The Works of Aristotle - OF DISEASES RELATING TO WOMEN'S MONTHLY COURSES.

OF DISEASES RELATING TO WOMEN'S MONTHLY COURSES.

 

SECT. I. Of Women's Monthly Courses in General.

THAT divine providence, which with a wisdom worthy of itself, has appointed woman to conceive by coition with the man, and to bear and bring forth children, has provided for the nourishment of children during their recess in the womb of their mother by that redundancy of the blood which is natural to all women, and which, flowing out at certain periods of time (when they are not pregnant), are from thence called terms; and menses, from their monthly flux of excrementious and unprofitable blood; now that the matter flowing forth is excrementious, is to be under stood only with respect to the redundancy and over plus thereof, being an excrement only with respect to its quantity; for as to its quality, it is as pure and incorrupt as any blood in the veins; and thus appears from the final cause of it, which is the propagation and conversation of mankind; and also from the generation of it, it being the superfluity of the last aliment of the fleshy parts. If any ask if the menstrues be not of a hurtful quality, how can it cause such venomous effects; as if it fell upon trees and herbs, it makes the one barren and mortifies the other? I answer: This malignity is contracted in the womb: for the woman wanting native heat to digest this superfluity, sends it to the matrix, where, seating itself till the mouth of the womb be dilated, it becomes corrupt and mortified; which may easily be, considering the heat and moistness of the place; and so this blood being out of its proper vessels, and too long retained, offends its quality. But if frigidity be the cause why women cannot digest all their last nourishment, and by consequence have these monthly purgations, how it comes to pass, may some say, why they are of so cold a constitution more thin men? Of this I have already spoken in the chapter of barrenness; only chiefly thus: The author of our being has Laid an injunction upon men and women to propagate their kind, has also wisely fitted them for that work; and seeing that in the act of coition there must be an agent and a patient (for if they be of one constitution there can be no propagation), there the man is hot and dry, and the woman cold and moist; he is the agent, she the patient or weaker vessel, that she might be subject to the office of the man. It is therefore necessary that the woman should be of a cold constitution, because in her is required a redundancy of matter for the infant depending on her; and this is wisely ordained by nature, for otherwise the child would detract from and weaken the principal parts of the mother, which would most naturally render the product of the infant the destruction of the parent. Now these monthly purgations usually begin about the fourteenth year, and continue till the forty-sixth or fiftieth year; yet not so constantly but that oftentimes there happens a suppression, which is sometimes natural and sometimes morbifical; when they are naturally suppressed, it is either in breeding women, or such as give suck; but that which is morbifical must be the subject of the following sections.

SECT. II. Of the Suppression of the Monthly Courses.

THE suppression of the terms, which is morbific, is an interception of that accustomary evacuation of blood which should come from the matrix every month, and which proceeds from the matter vitiated. The cause of this suppression is either internal or external; the internal cause is either instrumental material in the blood or in the womb. The blood may be faulty two ways; in quantity, or in quality; in quantity, when it is so consumed that there is no overplus left, as in viragoes and all virile women, who, through their heat and strength of nature, digest and consume all their best nourishment, but women of this constitution are rather to be accounted Anthropophagae, that is, women-eaters than women breeders; because they consume one of the principals of generation, which gives a being to the world, i.e., the menstruous blood. The blood may also be consumed and the terms stayed by too much bleeding at the nose; and likewise by a flux of the haemorrhoids, or by a dysenteria, evacuations and chronical and continued diseases. But secondly, the matter may be vicious in quality, as if it be sanguinous, phlegmatical, bilious or melancholic; each of these, if they offend in grossness, will cause an obstruction in the veins.

The womb also may be in the fault divers ways; as by the narrowness of the veins and passages by aposthumes, tumours, ulcers, and by overmuch cold and heat, the one vitiating the action, and the other consuming the matter; also by an evil composition of the matter; also by an evil composition of the uterine parts, by the neck of the womb being turned aside; and sometimes (though but rarely), by a membrane or excrescence of flesh growing about the womb.

The external cause may be heat, or dryness of the air, immoderate watching, great labour, violent motion, whereby the matter is so consumed, and the body is so exhausted, that there is no redundant blood remaining to be expelled; where it is recorded of the Amazons, that being active and always in motion, they had little or no monthly fluxes; it may also be caused by cold; and most frequently it is so, making the blood vicious and gross, condensing and binding up the passages, that it cannot flow forth. The signs of the disease are pains in the head, neck, back and loins, with weariness of the whole body, but especially of the hips and legs, by reason of a confinity which the womb hath in those parts; if the suppression proceeds from cold, it causes a heavy sluggish disposition, a pale colour, a slow pulse, the urine crude and waterish, and much in quantity, and no desire to copulation, and excrements of the guts being usually retained; but if it proceeds from heat, the signs are contrary. If it be natural, or caused by conception, it may be known by drinking water and honey after supper, going to bed; for if, after taking it, it causeth the woman to feel a bearing pain about the navel and lower parts 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; otherwise many dangerous diseases will follow, such as swoonings, faintings, intermission of pulse, obstructions, chachexies, jaundice, dropsies, hardness of the spleen, epilepsies, apoplexies, frensies, melancholy passions, etc., which makes it highly necessary to say something now of the cure.

The cure of this distemper must be by evacuation, for this suppression is a plethoric effect: it will therefore be best in the midst if the menstrual period to open the liver vein; and for the reversion of the humour two days before the wonted evacuation, open the saphena veins of both feet: and if the repletion be not great, apply cupping glasses to the legs and thighs; after letting blood, be humour must be prepared and made flexible with syrup of staechas, horehound, hyson, bettony, maiden-hair, of each one handful; make a decoction, and take thereof three ounces; syrup of mugwort, succory, maiden-hair, mix each half an ounce; and after she comes out of the bath let her drink it off. Then purge pil. de agaric, elephang, cooh. fadit. Galen in this case commends pilula de hiera cum coloquintida; for as they are proper to purge the humour offending, so they open the passages of the womb. If the stomach be overcharged, let her take a vomit; but if it be so prepared as to act both ways, lest the humours should be too much turned back by working only upwards; to which end, take trochisk of Agaria two drams, infuse them in three ounces of oximel, in which dissolve benedict. laxat, half an ounce, and of the electuary diasarum one scruple; and let her take it after the manner of a purge. When the humour has been thus purged, you may proceed to more proper and forcible remedies. Take an extract of mugwort one scruple and a half, rinds of cassia, parsley seed, castor, each a scruple; and with juice of smallage, or after supper, going to bed. Also administer to the lower parts by suffumigations, pessaries, unctions, injections, and infusions; make suffumigations of amber, galbanum, melanchum, bay-berries, mugwort, cinnamon, nutmegs, cloves, etc. Make pessaries of figs and the leaves of Mercury bruised, and rolled up with lint. Make injections of the decoction of Mercury, bettony, origin, mugwort, and figs, and inject it into the womb by an instrument fit for that purpose. For unction, take landant, oil of myrrh, of each two drams; oil of lilies, almonds, capers, camomile, of each half an ounce; and with wax make an unguent, with which let the place be anointed.

Let the air be hot and dry, her sleep shorter than ordinary; let her use moderate exercise before meals, and let her meat and drink be attenuating.

SECT. III. Of the Overflowing of the Monthly Courses.

This distemper is directly contrary to that of which I have spoken in the foregoing section, and is no less dangerous than the other, and therefore requires to be spoken to next in order. This distemper is a sanguinous excrement, proceeding from the womb, and exceeding in time and quality. I call it sanguinous, because there are two way by which the blood flows forth; one is by the internal veins in the body of the womb, which is properly called the monthly flux; the other is, by those veins which are terminated in the neck of the matrix, which some physicians called the haemorrhoids of the womb; and that it exceeds in quantity when they flow about three days; but this is the most certain sign of their excess in flowing, when they flow so long that the faculties of the body are thereby weakened; for in bodies abounding with gross humours, this immoderate flux does sometimes unburden nature of her load, and is not to be stopped without advice from a physician.

The cause of this immoderate flowing is either external or internal; the external cause may be the heat of the air, lifting and carrying heavy burden, unnatural child-births, falls, etc. The internal cause may be threefold: in the matter, instrument, or faculty; the matter, which is the blood, may be vicious two ways; first, in quantity, being so much that the veins are not able to contain it; secondly, in quality, being adhust, sharp, waterish, or unconcocted. The instrument, viz., the veins, are faulty by the dilatation of the orifice, which may be caused two ways; first, by the heat of the constitution, climate, or season, heating the blood, whereby the passages are dilated, and the faculty weakened, that it cannot retain in the blood; secondly, by falls, blows, violent motion, breaking of a vein, etc.

This inordinate flux may be known by the appetite's being decayed, the concoction depraved, and all the actions of the body weakened, the feet swelled, the colour of the face changed, and a general feebleness possessing the whole body. If it comes by the breaking of a vein, the body is sometimes cold, the blood flows forth on heaps, and that suddenly with great pain; if it comes through heat, the orifice of the veins being dilated, then there is little or no pain, yet the blood flows faster than it does in an erosion, and not so fast as 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. If it be by weakness of the womb, she has an aversion to copulation; if it proceeds from the 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.

The cure of this consists in three particulars; first, in repelling and carrying back the blood; secondly, in correcting and taking away the fluxibility of the matter; and thirdly, in corroborating the veins or faculties. For the first, to cause a regression of the blood, open a vein in her arm, and draw out so much blood as the strength of the patient will permit, and that not together, but at several times, for thereby the spirits are less weakened, and the retraction so much the better. Apply the cupping-glass to the liver, that the reversion may be in the fountain. To correct the fluxibility of the matter, cathartical means, moderated with astrictories, may be used. If it be caused by sharpness of blood, consider whether the erosion be by salt phlegm or a dust colour: if by salt phlegm, prepare with syrup of violets, wormwood, roses, citron peels, succory, etc.; then take this purgation following: mirobolana, cherbul half an ounce, trochisks of agaric, one dram; with plantain water make a decoction; add thereto syr. rosat. lux three ounces, and make a potion. If by a dust colour, prepare the body with syrup of roses, myrtles, sorrel, purslain mixed with water of plantain, knot grass and endive, then purge with this potion: take rinds of mirobolana, rhubarb, of each one dram, cinnamon fifteen grains; infuse them one night in endive water; add to it the straining pulp of roses one ounce, and make a potion. If the blood be waterish and unconcocted, as it is in hydroptical bodies, and flows forth by reason of the tenury, to draw off the water will be profitable; to which end, purge with agarci, elaterium, and coloquintida: Sweating is also very proper in this case, for by it the matter offending is taken away, and the motion of the blood is carried to the outward parts. To procure sweat, use cardamom water with mithridate; or the decoction of guiacum does also greatly provoke sweat: and pills of sarsaparilla taken every night going to bed, are worthily commended. If the blood flows forth from the opening or breaking of a vein, without any evil quality of itself, then ought corroboratives only to be applied, which is the thing to be done in this inordinate flux: bole armoniac one scruple, London treacle one dram, old conserve of roses half an ounce, with syrup of myrtles, make an electuary. Or, if the flux has continued long, take. of mastich two drams, olibani, tyoch. de careble, of each one dram; balanstium one scruple, make a powder; with syrup of quinces make it into pills, and take one always before meals.

SECT. IV. Of Terms coming out of order, either before or after the usual Time.

BOTH these have an ill constitution of body; every thing is beautiful in its order, in nature as well as in morality; and if the order of nature be broken, it shows the body to be out of order; of each of these effects briefly.

When the monthly courses come before their time, it shows a depraved excretion that comes for the time, often flowing sometimes twice a month; the cause why they come sooner is in the blood, which stirs up the expulsive faculty in the womb, or sometimes in the whole body, caused oftentimes by the person's diet, which increases the blood too much, makes it too sharp or too hot; and if the retentive faculty of the womb be weak and the expulsive faculty strong, and of a quick sense, it brings them forth the sooner; and sometimes they flow sooner by reason of a fall, stroke, or some violent passion which the parties themselves can best relate. If it be from heat, thin and sharp humours, it is known by the distemper of the whole body. The looseness of the vessels, and weakness of the retentive faculty, is known from a moist and loose habit of body. It is more troublesome than dangerous, but hinders conception, and therefore the awe is necessary for all, but especially such as desire children. If it proceeds from a sharp blood, let her temper it by a good diet, and medicines. To which purpose let her use baths of iron water that correct the distemper of the bowels, and then evacuate. If it proceeds from the retentive faculty, and looseness of the vessels it is to be corrected with gentle astringents.

As to the courses flowing after the usual time, the causes are thickness of the blood, and the smallness of the quantity, with straightness of the passage and weakness of the expulsive faculties, either of these singly may stop the courses, but if they all concur, they render the distemper the worse. If the blood abounds not in such a quantity as may stir up nature to expel it, its purging must necessarily be deferred till there be enough. And if the blood be thick, the passage stopped and the expulsive faculties weak, the menses must needs be out of order, and the purging of them retarded.

For the cure of this, if the quantity of blood be small, let her use a larger diet, and very little exercise. If the blood be thick and foul, let it be made thin, and the humours mixed therewith be evacuated. It is good to purge after the courses have done flowing, and to use calamints; and indeed the oftener she purges the better. She may also use fumes and necessaries, apply cupping glasses without scarification to the inside of the thighs, and rub the legs, and scarify the ankles, and hold the feet in warm water four or five days before the courses come down. Let her also anoint the bottom of her belly with things proper to provoke the terms.

SECT. V. Of the false Courses or Whites.

THE whites or false courses are a foul excretion from the womb; for from the womb proceeds not only the menstruous blood, but accidentally many other excrements, which is a distillation of a variety of corrupt humours through the womb, flowing from the whole body, or part of the same; which, though called the whites, are sometimes blue, or green, or reddish, not flowing at a set time or every month but in a disorderly manner, sometimes longer, and sometimes shorter. It is different from the running of the reins, being both less in quantity, and whiter and thicker in quality, and coming at a greater distance; it is different also from those night pollutions, which is only in sleep, and proceed from the imagination of venery.

The cause of this distemper is either promiscuously in the whole body, by a cacochymia, or weakness of the same, or in some of the parts; as in the liver, which, by the inability of the sanguificative faculty, causeth a generation of corrupt blood, and then the matter is reddish: sometimes in the gall being remiss in its office, not drawing away those choleric superfluities which are engendered in the liver, and then the matter is yellowish; sometimes in the spleen, not defecating and cleansing the blood of the excrementious parts, and then the matter flowing forth is blackish. It may also come from catarrhs in the head, or from any other putrefied or corrupt member. But if the matter of the flux be whiter, the case is either in the stomach or reins. In the stomach, by a phlegmatical and crude matter there contracted and vitiated through grief, melancholy and other distempers; for otherwise, if the matter were only pituitous, and no ways corrupt or vitiated, being taken into the liver, it might be converted into blood; for phlegm in the ventricle is called nourishment half digested. But being corrupt, though it be sent into the liver, it cannot correct that which the first hath corrupted, and therefore the liver sends it to the womb, which can neither digest it nor repel it, and so it is voided out, still keeping the colour which it had in the ventricle. The cause also may be in the veins being over-heated, whereby the spermatical matter, by reason of its tenuity, flows forth. The external cause may be the moistness of the air, eating corrupt meats, anger, grief, slothfulness, immoderate sleeping, and costiveness.

The signs are, extenuation of body, shortness and stinking breath, loathing of meat, pain in the head, swelling of the eyes, melancholy, humidity, flowings from the womb of divers colours, as reddish, black, green, yellow, white: it is known from the overflowing of the courses in that it keeps no certain periods, and is of so many colours, all which do degenerate from blood.

For the cure of this, it must be by methods adapted to the case; and as the causes are various, so must be the cure.

If it be caused by the distillation from the brain, take syrup of bettony, staechas and marjoram, purge with pilloch, napalia, of the juice of sage, hyssop, bettony, negalia, with one drop of oil of cloves, and a little silk cotton. Take elect. dianth. aromat. rosar. diamore, diamosci, dulcis, of each one dram; nutmeg, half a dram at night going to bed.

If the manner flowing forth be reddish, open a vein in the arm; if not, apply ligatures to the arms and shoulders; some have cured this distemper by rubbing the upper parts with crude honey; and so Galen says he cured the wife of Boetius.

If it proceeds from crudities in the stomach, or from a cold distempered liver, take every morning of the decoction of lignum sanctum; purge with pill. de agarico, de hermodact, de Hiera diacolocynthid. foetida. agragrative. Take of elect, aromat. ros. two drams, citron peel dried, nutmeg, long pepper, of each one scruple; diagalinga one dram, santali alba, ligni aloes, of each half a scruple; sugar six ounces; with mint water make lozenges of it, and then take it after meals.

If with frigidity of the liver be joined a repression of the stomach, purging by vomiting is commendable; for which take three drams of the electuary of diaru. Some physicians also allow of the dieurical means, as of opium, petrosolinum, etc.

If the matter of the syrup be melancholous, prepare with syrup of maiden-hair, epithimum, polypody, burrage, bugloss, sumetary, hart's tongue, and syrup of bysantinum, which must be made without vinegar, otherwise it will rather animate the disease than strengthen nature; for melancholy by the use of vinegar is increased, and by Hippocrates, Silvius, and Aventinus, it is disallowed of as an enemy to the womb, and therefore not to be used inwardly in uterine diseases: purges of melancholy are, pilulae eumartae, pilulae indae, pilulae de lap. Lazuli liosena, and confectio hameigh. Take of stamped prunes two ounces, senna one dram, epithimum, polypody, sumetary, of each a dram and a half; sour dates, one ounce, with endive water make a decoction; take of it four ounces; add unto it confectionis aamech three drams, manna three drams. Or, pil indatum, pil foetidarum, agarici trochisacri, of each one scruple, lapis lazuli, five grains, with syrup of erithimum make pills, and take one every week.

If the matter of the flux be choleric, prepare with syrup of endive, violets, succory, roses, and purge with mirobolana, manna, rhubarb, cassia; take of rhubarb two drams, aniseed one dram, cinnamon a scruple and a half; infuse them in six ounces of prune broth; add to the straining of manna an ounce, and take it according to art. Take spicicrum diatrionsontalon, diatragacant. frig. diarrhod. abbatis diaccnit, of each a dram, sugar four ounces, with plantain water make Lozenges.

Lastly, let the womb be cleansed from the corrupt matter, and then corroborated; and for the cleansing thereof, make injections of tho decoction of bettony, feverfew, mugwort, spikenard, bistort, mercury, sage, adding thereto sugar, oil of sweet almonds, of each two ounces. Then to corroborate the womb, prepare trochisks in this manner: take of myrrh, feverfew, mugwort, nutmegs, mace, amber, ligni, aloes, storax, red roses, of each one ounce, with mucilage of tragacanth make trochisks: cast them on the coals, and smother the womb therewith; fomentations may be also made for the womb of red wine, in which has been decocted mastich, fine bole, balustia and red roses; drying diet is best, because this distemper usually abounds with phlegmatic and crude humours. Immoderate sleep is hurtful, but moderate exercise will do well.

Thus have I gone through the principal effects peculiar to the female sex; and prescribed for each of them such remedies as, with the divine blessing, will cure their distempers, confirm their health, and remove all those obstructions which might otherwise prevent their bearing children; and I have brought it into so narrow a compass, that it might be of the more general use, being willing to put it into every one's power, that has occasion for it, to purchase this rich treasure at an easy rate.

 

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