb is a stretching of it by wind, called by some a windy mole; the wind proceeding from a cold matter, whether thick or thin, contained in the veins of the womb, by which the weak heat thereof is overcome and it either flows thither from other parts, or is gathered there by cold meats or drinks; cold air may be a procuring cause of it also, as women that lie in are exposed to it. The wind is contained either in the cavity of the vessels of the womb, or between the tunicles, and it may be known by a swelling in the region of the womb, which sometimes reaches to the navel, loins, and diaphragma; and it rises or abates as the wind increases or decreases. It differs from the dropsy, in that it never swells so high; and that neither the physician nor midwife may take it for a conception, let them observe the signs of a woman with child laid down in the first part of this book; and if one sign be wanting, they may suspect it to be an inflation, of which this is a farther sign, that in conception the swelling still increaseth, and sometimes decreaseth; also if you strike upon the belly, in an inflation, there will be a noise, but not so in case there is a conception. It also differs from a mole, because in that there is a weight and hardness in the belly; and when they move from one side to another, they feel a weight which moveth; but not so in this. If the inflation be without the cavity of the womb, the pain is greater and the more extensive, nor is there any noise, because the wind is more pent up.

This distemper is neither of a long continuation, nor dangerous, if looked after in time; and if it be in the cavity of the womb, is more easily expelled. To which purpose give her diaphnicon, with a little castor, and sharp clysters that expel wind. If this distemper happen to a women in travail, let her not purge after delivery, nor bleed, because it is from a cold matter; but if it come after child-bearing, and her terms come down sufficiently, and that she has fulness of blood, let the Saphena vein be opened; after which let her take the following electuary: take conserve of betony and rosemary, of each an ounce and a half; candied eringoes, citron peels candied, each half an ounce; Diacimium, diagalengal, each a dram; oil of aniseed six drops, and with syrup of citrons make an electuary. For outward applications make a cataplasm of rue, mugwort, camomile, dill, calamints, new pennyroyal; thyme, with oil of rue, keir, and camomile; and let the following clyster, to expel wind, be put into the womb: Take agnus castus, rye, calamint, each a handful; aniseed, castus, cinnamon, each two drams, boil them in wine to half a pint. She may likewise use sulphur, baths, and spa waters, both inward and outward, because they expel wind.

SECT. V. Of a Dropsy in the Womb.

THIS is another morbific effect of the womb, proceeding from water, as that before mentioned did from wind; by which the belly is so swelled, that it deceives many, causing them to think themselves with child, when indeed they are not; being no other than unnatural swelling raised by the gathering together of waters, from moisture, mixed with the terms, and with an evil sanguification from the liver and spleen; also by immoderate drinking, or the eating of crude meats, all which causing a repletion, do suffocate the native heat; it may also be caused by the overflowing of the courses, or by any other immoderate evacuation. The signs of this distemper are: the lower parts of the belly, with the privities, are puffed up and pained; the feet swell, the natural colour of the face decays; the appetite is departed, the terms also are fewer, and cease before their time; her breasts are also soft, but without milk. This is distinguished from a general dropsy, in that the lower parts of the belly are most swelled; neither does the sanguificative faculty appear so hurtful, nor the urine so pale, nor the countenance so soon changed, neither are the superior parts so extenuated, as in a general dropsy. But yet this distemper foretells the total ruin of the natural functions, by that singular consent the womb hath with the liver, and therefore an evil habit of body or a general dropsy will follow.

For the cure of this disease, first mitigate the pain with fomentations, of mellilot mallows, linseed, camomile, and althea, then let the humour be prepared with syrup of stoechus, calamint, mugwort of both sorts, with the distilled waters or decoctions of elder, marjoram, sage, origin, speerage, pennyroyal, and bettony; and let her purge with senna, agaric, rhubarb, and eliterian. To purge the water; take calamints, mugwort, lovage roots, pennyroyal, each a handful; savil, a pugil; madder roots, angelica, of each half an ounce; boil them in water, and sweeten them with sugar. Or, if she likes it better, make broths of the same. Also take specirem diambree, diamesci, dulcis, diacalamenti, diacinnamoni, diacimini, troce de myrrh, of each two drams; sugar one pound, with bettony water make lozenges, and let her take of them two hours before meals. Apply also to the bottom of the belly, as hot as can be endured, a little bag of camomile, cummin, and mellilot boiled in oil of rue; and anoint the belly and privities with unguentum Agrippae, mingling therewith oil of Iroes. Let the lower parts of the belly be covered with a plaister of bay berries, or with a cataplasm made of cummin, camomile and briony roots, adding thereto cows' and goats' dung. For injection into the womb: Take asarum roots three drams, pennyroyal, calamint, each half a handful, savin, a pugil, mechoacan a dram; aniseed, cummin, each half a dram. Boil them, and take six ounces strained, with oil of elder and orris, each an ounce; and inject it into the womb by a metrenchita; let the air be hot and dry; moderate exercise may be allowed, but much sleep is forbidden. She may eat the flesh of partridges, larks, chickens, mountain birds, hares, coneys, etc.; and let her drink be wine, mixed with a little water.

SECT. VI. Of an Inflammation of the Womb.

THIS effect is a tumour possessing the womb, accompanied with unnatural heat, by obstruction, and gathering together of corrupt blood; for the blood that comes to the womb gets out of the vessels into its substance, and grows hot, putrefies, and causeth inflammation, either all over, or in part, before or behind, above or below. This happens also by suppression of the menstrues, repletion of the whole body, immoderate copulation, often handling of the genitals, difficult child-birth, vehement agitation of the body, or by falls or blows. The signs of this inflammation are tumours, with heat and pain in the region of the womb, stretching and heaviness in the privities, also a pain in the head and stomach, with vomiting, coldness of the knees, convulsions of the neck, dotting, trembling of the heart, and sometimes straitness of the breath, by reason of heat which is communicated to the diaphragma, or midriff; and the breasts, sympathising with the womb, are pained and swelled; but more particularly if the forepart of the matrix be inflamed, the privities are grieved, and the urine is suppressed, or flows forth with difficulty; if it be behind, the loins and back suffer, and the belly is bound; if the inflammation be in the bottom of the womb, the pain is towards the navel; if the neck of the womb be affected, the midwife, putting up her finger, may feel the mouth of it retracted and closed up, with a hardness about it. As to the prognostics of it, all inflammations of the womb are dangerous, and sometimes deadly; especially if it be all over the womb; if the woman be with Child she rarely escapes; an abortion follows, and the mother dies.

As to the cure: First, let the humours flowing to the womb be repelled; for the effecting of which, after the belly hath been opened by cooling clysters, letting of blood will be needful; open therefore a vein in the arm, but have a care of bleeding in the foot, lest thereby you draw more blood to the womb; but afterwards to derive; if it be from the terms, stop it you may. The opinion of the Galen is, that the blood may be diverted by bleeding in the arm, or cupping the breasts; and that may be by opening an ankle vein, and cupping upon the hips. Then purge gently with cassia, rhubarb, senna, and mirobolana, thus: Take senna two drams, aniseed one scruple, mirobolana half an ounce, barley water a sufficient quantity, make a decoction; dissolve it in syrup of succory, with rhubarb two ounces, pulp of cassia half an ounce, oil of aniseed two drops, and make a potion. Also at the beginning of the disease anoint the privities and reins with oil of roses and quinces. Make plaisters of plantain, linseed, barley-meal, mellilot, fenugreek, and white of eggs; and if the pain be vehement, add a little opium. For repellers and anodynes take Venus-narvel, purslain, lettuce, house-leek, vine-leaves, each a handful, boil them in wine, and barley-meal, two ounces; pomegranate flowers two drams, boil a dram with oil of roses, and make a poultice. Or take diacibilon simple, two ounces, juice of Venus-narvel, and plantain, each half an ounce, take of fenugreek, mallow roots, decocted figs, linseed. barley-meal, dove's dung, turpentine, of each three drams; deer's suet, half a dram, opium half a scruple, and with wax make a plaister. After it is ripe, break it by motion of the body, coughing, sneezing, or else by cupping and pessaries: as, Take rue half a handful, figs an ounce, pigeon's dung, orris roots, each half a dram; with wool make a pessary. After it is broken, and the pains abate, then cleanse and heal the ulcer with such cleansers as these: viz., whey, barley water, honey, wormwood, smallage, gribus, orris, birthwort, myrrh, turpentine, alum: as take new milk boiled a pint, honey, half a pint, orris powder half an ounce, and use it very often every day. If it break about the bladder use an emulsion of cold seeds, whey, and syrup of violets. Let her drink barley water or clarified whey, and her meat be chickens, and chicken broth, boiled with endive, succory, bugloss, and mallows.

SECT. VII. Of Schirrosity And Hardness of the Womb.

PHLEGM or swelling in the womb neglected, or not perfectly cured, often produces a schirrosity in the matrix, which is a hard insensible, unnatural swelling, causing barrenness, and begetting an indisposition of the whole body. The immediate cause is a thick, earthy humour (as natural melancholy for instance), gathered in the womb, and causing a schirrous without inflammation. It is a proper schirrous when there is neither sense nor pain, and it is an improper schirrous when there is some little sense and pain. This distemper is most usual in women of a melancholy constitution, and such also as have not been cleansed from their menstrues, or from the retention of the lochia or after purgings; it is likewise sometimes caused by eating corrupt meat; for those inordinate longings called Pica; to which breeding women are often subject: and lastly, it may also proceed from obstructions and ulcers in the womb, or some evil effects in the liver and spleen. It may be known by these signs. If the effect be in the bottom of the womb, she feels as it were a heavy burden representing a mole, yet differing, in that the breasts are attenuated, and the whole body also. If the neck of the womb be hardened no outward humour will appear, the mouth of it is retracted, and touched with the finger feels hard; nor can she have the company of a man without great pains and pricklings. This schirrosity or hardness is (when confirmed) incurable, and will turn into a cancer, or dropsy; and ending in a cancer, proves deadly; the reason of which is, because the native heat in those parts being almost smothered, it is hardly to be restored again.

For the cure of this, first prepare the humour with syrup of burrage, succory, epilcymum and clarified whey; which being done, take of these pills following; according to the strength of the patient: Take hicra pikra six drams and a half; agaric, lazuli abluti falis Indiae, coloquintida, of each one dram and a half; mix them and make pills. The body being purged proceed to mollify the hardness as followeth: anoint the privities and the neck of the womb with the following ointment: Take oil of capers, lilies, sweet almonds, jessamin, each an ounce; fresh butter, hen's grease, goose grease, of each an ounce; mucilage, fenugreek, althea, ointments of althea, each six drams; ammoniacum dissolved in wine, an ounce, which with wax make an ointment. Then apply below the navel diachylon fernelli; and make emulsions of figs, mugwort, mallows, penny-royal, althea, fennel roots, mellilot, fenugreek, and linseed boiled in water; but for injection, take bedellium dissolved in wine, oil of sweet almonds, lilies, camomile, each two ounces, marrow of veal bone and hen's grease each an ounce, with the yolk of an egg. The air must be temperate; and as for her diet let her abstain from all gross, vicious, and fat meats, as pork, fish, old cheese, etc.

SECT. VIII. Of the Straitness of the Womb, and its Vessels.

THIS is another effect of the womb, which is an obstruction to the bearing of the children, as hindering both the flowing of the menstrues and conception, and is seated in the vessels of the womb, and of the neck thereof. The cause of, this straitness are thick and rough humours, that stop the mouth of the veins and arteries; these humours are bred of either gross or too much nourishment: when the heat of the womb is so weak that it cannot attenuate the humours, which, by reason thereof, either flow from the whole body, or are gathered into the womb. Now the vessels are made closer or straiter several ways: Sometimes by inflammation, schirrous, or other tumours; sometimes by compressions or by a scar, or flesh, or membrane that grows after the wound. The signs by which this is known are the stoppage of the terms, not conceiving, crudities abounding in the body, which are known by particular signs; for if there was a wound, or the secundine was pulled out by force, phlegm comes from the womb. If stoppage of the terms be from an old obstruction by humours it is hard to be cured; if it be only from the disorderly use of astringents, it is more curable; if it be from a schirrous of other tumours that compresseth or closeth the vessels, the disease is incurable.

For the cure of that which is curable obstructions must be taken away, phlegm must be purged, and she must be let blood, as will be hereafter directed in the stoppage of the terms. Then use the following medicines: take of aniseed and fennel-seed, each a dram; rosemary, penny-royal, calamint, bettony flowers, each an ounce; castus, cinnamon, galangal, each half an ounce; saffron half a dram, with wine. Or take asparagus roots, parsley roots, each an ounce; penny-royal, calamints, each a handful; wall-flowers, dill-flowers, each two pugils; boil, strain, and add syrup of mugwort, an ounce and a half. For a fomentation, take penny-royal, mercury, calamint, marjoram, mugwort, each two handfuls; sage, rosemary, bays, camomile flowers, each a handful; boil them in water and foment the groin and bottom of the belly, or let her sit up to the navel in a bath and then anoint about the groin with oil of rue, lilies, dill, etc.

SECT. IX. Of the Falling of the Womb.

THIS is another evil effect of the womb, which is both very troublesome, and also a hindrance to conception. Sometimes the womb falleth to the middle of the thighs, nay, almost to the knees, and may be known then by its hanging out. Now that which causeth the womb to change its place, is when the ligaments by which it is bound to the other parts are not in order: for there are four ligaments, two above, broad and membranous that come from the peritoneum, and two below, that are nervous, round, and hollow; it is also bound to the great vessels by veins and arteries, and to the back nerves; now the place is changed when it is drawn another way, or when the ligaments are loose, and it falls down by its own weight. It is drawn on one side when the menstrues are hindered from flowing, and the veins and arteries are full family those which go to the womb. If it be a mole on one side, the liver and spleen cause it; by the liver veins on the right side and the spleen on the left, as they are more or less filled. Others are of opinion it comes from the solution of the connection of the fibrous neck and the parts adjacent; and that is from the weight of the womb descending: this we deny not; but the ligaments must be loose or broken. But women in a dropsy could not be said to have the womb fallen down if it come only from looseness, but in them it is caused by the saltness of the water, which dries more than it moistens. Now if there be a little tumour within or without the privities, like a skin stretched, or a weight felt about the privities, it is nothing else but a descent of the womb; but if there be a tumour like a goose egg, and a hole at the bottom, there is at first a great pain in the parts to which the womb is fastened, as the loins, the bottom of the belly, and the os sacrum, which proceeds from the breaking or stretching of the ligaments, but a little after the pain is abated; and there is an impediment in walking, and sometimes blood comes from the breach of the vessels, and the excrements and urine are stopped, and then a fever and convulsions ensueth, and then it oftentimes proves mortal, especially if it happens to women with child.

For the cure of this distemper; first put it up before the air alter it, or it be swollen or inflamed; and therefore, first of all give a clyster to remove the excrements, then lay her upon her back, with her legs abroad, and thighs lifted up, and head down; then take the tumour in your hand, and thrust it in without violence; if it be swelled by alteration and cold, foment it with the decoction of mallows, althea, line, fenugreek, camomile flowers, bay berries, and anoint it with oil of lilies and hen's grease. If there be an inflammation, don't put it up, but fright it in, by putting a red hot iron before it, and making a show as If you intended to burn it, but first sprinkle upon it the powder of mastich, frankincense and the like: thus take frankincense, mastich, each two drams; sarcocol, steeped in milk, a dram; mummy, pomegranate flowers, sanguis draconis, each half a dram; when it is put up let her lie with her legs stretched, and one upon he other, for eight or ten days, and make a pessary in the form pear with cork or sponge, and put it into the womb, dipped in sharp wine, or juice of acacia, with powder of sanguis, with galbanum, bedellium. Also apply a cupping-glass with great flame under the navel or paps, or to both kidneys, and lay this plaster to the back; take opoponix two ounces, storax liquid half an ounce, mastich, frankincense, pitch, bole, each two drams; then with wax make a plaister, or, take laudanum a dram and a half, mastich and frankincense each a dram; ash-coloured ambergrease four grains, musk half a scruple; make two round plaisters to be laid on each side of the navel; make a fume of snails' skins salted, or of garlic, and let it be taken in by the funnel. Use also astringent fomentations of bramble leaves, plantain, horsetails, myrtles, each two handfuls, wormseed two pugils, pomegranate flowers half an ounce; boil them in wine and water. For an injection take comfrey roots an ounce, rupture-wort two drams, yarrow, mugwort, each half an ounce, boil them in red wine, and inject it with a syringe. To strengthen the womb, take hartshorn, bays, of each a dram, myrrh half a dram; make a powder for two doses, and give it with sharp wine. Or you may take zedoary, parsnip seed, crabs' eyes prepared, each a dram; nutmeg half a dram, and give a dram in powder: but astringents must he used with great caution, lest by stopping the courses a worse mischief follow. To keep it in its place, make rollers and ligatures as for the rupture, and put pessaries into the bottom of the womb, that may force it to remain. I know some physicians object, against this, and say they hinder conception: but others in my opinion much more justly affirm, that they neither hinder conception, nor bring any inconvenience; nay, so far from that, they help conception and retain it, and cure the disease perfectly. Let the diet be such as has drying, astringent, and glowing qualities, such as rice, starch, quinces, pears, and green cheese; but let summer fruits be avoided; and let her wine be astringent and red.

 

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