The Works of Aristotle the Famous Philosopher
by
Anonymous

Part 2 out of 6



infant would weaken the mother, and like as in the viper, the birth of
the infant would be the death of the parent.

The monthly purgations continue from the fifteenth to the forty-sixth or
fiftieth year; but a suppression often occurs, which is either natural
or morbid: the courses are suppressed naturally during pregnancy, and
whilst the woman is suckling. The morbid suppression remains to be
spoken of.

* * * * *




CHAPTER II

_Of the Retention of the Courses._


The suppression of the menstrual periods, is an interruption of that
accustomed evacuation of blood, which comes from the matrix every month,
and the part affected is the womb.



CAUSE.

The cause of this suppression is either external or internal. The
external cause may be heat or dryness of air, want of sleep, too much
work, violent exercise, etc., whereby the substance is so consumed, and
the body so exhausted that nothing is left over to be got rid of, as is
recorded of the Amazons who, being active and constantly in motion, had
their courses very little, if at all. Or it may be brought about by cold
which is very frequent, as it vitiates and thickens the blood, and binds
up the passages, so that it cannot flow out.

The internal cause is either instrumental or material; in the womb or in
the blood. In the womb, it may be in various ways; by humours, and
abscesses and ulcers, by the narrowness of the veins and passages, or by
the adipose membrane in fat bodies, pressing on the neck of the matrix,
but then they must have hernia, zirthilis, for in men the membrane does
not reach so low; by too much cold or heat, the one vitiating the
action, and the other consuming the matter through the wrong formation
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 at the mouth or neck of the womb. The blood may be in fault in
two ways, in quantity and in quality; in quantity, when it is so
consumed that no surplus is left over, as in viragoes or virile women,
who, through their heat and natural strength, consume it all in their
last nourishment; as Hippocrates writes of Prethusa, for when her
husband praised her overmuch, her courses were suppressed, her voice
changed and she got a beard with a manly face. But I think, rather that
these must be _Gynophagi_, or woman-eaters, rather than women-breeders,
because they consume one of the principles of generation, which gives a
being to the world, viz., the menstruous blood. The blood may likewise
be lost, and the courses checked by nosebleeding, by bleeding piles, by
dysentery, commonly called the bloody flux, by many other discharges,
and by chronic diseases. Secondly, the matter may be vitiated in
quality, and if it be sanguineous, sluggish, bilious or melancholy, and
any of these will cause an obstruction in the veins.



SIGNS.

Signs which manifest the disease are pains in the head, neck, back and
loins; weariness of the whole body (but especially of the hips and legs,
because the womb is near those parts); palpitation of the heart. The
following are particular signs:--If the suppression arises from a cold,
the woman becomes heavy, sluggish, pale and has a slow pulse; Venus'
combats are neglected, the urine is thick, the blood becomes watery and
great in quantity, and the bowels become constipated. If it arises from
heat, the signs are just the opposite. If the retention be natural and
arises from conception, this may be known by drinking hydromel, i.e.,
water and honey, after supper, before going to bed, by the effect which
it has; for if after taking it, she feels a heating pain about the navel
and the lower parts of the abdomen, it is a sign that she has conceived,
and that the suppression is natural.



PROGNOSTICS.

The whole body is affected by any disorder of the womb, and especially
the heart, the liver and the brain, and there is a singular sympathy
between the womb and those three organs. Firstly, the womb communicates
with the heart by the mediation of those arteries which come from the
aorta. Hence, when menstruation is suppressed, fainting, swooning, a
very low pulse, and shortness of breath will ensue. Secondly, it
communicates with the liver by the veins derived from the hollow vein.
Obstructions, jaundice, dropsy, induration of the spleen will follow.
Thirdly, it communicates with the brain by the nerves and membranes of
the back; hence arise epilepsy, madness, fits of melancholy, pains in
the back of the head, unaccountable fears and inability to speak. I may,
therefore, well agree with Hippocrates that if menstruation be
suppressed, many dangerous diseases will follow.



CURE.

In the cure of this, and of all the other following cases, I shall
observe the following order:--The cures will be taken from surgical,
pharmaceutical and diuretical means. The suppression has a plethoric
effect, and must be removed by the evacuation; therefore we begin with
bleeding. In the middle of the menstrual period, open the liver vein,
and two days before, open the saphena in both feet; if the repletion is
not very great apply cupping glasses to the legs and thighs, although
there may be no hope of removing the suppression. As in some women, the
cotyledones are so closed up that nothing but copulation will open them,
yet it will be well to relieve the woman as much as possible by opening
the hemoroid veins by applying a leech. After bleeding let the place be
prepared and made flexible with syrup of stychas, calamint, betony,
hyssop, mugwort, horehound, fumitary, maidenhair. Bathe the parts with
camomiles, pennyroyal, savias, bay-leaves, juniper-berries, rue,
marjoram, feverfew. Take a handful each of nep, maidenhair, succory and
betony leaves and make a decoction, and take three ounces of it, syrup
of maidenhair, mugwort and succory, half an ounce of each. After she
comes out of her bath, let her drink it off. Purge with _Pill agaric,
fleybany, corb, feriae_. In this case, Galen recommends _pilulae of
caberica coloquintida_; for, as they are good for purging the bad
humours, so also they open the passages of the womb, and strengthen it
by their aromatic qualities.

If the stomach be over-loaded, let her take an emetic, yet such a one as
may work both ways, lest if it only works upwards, it should check the
humours too much. Take two drachms of trochisks of agaric, infuse this
in two ounces of oxymel in which dissolve one scruple and a half of
_electuary dissarum_, and half an ounce of _benedic laxit_. Take this as
a purge.

After the humour has been got rid of, proceed to more suitable and
stronger remedies. Take a drachm and a half of trochisk of myrrh; ten
grains of musk with the juice of smallage; make twelve pills and take
six every morning, or after supper, on going to bed. Take half an ounce
of cinnamon, two drachms each of smirutium, or rogos, valerin
aristolochia; two scruples each of astrumone root and saffron; two
drachms of spec. diambia; four scruples of trochisk of myrrh; two
scruples tartari vitriolari; make half into a powder; make lozenges with
mugwort water and sugar, and take one drachm of them every morning; or
mix a drachm of the powder with one drachm of sugar, and take it in
white wine. Take two drachms each of prepared steel and spec. hair; one
scruple each of borax and spec. of myrrh, with savine juice; make it up
into eighty-eight lozenges and take three every other day before dinner.
Take one scruple of castor, half a drachm of wild carrot seed with syrup
of mugwort, and make four pills, take them in the morning fasting, for
three days following, before the usual time of purging. Take five
drachms each of agaric, aristolochia, and juice of horehound; six
drachma each of rhubarb, spikenard, aniseed, guidanum, asafoetida,
mallow-root, gentian, of the three peppers and of liquorice: make an
electuary with honey, and take three drachms for a dose. For phlegmatic
constitutions nothing can be better than the decoction of guaiacum wood
with a little disclaim, taken fasting in the morning, for twelve days
consecutively, without producing sweating.

Treat the lower parts of the body to suffumigating, pessaries, ointments
and injections; for fumigating use cinnamon, nutmeg, the berries of the
bay tree, mugwort, galbanum, molanthium, amber, etc. Make pessaries of
figs and the bruised leaves of dog's mercury, rolled up in lint, and if
a stronger one is required, make one of myrrh, opopanax, ammoniac,
galbanum, sagepanum, mithridate, agaric, coloquintida, tec. Make
injections of a decoction of origane mugwort, dog's mercury, betony, and
eggs; inject into the womb with a female syringe. Take half an ounce
each of oil of almonds, lilies, capers, camomiles; two drachms each of
laudanum and oil of myrrh; make a salve with wax, with which anoint the
place; make injections of fenugreek, camomiles, melilot, dill, marjoram,
pennyroyal, feverfew, juniper berries and calamint; but if the
suppression arises from a lack of matter, then the courses ought not to
be brought on until the spirits be raised and the amount of blood
increased; or if it arises from affections of the womb itself, as dropsy
or inflammation, then particular care must be used; but I will not lay
stress on this here, but will mention the remedies in their order.

If the retention comes from repletion or fullness, if the air be hot and
dry, take moderate exercise before meals, and very light diet and
drinks, and with your food take garden savory--thyme and origane, if it
arises from emptiness and defect of matter: if the weather be moist and
moderately hot, avoid exercise and late hours; let your food be
nourishing and easy of digestion, such as raw eggs, lamb, chickens,
almonds, milk and the like.

* * * * *




CHAPTER III

_Of Excessive Menstruation._


The learned say, that truth is manifested by comparing contraries, and
so, as I have above spoken of the suppression of menstruation, it is now
necessary that I should treat of excessive menstruation, which is no
less dangerous than the former. This immoderate monthly flow is defined
as a sanguineous discharge, as it consists merely of blood, wherein it
differs from the false courses or whites, of which I shall speak further
on. Secondly, it is said to proceed from the womb; for there are two
ways in which the blood issues forth; one by the internal veins of the
body of the womb (and this is properly called the monthly flow), the
other is by those veins which terminate in the neck of the matrix, which
Aetius calls haemorrhoids of the womb. In quantity, Hippocrates said, it
should be about eighteen ounces, and they should last about three days:
and when the faculties of the body are weakened by their flow, we may
take it that the discharge is inordinate. In bodies which abound in
gross humours, this immoderate flow sometimes unburdens nature of her
load and ought not to be checked without a physician's advice.



CAUSE.

The cause is either internal or external. The internal cause is
threefold; in the substance, the instrument or the power. The matter,
which is the blood, may be vitiated in two ways; first, by the heat of
the constitution, climate or season, heating the blood, whereby the
passages are dilated, and the power weakened so that it cannot retain
the blood. Secondly, by falls, blows, violent motions, rupture of the
veins, etc. The external cause may be the heat of the air, heavy
burdens, unnatural childbirth, etc.



SIGNS.

In this excessive flow the appetite is lessened, conception is checked
and all the functions weakened; the feet swell, the colour of the face
changes, and the whole body is weakened. If the flow comes from the
rupture of a vein, the body is sometimes cold, the blood flows out in
streams, suddenly, and causes great pain. If it arises from heat, and
the orifice of the vein is dilated, there is little or no pain, but yet
the blood flows faster than it does when caused by erosion, but not so
fast as it does in a rupture. If caused by erosion, the woman feels a
scalding of the passage, and it differs from the other two, in so much
as it does not flow so quickly or so freely as they do. If it is caused
by weakness of the womb, the woman feels a dislike for sexual
intercourse. Lastly, if it proceeds from the defective quality of the
blood let some of it drop into a cloth, and when it is dry, you may
judge, of the quality by the colour. If it be passionate it will be
yellow; if melancholy, it will be black, and if phlegmatic, it will be
waterish and whitish.



PROGNOSTICS.

If convulsions are joined to the flow, it is dangerous, because that
intimates that the noble parts are affected, convulsions caused by
emptiness are deadly. If they continue long, they will be very difficult
to cure, and it was one of the miracles which our Saviour Christ
wrought, to cure a woman of this disease of twelve years standing.

To conclude, if the flow be excessive, many diseases will follow, which
will be almost impossible to cure; the blood, being consumed together
with the innate heat, either morbid, dropsical, or paralytical diseases
will follow.



CURE.

The cure consists in three particulars. First, in expelling and
carrying away the blood. Secondly, in connecting and removing the
fluxibility of the matter. Thirdly, in incorporating the veins and
faculties. For the first, to get rid of the superfluous blood, open a
vein in the arm, and draw off as much blood as the strength of the
patient will allow; not all at one time, but at intervals, for by those
means the spirits are less weakened, and the reaction so much the
greater.

Apply cupping glasses to the breasts and also over the liver, and to
correct the flexibility of the matter, purgative means, moderated by
astringents, may be employed.

If it is caused by erosion, and salt phlegm, prepare with syrup of
violets, wormwood, roses, citron peel, succory, etc. Then make the
following purge:--mirabolans, half an ounce; trochisks of agaric, one
drachm; make a decoction with the plantain-water, and add syrup of roses
lax. three ounces, and make a draught.

If caused by any mental excitement, prepare the body by syrup of roses,
myrtles, sorrel and parsley, mixed with plantain-water, knot-grass and
endive. Then purge with the following draught:--Take one drachm each of
the void of mirabolans, and rhubarb, cinnamon fifteen grains; infuse for
a night in endive water; add to the strained water half an ounce of pulp
of tamarinds and of cassia, and make a draught. If the blood be
waterish as it is in dropsical subjects and flows out easily on account
of its thinness, it will be a good plan to draw off the water by purging
with agaric, elaterium and coloquintida. Sweating is also useful in this
case, as by it the noxious matter is carried off, and the motion of the
blood to other parts. To produce sweating, employ cardus water, and
mithridate, or a decoction of guaiacum and sarsaparilla. Gum guaiacum is
also a great producer of perspiration, and sarsaparilla pills, taken
every night before going to bed are also highly to be recommended. If
the blood pours out, without any evil quality in itself, then
strengthening means only should be employed, which is a thing to be done
in cases of inordinate discharge.

Take one scruple of ol. ammoniac, one drachm of treacle, half an ounce
of conserve of roses and make an electuary with syrup of myrtle, or if
the discharge be of long standing take two drachms of matrix, one drachm
of olilanum troch. de carbara, a scruple of balustium; make into a
powder and form into pills with syrup of quinces, and take one before
every meal. Take two scruples each of troch. dechambede, scoriaferri,
coral and frankincense; pound these to a fine powder, and make into
lozenges with sugar and plantain water. Asses' dung is also approved
of, whether taken inwardly with syrup of quinces or applied outwardly
with steeled water. Galen by sending the juice of it into the womb by
means of a syringe for four days consecutively, cured this immediate
flow, which could not be checked in any other way. Let the patient take
one scruple and a half of pilon in water before going to bed; make a
fumigation for the womb of mastic, frankincense and burnt frogs, adding
the hoof of a mule. Take an ounce each of the juice of knot-grass,
comfoly and quinces; a drachm of camphor; dip a piece of silk or cotton
into it and apply it to the place. Take half an ounce each of oil of
mastic, myrtle, and quinces; a drachm each of fine bole and troch.
decardas, and a sufficient quantity of dragon's blood, make an ointment
and apply it before and behind. Take an ounce and a half each of
plantain, shepherd's purse and red rose leaves; an ounce of dried mint,
and three ounces of bean flour; boil all these in plantain water and
make two plasters:--apply one before and one behind. If the blood flows
from those veins which are terminated at the neck of the matrix, then it
is not called an undue discharge of the _menses_, but haemorrhoids of
the womb. The same remedy, however, will serve for both, only the
instrumental cure will be a little different; for in uterine
haemorrhoids, the ends of the veins hang over like teats, which must
be removed by cutting, and then the veins closed with aloes, fine bole,
burnt alum, myrrh, mastic, with comfoly-juice and knot grass, laid upon
it like a plaster.

[Illustration: _Position of the Embryos in a plural conception_]

[Illustration: Process of Delivery.]

The air should be cold and dry, and all motion of the body should be
prohibited. Her diet should consist of pheasants, partridges, grouse,
rabbits, calves' feet, etc., and her drink should be mixed with the
juice of pomegranates and quinces.

* * * * *




CHAPTER IV

_Of the Weeping of the Womb._


The weeping of the womb is an unnatural flow of blood, coming from it in
drops, like tears, and causing violent pains in it, and occurring at no
fixed period or time. By some it is supposed to be produced by the
excessive flow of the courses, as they flow copiously and freely; this
is continued, though only little at a time, and accompanied by great
pain and difficulty of passing it, and on this account it is compared
to the strangury.

The cause is in the power, instrument or matter; in the power, on
account of its being enfeebled so that it cannot expel the blood, and
which, remaining there, makes that part of the womb grow hard, and
distends the vessels, and from that, pains in the womb arise. In the
instrument, from the narrowness of the passage. Lastly, it may be the
matter of the blood which is at fault, and which may be in too great
quantities; or the quality may be bad, so that it is thick and gross and
cannot flow out as it ought to do, but only in drops. The signs will
best be ascertained by the patient's own account, but there will be
pains in the head, stomach and back, with inflammation, difficulty of
breathing and excoriation of the matrix. If the patient's strength will
permit it, first open a vein in the arm, rub the upper parts and let a
cord be fastened tightly round the arm, so that the force of the blood
may be carried backward; then apply such things as may relax the womb,
and assuage the heat of the blood, as poultices made of bran, linseed,
mallows, dog's mercury and artiplex. If the blood be viscous and thick,
add mugwort, calamint, dictain and betony to it, and let the patient
take about the size of a nutmeg of Venic treacle, and syrup of mugwort
every morning; make an injection of aloes, dog's mercury, linseed,
groundsel, mugwort, fenugreek, with sweet almond oil.

Sometimes it is caused by wind, and then bleeding must not be had
recourse to, but instead take one ounce of syrup of feverfew; half an
ounce each of honey, syrup of roses, syrup of stachus; an ounce each of
calamint water, mugwort, betony and hyssop, and make a julep. If the
pain continues, use this purge:--Take a drachm of spec. Hitrae, half an
ounce of diacatholicon, one ounce of syrup of roses and laxative, and
make a draught with a decoction of mugwort and the four cordial flowers.
If it proceeds from weakness, she must be strengthened, but if from
grossness of blood, let the quality of it be altered, as I have shown in
the preceding chapter. Lastly, if her bowels are confined, move them by
an injection of a decoction of camomiles, betony, feverfew, mallows,
linseed, juniper-berries, cumminseed, aniseed, melilot, and add to it
half an ounce of diacatholicon; two drachms of hiera piera, an ounce
each of honey and oil and a drachm and a half of sol. nitre. The patient
must abstain from salt, acid and windy food.

* * * * *




CHAPTER V

_The false Courses, or Whites._


From the womb, not only the menstruous blood proceeds, but many
evacuations, which were summed up by the ancients under the title of
_rhoos gunaikeios_,[6] which is the distillation of a variety of corrupt
humours through the womb, which flow from the whole body or a part of
it, varying both in courses and colour.



CAUSE.

The cause is either promiscuously in the whole body, by a cacochymia; or
weakness of it, or in some of its parts, as in the liver, which by a
weakness of the blood producing powers, cause a production of corrupt
blood, which then is reddish. Sometimes, when the fall is sluggish in
its action, and does not get rid of those superfluities engendered in
the liver, the matter is yellowish. Sometimes it is in the spleen when
it does not cleanse the blood of the dregs and rejected particles, and
then the matter which flows forth is blackish. It may also come from a
cold in the head, or from any other decayed or corrupted member, but if
the discharge be white, the cause lies either in the stomach or loins.
In the stomach, by some crude substance there, and vitiated by grief,
melancholy or some other mental disturbance; for otherwise, if the
matter were only crude phlegm and noways corrupt, being taken into the
liver it might be converted into the blood; for phlegm in the ventricle
is called nourishment half digested; but being corrupt, though sent into
the liver it cannot be turned into nutriment, for the second decoction
in the stomach cannot correct that which the first corrupted; and
therefore the liver sends it to the womb, which can neither digest nor
reject it, and so it is voided out with the same colour which it had in
the ventricle. The cause may also be in the veins being overheated
whereby the spermatical matter flows out because of its thinness. The
external causes may be moistness of the air, eating bad food, anger,
grief, sloth, too much sleep, costiveness.

The signs are bodily disturbances, shortness of breathing, and foul
breath, a distaste for food, swollen eyes and feet, and low spirits;
discharges of different colours, as red, black, green, yellow and white
from the womb. It differs from the flowing of the courses and from too
abundant menstruation, in so far as it keeps no certain period, and is
of many colours, all of which spring from blood.

If the flux be phlegmatic, it will last long and be hard to cure, but if
sickness or diarrhoea supervene, it carries off the humour and cures the
disease. If it is abundant it does not last so long, but it is more
dangerous, for it will cause a cleft in the neck of the womb, and
sometimes also an excoriation of the matrix; if melancholy, it must be
dangerous and obstinate. The flux of the haemorrhoids, however, assists
the cure.

If the matter which flows out be reddish, open a vein in the arm; if
not, apply ligatures to the arms and shoulders. Galen boasts that he
cured the wife of Brutus, who was suffering from this disease, by
rubbing the upper part with honey.

If it is caused by the brain, take syrup of betony and marjoram. Give as
a purgative _Pill. coch._ or _Agaric_; make nasalia of sage, or hyssop
juice, betony, flagella, with one drop of oil of _Elect. Dianth. Rosat.
Diambrae, diamosci dulus_, one drachm of each, and make lozenges to be
taken every morning and evening. _Auri Alexandrina_, half a drachm at
night on going to bed. If these things have no effect, try suffumigation
and plasters, as they are prescribed above.

If it arises from crudities of the stomach or from a cold, disordered
liver, take a decoction of _lignum sanctum_ every morning, purge with
_pill de agaric, de hermadact, de hiera, diacolinthis, foetid-agrigatio_;
take two drachms of elect. aromet-roses, one scruple each of dried
citron peel, nutmeg, long pepper; one drachm of draglanga; half a
scruple each of _fantalum album_, ling, aloes; six ounces of sugar, with
mint water: make lozenges of it, and take them before meals. If there be
repletion besides the rigidity of the liver, purging by means of an
emetic is to be recommended, for which take three drachms of the
electuary diasatu. Galen allows diuretical remedies, such as _aqua
petrofolma_.

If the discharge be angry, treat it with syrup of roses, violets, endive
and succory; give a purge of mirabolans, manna, rhubarb, and cassia.
Take two drachms of rhubarb, one of aniseed, and one scruple and a half
of cinnamon; infuse them into six ounces of syrup of prunes, and add one
ounce of strained manna, and take it in the morning as required. Take
one drachm each of the following drugs: _diatonlanton, diacorant,
diarthod, abbaris, dyacydomei_, four ounces of sugar, and make into
lozenges with plantain water. If the gall be sluggish, and does not stir
the bowels, give warm injections of a decoction of the four mollifying
herbs, with honey of roses and aloes.

If the flow be bilious, treat the patient with syrup of maiden-hair;
epithynium, polypody, borage, buglos, fumitary, hart's tongue and
syrups, bisantius, which must be made without vinegar, else it will
assist the disease instead of nature, for melancholy is increased by the
use of vinegar, and both Hippocrates, Silvius and Avenzoar reject it as
injurious for the womb, and therefore not to be used internally in
uterine diseases. _Pilulae sumariae, pilulae lud. delupina, lazuli
diosena_ and _confetio hamec_ are purges of bile. Take two ounces of
pounded prunes, one drachm of senna, a drachm and a half each of
epithimium, polypody and fumitary, and an ounce of sour dates, and make
a decoction with endive water; take four ounces of it and add three
drachms of hamesech and three of manna. Or take a scruple each of _pil.
indic. foetid, agarici, trochis ati_; one scruple of rhubarb pills, six
grains of lapis lazuli, make into pills with epithimium, and take them
once a week. Take three drachms of elect. loetificans. Galen three
drachms, a drachm each of _diamargaritum, calimi, diamosci dulus_; a
drachm of conserve of borage, violets and burglos; one drachm of candied
citron peel, seven ounces of sugar, and make into lozenges with rose
water.

Lastly let the womb be cleansed of all corrupt matter, and then be
strengthened. In order to purify it, make injections of the decoction of
betony, feverfew, spikenard, bismust, mercury and sage, and add two
ounces each of sugar and sweet almond oil; pessaries may also be made of
silk or cotton, softened in the juice of the above mentioned herbs.

You must prepare trochisks, thus, to strengthen the womb. Take one ounce
each of mugwort, feverfew, myrrh, amber, mace, storax, ling aloes and
red roses, and make lozenges or troches with mucilage of tragacanth;
throw one of them on to hot coals and fumigate the womb with red wine,
in which mastic, fine bole, malustia and red roots have been decocted;
anoint the matrix with oil of quinces and myrtles, and apply a plaster
to it, for the womb; and let the woman take _diamosdum dulco_, _aract_,
and _slemoticum_ every morning.

A drying diet is recommended as best, because in these cases the body
abounds with phlegmatic and crude humours. On this account, Hippocrates
advises the patient to go to bed supperless. Her food should consist of
partridges, pheasant and grouse, roasted rather than boiled, too much
sleep must be prohibited whilst moderate exercise is very advisable.



FOOTNOTES:

[6] The female flowing.

* * * * *




CHAPTER VI

_The Suffocation of the Mother._


This, which if simply considered, will be found to be merely the cause
of an effect, is called in English, "the suffocation of the mother," not
because the womb is strangled, but because by its retraction towards the
midriff and stomach, which presses it up, so that the instrumental cause
of respiration, the midriff, is suffocated, and acting with the brain,
cause the animating faculty, the efficient cause of respiration, also to
be interrupted, when the body growing cold, and the action weakened, the
woman falls to the ground as if she were dead.

Some women remain longer in those hysterical attacks than others, and
Rabbi Moses mentions some who lay in the fit for two days. Rufus writes
of one who continued in it for three days and three nights, and revived
at the end of the three days. And I will give you an example so that we
may take warning by the example of other men. Paroetus mentions a
Spanish woman who was suddenly seized with suffocation of the womb, and
was thought to be dead. Her friends, for their own satisfaction, sent
for a surgeon in order to have her opened, and as soon as he began to
make an incision, she began to move, and come to herself again with
great cries, to the horror and surprise of all those present.

In order that the living may be distinguished from the dead, old writers
prescribe three experiments. The first is, to lay a feather on the
mouth, and by its movements you may judge whether the patient be alive
or dead; the second is, to place a glass of water on the breast, and if
it moves, it betokens life; the third is, to hold a bright, clean,
looking-glass to the mouth and nose, and if the glass be dimmed with a
little moisture on it, it betokens life. These three experiments are
good, but you must not depend upon them too much, for though the feather
and the glass do not move, and the looking-glass continues bright and
clear, yet it is not a necessary consequence that she is dead. For the
movement of the lungs, by which breathing is produced, may be checked,
so that she cannot breathe, and yet internal heat may remain, which is
not evident by the motion of the breast or lungs, but lies hidden in the
heart and arteries.

Examples of this we find in flies and swallows, who seem dead to all
outward appearances, breathless and inanimate, and yet they live by that
heat which is stored up in the heart and inward arteries. At the
approach of summer, however, the internal heat, being restored to the
outer parts, they are then brought to life again, out of their sleeping
trance.

Those women, therefore, who apparently die suddenly, and from no visible
cause, should not be buried until the end of three days, lest the living
be buried instead of the dead.



CURE.

The part affected is the womb, of which there are two motions--natural
and symptomatic. The natural motion is, when the womb attracts the male
seed, or expels the infant, and the symptomatical motion, of which we
are speaking, is a convulsive drawing up of the womb.

The cause is usually in the retention of the seed, or in the suppression
of the menses, which causes a repletion of the corrupt humours of the
womb, from which a windy refrigeration arises, which produces a
convulsion of the ligaments of the womb. And just as it may arise from
humidity or repletion, so also, as it is a convulsion, it may be caused
by dryness or emptiness. Lastly also, it may arise from abortion or from
difficult childbirth.



SIGNS.

On the approach of suffocation of the womb the face becomes pale, there
is a weakness of the legs, shortness of breathing, frigidity of the
whole body, with a spasm in the throat, and then the woman falls down,
bereft of sense and motion; the mouth of the womb is closed up, and
feels hard when touched with the finger. When the paroxysm or the fit is
over, she opens her eyes, and as she feels an oppression of the stomach,
she tries to vomit. And lest any one should be deceived into taking one
disease for another, I will show how it may be distinguished from those
diseases which most resemble it.

It differs from apoplexy, as it comes without the patient crying out; in
hysterical fits also the sense of feeling is not altogether destroyed
and lost, as it is in apoplexy; and it differs from epilepsy, as the
eyes are not distorted, and there is spongy froth from the mouth. That
convulsive motion also, which is frequently accompanied by symptoms of
suffocation, is not universal, as it is in epilepsy, but there is some
convulsion, but that without any violent agitation. In syncope both
breathing and the pulse fail, the face grows pale, and the woman faints
suddenly; but in hysterical attacks there are usually both breathing
and pulse, though these are indistinct; the face is red and she has a
forewarning of the approaching fit. It cannot, however, be denied that
syncope may accompany this feeling of suffocation. Lastly, it can be
distinguished from lethargy by the pulse, which is rapid in the former,
but weak in the latter.



CURE.

In the cure of this affection, two things must be taken care of:--_In
the first place_, nature must be stimulated to expel these hurtful
humours which obscure the senses, so that the woman may be brought back
from that sleepy fit. _Secondly_, during the intervals of the attack,
proper remedies must be employed, in order to remove the cause.

To stimulate nature, apply cupping-glasses to the hips and navel: apply
ligatures to the thighs, rub the extremities with salt, mustard and
vinegar, and shout and make a great noise in her ears. Hold asafoetida
to the nose, or sacopenium steeped in vinegar; make her sneeze by
blowing castor-powder, white pepper and hellebore up her nose; hold
burnt feathers, hair, leather, or anything else with a strong, stinking
smell under her nose, for bad odours are unpleasant to nature, and the
animal spirits so strive against them, that the natural heat is restored
by their means. The brain is sometimes so oppressed, that it becomes
necessary to burn the outer skin of the head with hot oil, or with a hot
iron, and strong injections and suppositories are useful. Take a handful
each of sage, calamint, horehound, feverfew, marjoram, betony and
hyssop; half an ounce of aniseed; two drachma each of coloquintida,
white hellebore and salgem; boil these in two quarts of water till
reduced to half; add two ounces of castor oil and two drachms of hiera
piera and make an injection of it. Or take two ounces of boiled honey,
half a scruple of spurge, four grains of coloquint, two grains of
hellebore and drachm of salt; make a suppository. Hippocrates mentions a
hysterical woman who could only be relieved of the paroxysms by pouring
cold water on her: yet this is a strange cure, and should only be
administered in the heat of summer, when the sun is in the tropic of
Cancer.

If it be caused by the retention and corruption of the seed, let the
mid-wife take oil of lilies, marjoram and bay leaves, and dissolve two
grains of civet in them, and the same quantity of musk, and at the
moment of the paroxysm let her dip her finger into the mixture and put
it into the neck of the womb, and tickle and rub it with it.

When the fit is over, proceed to remove the cause. If it arises from
suppression of the menses, look in Chapter XI, p. 102, for the cure. If
it arises from the retention of the seed, a good husband will administer
the cure, but those who cannot honourably obtain that remedy, must use
such means as will dry up and diminish the seed, as diaciminum,
diacalaminthes, etc. The seed of the agnus castus is highly valued as a
draught, whether taken inwardly, applied outwardly or used as a
suffumigation. It was held in high esteem by the Athenian women, for by
its means they remained as pure vessels and preserved their chastity, by
only strewing it on the bed on which they lay, and hence the name of
_agnus castus_, which was given to it, as denoting its effects. Make an
issue on the inside of each leg, four inches below the knee, and then
make lozenges of two scruples of agric, half a scruple each of wild
carrot seed and ligne aloes; three drachms of washed turpentine, and
make a bolus with a conserve of flowers. Eight drachms of castor taken
in white wine are very useful in this case, or you may make pills of it
with dog's tooth, and take them on going to bed. Take an ounce of white
briony root dried and cut up like carrots, put it into a little wine and
place it on the fire, and drink when warm. Take one scruple each of
myrrh, castor and asafoetida; four grains each of saffron and rue-seed,
and make eight pills and take two every night on going to bed.

Galen, from his own experience, recommends powdered agaric, of which he
frequently gave one scruple in white wine. Put a head of bruised garlic
on the navel at bed time, and fasten it with a swathing band. Make a
girdle for the waist of galbanum, and also a plaster for the stomach,
and put civet and musk on one part of it, which must be applied to the
navel. Take two drachms each of pulvis benedict, and of troches of
agaric, a sufficient quantity of mithridate, and make two pessaries, and
that will purge the matrix of wind and phlegm; foment the private parts
with salad oil in which some feverfew and camomiles have been boiled.
Take a handful of roseleaves and two scruples of cloves, sew them in a
little cloth and boil them for ten minutes in malmsey; then apply them,
as hot as they can be borne, to the mouth of the womb, but do not let
the smell go up her nose. A dry diet must still be adhered to and the
moderate use of Venus is advisable. Let her eat aniseed biscuits
instead of bread, and roast meat instead of boiled.

* * * * *




CHAPTER VII

_Of the Descending or Falling of the Womb._


The descent of the womb is caused by a relaxation of the ligatures,
whereby the matrix is carried backward, and in some women it protrudes
to the size of an egg, and there are two kinds of this, distinguished by
a descending and a precipitation. The descending of the womb is, when it
sinks down to the entrance of the private parts, and appears either very
little or not at all, to the eye. Its precipitation is when it is turned
inside out like a purse, and hangs out between the thighs, like a
cupping glass.



CAUSE.

This is either external or internal. The external cause is difficult
childbirth, violent pulling away, or inexperience in drawing away the
child, violent coughing, sneezing, falls, blows, and carrying heavy
burdens. The internal cause, is generally the flow of too much moisture
into these parts, which hinders the operation of the womb, whereby the
ligaments by which the womb is supported are relaxed. The particular
cause, however, lies in the retention of the _semen_, or in the
suppression of the monthly courses.



SIGNS.

The principal gut and the bladder are often so crushed, that the passage
of both evacuations is hindered. If the urine flows out white and thick,
and the midriff is interfered with, the loins suffer, the private parts
are in pain, and the womb descends to them, or else comes clean out.



PROGNOSTICS.

If an old woman is thus affected, the cure is very difficult, because it
weakens the womb, and therefore, though it may be put back into its
proper place, yet it is apt to get displaced again, by a very slight
amount of illness. And also with younger women, if this disease is
inveterate, and if it is caused by putrefaction of the nerves, it is
incurable.



CURE.

The womb, being placed by nature between the straight gut and the
bladder, ought not to be put back again until the powers of both are
excited. Now that nature is relieved of her burden, let the woman be
laid on her back so that her legs may be higher than her head; let her
feet be drawn up towards her private parts, and her knees spread open.
Then apply oil of sweet almonds and lilies, or a decoction of mallows,
beet, fenugreek and linseed, to the swelling; when the inflammation is
reduced, let the midwife rub her hand with oil of mastic, and restore
the womb to its proper place. When the matrix is up, the patient's
position must be changed. Her legs must be put out quite straight and
laid together, and apply six cupping glasses to her breast and navel.
Boil feverfew, mugwort, red rose leaves and comfrey in red wine; make a
suffumigation for the matrix, and apply sweet scents to her nose. When
she comes out of her bath, give her an ounce of syrup of feverfew with a
drachm of dog's tooth (_mithridate_). Take three drachms each of
laudanum and mastic, and make a plaster for the navel of it, and then
make pessaries of asafoetida, saffron, comfrey, and mastic, adding a
little castor oil.--Parius in such cases makes his pessaries only of
cork, shaped like a small egg; he covered them with wax and mastic
dissolved together, and fastening them to a thread, he put them into the
womb.

The immediate danger being now removed and the matrix returned to its
natural place the remote cause must be got rid of. If she be of full
habit of body open a vein, after preparing her with syrup of betony,
calamint, hyssop and feverfew. Give a purge, and if the stomach be
oppressed with any crude matter relieve it by emetics and by sudorifics
of lignum sanctum and sassafras taken twenty days consecutively, which
dry up the superfluous moisture, and consequently suppress the cause of
the disease.

The air should be hot and dry, and her diet hot and attenuating. Let her
abstain from dancing, jumping, sneezing, as well as from all mental and
bodily emotions, eat sparingly, not drink much, and be moderate in her
sleep.

* * * * *




CHAPTER VIII

_Of the Inflammation of the Womb._


The phlegmon, or inflammation of the matrix, is a humour which affects
the whole womb, and is accompanied by unnatural heat, by obstruction and
by an accumulation of corrupt blood.



CAUSE.

The cause of this affection is suppression of the courses, fullness of
body, the immoderate use of sexual intercourse, frequent handling the
genitals, difficult child-birth, violent motions of the body, falls,
blows, to which may be added, the use of strong pessaries, whereby the
womb is frequently inflamed, cupping glasses, also, fastened to the
_pubis_ and _hypogastrium_, draw the humours of the womb.



SIGNS.

The signs are pains in the lower parts of the body and head, humours,
sickness, coldness in the knees, throbbing in the neck, palpitation of
the heart. Often, also, there is shortness of breath because of the
heart which is close to the midriff, and the breasts sympathising with
the swollen and painful womb. Besides this, if the front of the matrix
be inflamed, the privates suffer, and the urine is suppressed, or only
flows with difficulty. If the hinder part be inflamed, the loins and
back suffer, and the bowels are very costive; if the right side be
inflamed, the right hip suffers, and the right leg is heavy and moves
slowly, so that at times she seems almost lame. If, however, the left
side of the womb be inflamed, then the left hip suffers and the left leg
is weaker than the right. If the neck of the womb is affected, by
putting her finger in, the midwife feels that its mouth is contracted
and closed up, and that it is hard round it.



CURE.

In the cure, first of all, let the humours which flow to the womb be
expelled. To effect this, after the bowels have been loosened by cooling
clysters bleeding will be necessary. Therefore, open a vein in the arm,
if she is not with child; the day after strike the saphena in both feet,
fasten ligatures and cupping glasses to the arm, and rub the upper part.
Purge gently with cassia, rhubarb, senna and myrobalan. Take one drachm
of senna, a scruple of aniseed, myrobalan, half an ounce, with a
sufficient quantity of barley water. Make a decoction and dissolve syrup
of succory in it, and two ounces of rhubarb; pound half an ounce of
cassia with a few drops of oil of aniseed and make a draught. At the
commencement of the disease, anoint the private parts and loins with oil
of roses and quinces: make plasters of plantain, linseed, barley meal,
melilot, fenugreek, white of eggs, and if the pain be intense, a little
laudanum; foment the genitals with a decoction of poppy-heads, purslace,
knot-grass and water-lilies. Make injections of goat's milk, rose water,
clarified whey and honey of roses. When the disease is on a decline, use
injections of sage, linseed, mugwort, pennyroyal, horehound, fenugreek,
and anoint the lower parts of the stomach with oil of camomiles and
violets.

Take four ounces each of lily and mallow roots, a handful of dog's
mercury, a handful and a half each of mugwort, feverfew, camomile
flowers and melilot, bruise the herbs and roots, and boil them in a
sufficient quantity of milk; then add two ounces each of fresh butter,
oil of camomiles and lilies, with a sufficient quantity of bran, make
two plasters, and apply one before and the other behind.

If the tumour cannot be removed, but seems inclined to suppurate, take
three drachms each of fenugreek, mallow roots, boiled figs, linseed,
barley meal, dove's dung and turpentine; half a drachm of deer's suet,
half a scruple of opium and make a plaster of wax.

Take bay leaves, sage, hyssop, camomiles, and mugwort, and make an
infusion in water.

Take half a handful of wormwood and betony and half a pint each of white
wine and milk, boil them until reduced to half; then take four ounces of
this decoction and make an injection, but you must be careful that the
humours are not brought down into the womb. Take three drachms each of
roast figs, and bruised dog's mercury; three drachms each of turpentine
and duck's grease, and two grains of opium; make a pessary with wax.

The room must be kept cool, and all motions of the body, especially of
the lower parts, must be prohibited. Wakefulness is to be recommended,
for humours are carried inward by sleep, and thus inflammation is
increased. Eat sparingly, and drink only barley water or clarified whey,
and eat chickens and chicken broth, boiled with endive, succory, sorrel,
bugloss and mallows.

* * * * *




CHAPTER IX

_Of Scirrhous Tumours, or Hardness of the Womb._


A _scirrhus_, or a hard unnatural swelling of the matrix is generally
produced by neglected, or imperfectly cured phlegm, which, insensibly,
hinders the functions of the womb, and predisposes the whole body to
listlessness.



CAUSE.

One cause of this disease may be ascribed to want of judgment on the
part of the physician, as many empirics when attending to inflammation
of the womb, chill the humour so much that it can neither pass backward
nor forward, and hence, the matter being condensed, turns into a hard,
stony substance. Other causes may be suppression of the menses,
retention of the _Lochein_, commonly called the after purging; eating
decayed meat, as in the disordered longing after the _pleia_ to which
pregnant women are often subject. It may, however, also proceed from
obstructions and ulcers in the matrix or from some evil affections of
the stomach or spleen.

If the bottom of the womb be affected, she feels, as it were, a heavy
burden representing a mole,[7] yet differing from it, in that the
breasts are attenuated, and the whole body grows less. If the neck of
the womb be affected, no outward humours will appear; its mouth is
retracted and feels hard to the touch, nor can the woman have sexual
intercourse without great pain.



PROGNOSTICS.

Confirmed scirrhus is incurable, and will turn to cancer or incurable
dropsy, and when it ends in cancer it proves fatal, because as the
innate heat of these parts is almost smothered, it can hardly be
restored again.



CURE.

Where there is repletion, bleeding is advisable, therefore open a vein
in one arm and in both feet, more especially if the menses are
suppressed.

Treat the humours with syrup of borage, succory made with a poultice,
and then take the following pills, according to the patient's strength.

Hiera piera six drachms, two and a half drachms each of black hellebore
and polypody; a drachm and a half each of agaric, lapis lazuli, sal
Indiae, coloquintida, mix them and make two pills. After purging,
mollify the hardness as follows:--the privy parts and the neck of the
womb with an ointment of decalthea and agrippa; or take two drachms each
of opopanax, bdellium, ammoniac and myrrh, and half a drachm of saffron;
dissolve the gum in oil of lilies and sweet almond and make an ointment
with wax and turpentine. Apply diacatholicon ferellia below the navel,
and make infusions of figs, mugwort, mallows, pennyroyal, althea, fennel
roots, melilot, fenugreek and the four mollifying herbs, with oil of
dill, camomiles and lilies dissolved in it. Take three drachms of gum
bdellium, put the stone pyrites on the coals, and let her take the fumes
into her womb. Foment the privy parts with a decoction of the roots and
leaves of dane wort. Take a drachm each of gum galbanum and opopanax,
half an ounce each of juice of dane wort and mucilage of fenugreek, an
ounce of calve's marrow, and a sufficient quantity of wax, and make a
pessary. Or make a pessary of lead only, dip it in the above mentioned
things, and put it up.

The atmosphere must be kept temperate, and gross and salt meats such as
pork, bull beef, fish and old cheese, must be prohibited.



FOOTNOTES:

[7] _Mole_: "A somewhat shapeless, compact fleshy mass occurring in the
uterus, due to the retention and continued life of the whole or a part
of the foetal envelopes, after the death of the foetus (a _maternal or
true mole_); or being some other body liable to be mistaken for this, or
perhaps a polypus or false mole." (_Whitney's Century Dictionary_.)

* * * * *




CHAPTER X

_Of Dropsy of the Womb._


Uterine dropsy is an unnatural swelling, caused by the collection of
wind or phlegm in the cavity, membranes or substance of the womb, on
account of the want of innate heat and of sufficient alimentation, and
so it turns into an excrescence. The causes are, too much cold and
moisture of the milt and liver, immoderate drinking, eating
insufficiently cooked meat, all of which by causing repletion, overpower
the natural heat. It may likewise be caused by undue menstruation, or by
any other immoderate evacuation. To these may be added abortions,
subcutaneous inflammations and a hardened swelling of the womb.



SIGNS.

The signs of this affection are as follows:--The lower parts of the
stomach, with the genitals, are swollen and painful; the feet swell, the
natural colour of the face is lost, the appetite becomes depraved, and
there is a consequent heaviness of the whole body. If the woman turns
over in bed a noise like flowing water is heard, and sometimes water is
discharged from the womb. If the swelling is caused by wind and the
stomach feels hot, it sounds like a drum; the bowels rumble, and the
wind escapes through the neck of the womb with a murmuring noise. This
affection may be distinguished from true conception in many ways, as
will be shown in the chapter on _conception_. It is distinguished from
common dropsy, by the lower parts of the stomach being most swollen.
Again, it does not appear so injurious in this blood-producing
capability, nor is the urine so pale, nor the face so altered. The upper
parts are also not so reduced, as in usual dropsy.



PROGNOSTICS.

This affection foretells the ruin of the natural functions, by that
peculiar sympathy it has with the liver, and that, therefore,
_kathydria_, or general dropsy will follow.



CURE.

In the cure of this disease, imitate the practice of Hippocrates, and
first mitigate the pain with fomentations of melilot, dog's mercury,
mallows, linseed, camomiles and althoea. Then let the womb be prepared
with syrup of stoebis, hyssop, calamint, mugwort, with distilled water,
a decoction of elder, marjoram, sage, origan, spearage, pennyroyal, and
betony. Purge with senna, agaric, rhubarb, and claterium. Take spicierum
hier, a scruple each of rhubarb, agaric lozenges, and make into pills
with iris juice.

When diseases arise from moistness, purge with pills, and in those
affections which are caused by emptiness or dryness, purge by means of a
draught. Apply cupping glasses to the stomach and also to the navel,
especially if the swelling be flatulent. Put a seton on to the inside of
each leg, the width of a hand below the knee. Take two drachms each of
sparganium, diambrae, diamolet, diacaliminti, diacinamoni, myrrh
lozenges, and a pound of sugar; make these into lozenges with betony
water, and take them two hours before meals. Apply a little bag of
camomiles, cummin and melilot boiled in oil of rue, to the bottom of the
stomach as hot as it can be borne; anoint the stomach and the privates
with unguent agripp, and unguent aragon. Mix iris oil with it, and cover
the lower part of the stomach with a plaster of bay berries, or a
cataplasm made of cummin, camomiles, briony root, adding cows' and
goats' dung.

Our modern medical writers ascribe great virtues to tobacco-water,
injected into the womb by means of a clyster. Take a handful each of
balm of southernwood, origanum, wormwood, calamint, bay berries and
marjoram, and four drachms of juniper berries; make a decoction of these
in water, and use this for fomentations and infusions. Make pessaries of
storax, aloes, with the roots of dictam, aristolochia and gentian, but
instead of this you may use the pessary prescribed at the end of Chapter
XVII. Let her take aromatic electuary, disatyrion and candied eringo
roots, every morning.

The air must be hot and dry, moderate exercise is to be taken and too
much sleep prohibited. She may eat the flesh of partridges, larks,
grouse, hares, rabbits, etc., and let her drink diluted urine.

* * * * *




CHAPTER XI

_Of Moles[8] and False Conceptions._


This disease may be defined as an inarticulate shapeless piece of flesh,
begotten in the womb as if it were true conception. In this definition
we must note two things: (1) because a mole is said to be inarticulate
or jointless, and without shape, it differs from monstrosities which are
both _formata_ and _articulata_; (2) it is said to be, as it were a true
conception, which makes a difference between a true conception, and a
mole, and this difference holds good in three ways. First, in its genus,
because a mole cannot be said to be an animal: secondly, in the species,
because it has not a human figure and has not the character of a man;
thirdly, in the individual, for it has no affinity to the parent, either
in the whole body, or in any particular part of it.



CAUSE.

There is a great difference of opinion amongst learned writers as to the
cause of this affection. Some think, that if the woman's seed goes into
the womb, and not the man's, that the mole is produced thereby. Others
declare that it springs from the menstruous blood, but if these two
things were granted, then virgins, by having their courses or through
nocturnal pollutions, might be liable to the same things, which none
have ever been yet. The true cause of this fleshy mole is due both to
the man and from the menstruous blood in the woman both mixing together
in the cavity of the womb. Nature finding herself weak there (and yet
wishing to propagate her species), labours to bring forth a defective
conception rather than nothing and instead of a living creature produces
a lump of flesh.



SIGNS.

The signs of a mole are these. The _menses_ are suppressed, the appetite
becomes depraved, the breasts swell and the stomach becomes inflated and
hard. So far the symptoms in a pregnant woman and in one that has a mole
are the same, but now this is how they differ. The first sign of
difference is in the movements of a mole. It may be felt moving in the
womb before the third month, whereas an infant cannot be so felt; yet
this motion cannot proceed from any intelligent power in the mole, but
from the capabilities of the womb, and of the seminal vigour,
distributed through the substance of the mole, for it does not live an
animal, but a vegetable life, like a plant. _Secondly_, in a mole the
stomach swells suddenly, but in true conception it is first contracted,
and then rises by degrees. _Thirdly_, if the stomach is pressed with the
hand, the mole gives way, and returns to its former position as soon as
the hand is removed. But a child in the womb does not move immediately
though pressed with the hand, and when the hand is removed it returns
slowly or not at all. _Lastly_, no child continues in the womb more than
eleven months, but a mole continues for four or five years, more or
less, sometimes according as it is fastened to the matrix; and I have
known a mole pass away in four or five months. If, however, it remains
until the eleventh month, the woman's legs grow weak and the whole body
wastes away, but the stomach still increases, which makes some women
think that they are dropsical, though there is no reason for it, for in
dropsy the legs swell and grow big, but in a mole they wither and fall
away.



CURE.

In the school of Hippocrates we are taught that bleeding causes
abortion, by taking all the nourishment which should preserve the life
of the embryo. In order, therefore, that this faulty conception may be
deprived of that nourishing sap by which it lives, open the liver vein
and saphena in both feet, apply cupping glasses to the loins and sides
of the stomach, and when that has been done, let the uterine parts be
first softened, and then the expulsive powers be stimulated to get rid
of the burden.

In order to relax the ligatures of the mole, take three handfuls of
mallows with their roots, two handfuls each of camomiles, melilot,
pellitory of the wall, violet leaves, dog's mercury, fennel roots,
parsley, and one pound each of linseed and fenugreek; boil them in oil
and let the patient sit in it up to her navel. When she comes out of her
bath, she should anoint her private parts and loins with the following
ointment:--"Take one ounce each of oil of camomiles, lilies and sweet
almonds: half an ounce each of fresh butter, laudanum and ammoniac, and
make an ointment with oil of lilies. Or, instead of this, you may use
unguentum agrippae or dialthea. Take a handful of dog's mercury and
althea roots; half a handful of flos brochae ursini; six ounces of
linseed and barley meal. Boil all these together in honey and water and
make a plaster, and make pessaries of gum galbanum, bdellium, ammoniac,
figs, pig's fat and honey.

After the ligaments of the mole are loosened, let the expulsive powers
be stimulated to expel the mole, and for doing this, all those drugs may
be used which are adapted to bring on the courses. Take one ounce of
myrrh lozenges, half an ounce each of castor, astrolachia, gentian and
dittany and make them into a powder, and take one drachm in four ounces
of mugwort water. Take calamint, pennyroyal, betony, hyssop, sage,
horehound, valerian, madder and savine; make a decoction in water and
take three ounces of it, with one and a half ounces of feverfew. Take
three scruples each of mugwort, myrrh, gentian and pill. coch.; a drachm
each of rue, pennyroyal and opopanax, and the same of asafoetida,
cinnamon, juniper-berries and borage, and make into pills with savine
juice, to be taken every morning. Make an infusion of hyssop, bay
leaves, bay berries, calamint, camomiles, mugwort and savine. Take two
scruples each of sacopenium, mugwort, savine, cloves, nutmeg, bay
berries; one drachm of galbanum; one scruple each of hiera piera and
black hellebore, and make a pessary with turpentine.

But if these medicaments are not procurable, then the mole must be
pulled out by means of an instrument called the _pes gryphis_,[9] which
may be done without much danger if it be performed by a skilful surgeon.
After she has been delivered of the mole (because the woman will have
lost much blood already), let the flow of blood be stopped as soon as
possible.

Apply cupping glasses to the shoulders and ligatures to the arms, and if
this be not effective, open the liver vein in the arm.

The atmosphere of the room must be kept tolerably dry and warm, and she
must be put on a dry diet, to soothe the system; she must, however,
drink white wine.



FOOTNOTES:

[8] _Mole_: "A somewhat shapeless, compact fleshy mass occurring in the
uterus, due to the retention and continued life of the whole or a part
of the foetal envelopes, after the death of the foetus (_a maternal or
true mole_); or being some other body liable to be mistaken for this, or
perhaps a polypus or false mole." (_Whitney's Century Dictionary_.)

[9] _Griffin's claw_, a peculiar hooked instrument.

* * * * *




CHAPTER XII

_Of Conception and its Signs, and How a Woman may know whether it
be Male or Female._


Ignorance often makes women the murderesses of the fruit of their own
body, for many, having conceived and finding themselves out of order,
and not rightly knowing the cause, go to the shop of their own conceit
and take whatever they think fit, or else (as the custom is) they send
to the doctor for a remedy, and he, not perceiving the cause of their
trouble, for nothing can be diagnosed accurately by the urine,
prescribes what he thinks best; perhaps some diuretic or cathartic,
which destroy the embryo. Therefore Hippocrates says, it is necessary
that women should be instructed in the signs of conception, so that the
parent as well as the child may be saved from danger. I shall,
therefore, lay down some rules, by which every woman may know whether
she is pregnant or not, and the signs will be taken from the woman, from
her urine, from the child and from experiments.



SIGNS.

The first day after conception, she feels a slight quivering and
chilliness throughout her body; there is a tickling of the womb and a
little pain in the lower parts of her stomach. Ten or twelve days after
she feels giddy and her eyes dim and with circles round them; the
breasts swell and grow hard, with some pain and pricking in them, whilst
the stomach rises and sinks again by degrees, and there is a hardness
about the navel. The nipples grow red, the heart beats unusually
strongly, the natural appetite abates, and the woman has a craving after
strange food. The neck of the womb is contracted, so that it can
scarcely be felt when the finger is put in. And the following is an
infallible sign; she is alternately in high spirits and melancholy; the
monthly courses cease without any apparent cause, the evacuations from
the bowels are retained unusually long, by the womb pressing on the
large gut, and her desire for sexual intercourse is diminished. The
surest sign is taken from the infant, which begins to move in the womb
in the third or fourth month, and not in the manner of a mole, mentioned
above, from side to side like a stone, but gently, as may be perceived
by applying the hand cold upon the stomach.



SIGNS TAKEN FROM THE URINE.

The best writers affirm that the water of a pregnant woman is white and
has little specks in it, like those in a sunbeam, ascending and
descending in it, of an opal colour, and when the sediment is disturbed
by shaking the urine, it looks like carded wool. In the middle of
gestation it turns yellow, then red and lastly black, with a red film.
At night on going to bed, let her drink water and honey, and if
afterwards she feels a beating pain in her stomach and about the navel,
she has conceived. Or let her take the juice of cardius, and if she
brings it up again, that is a sign of conception. Throw a clean needle
into the woman's urine, put it into a basin and let it stand all night.
If it is covered with red spots in the morning, she has conceived, but
if it has turned black and rusty, she has not.



SIGNS TAKEN FROM THE SEX, TO SHOW WHETHER IT BE A MALE OR FEMALE.

If it is a male, the right breast swells first, the right eye is
brighter than the left, the face is high-coloured, because the colour is
such as the blood is, and as the male is conceived of purer blood and of
more perfect seed than the female, red specks in the urine, and making a
sediment, show that a male has been conceived, but if they are white, a
female. Put the urine of the woman into a glass bottle, let it stand
tightly stoppered for two days, then strain it through a fine cloth,
and you will find little animals in it. If they are red, it is a male,
but if white, it is a female.

The belly is rounder and lies higher with a boy than with a girl, and
the right breast is harder and plumper than the left, and the right
nipple redder, and the woman's colour is clearer than when she has
conceived a girl.

To conclude, the most certain sign to give credit to, is the motion of
the child, for the male moves in the third month, and the female not
until the fourth.

* * * * *




CHAPTER XIII

_Of Untimely Births._


When the fruit of the womb comes forth before the seventh month (that
is, before it comes to maturity), it is said to be abortive; and, in
effect, the children prove abortive, that is, do not live, that are born
in the eighth month. Why children born in the seventh or ninth month
should live, and not those born in the eighth, may seem strange, and yet
it is true. The cause of it is ascribed by some to the planet under
which the child is born; for every month, from conception to birth, is
governed by its own planet, and in the eighth month Saturn predominates,
which is dry and cold; and coldness, being an utter enemy to life,
destroys the natural constitution of the child. Hippocrates gives a
better reason, viz.:--The infant, being every way perfect and complete
in the seventh month, wants more air and nourishment than it had before,
and because it cannot obtain this, it tries for a passage out. But if it
have not sufficient strength to break the membranes and to come out as
ordained by nature, it will continue in the womb until the ninth month,
so that by that time it may be again strengthened. But if it returns to
the attempt in the eighth month and be born, it cannot live, because the
day of its birth is either past or is to come. For in the eighth month
Avicunus says, it is weak and infirm, and therefore on being brought
into the cold air, its vitality must be destroyed.



CURE.

Untimely births may be caused by cold, for as it causes the fruit of the
tree to wither and fall before it is ripe, so it nips the fruit of the
womb before it comes to perfection, or makes it abortive;--sometimes by
humidity, which weakens its power, so that the fruit cannot be retained
until the proper time. It may be caused by dryness or emptiness, which
rob the child of its nourishment, or by an alvine discharge, by bleeding
or some other evacuation, by inflammation of the womb, and other severe
disease. Sometimes it is caused by joy, anger, laughter and especially
by fear, for then the heat forsakes the womb, and goes to the heart, and
so the cold sinks into the womb, whereby the ligaments are relaxed, and
so abortion follows. On this account, Plato recommended that the woman
should avoid all temptations to excessive joy and pleasure, as well as
all occasions for fear and grief. Abortion may also be caused by the
pollution of the air by filthy odours, and especially by the smell of
the smouldering wick of a candle, and also by falls, blows, violent
exercise, jumping, dancing, etc.



SIGNS.

Signs of coming abortion are a falling away of the breast, with a flow
of watery milk, pains in the womb, heaviness in the head, unusual
weariness in the hips and thighs, and a flowing of the courses. Signs
denoting that the fruit is dead in the womb are sunken eyes, pains in
the head, frights, paleness of the face and lips, gnawing at the
stomach, no movements of the infant; coldness and looseness of the
mouth of the womb. The stomach falls down, whilst watery and bloody
discharges come from the womb.

* * * * *




CHAPTER XIV

_Directions for Pregnant Women._


The prevention of untimely births consists in removing the
aforementioned causes, which must be effected both before and after
conception.

Before conception, if the body be too hot, dry or moist, employ such
treatment as to counteract the symptoms; if the blood be vitiated purify
it, if plethoric, open the liver vein; if gross, reduce it; if too thin
strengthen and nourish it. All the diseases of the womb must be removed
as I have shown.

After conception, let the atmosphere be kept temperate, do not sleep too
much, avoid late hours, too much bodily exercise, mental excitement,
loud noises and bad smells, and sweet smells must also be avoided by
those who are hysterical. Refrain from all things that may provoke
either urine or menstruation, also salt, sour, and windy food, and keep
to a moderate diet.

If the bowels are confined, relieve the stomach with injections made of
a decoction of mallows and violets, with sugar and salad oil; or make a
broth with borage, buglos, beetroot, and mallows, and add a little manna
to it. If, on the other hand, she be troubled with looseness of the
bowels, do not check it with medical advice, for all the uterine fluxes
have some bad qualities in them, which must be evacuated before the
discharge is stopped.

A cough is another thing to which pregnant women are frequently liable,
and which causes them to run great danger of miscarrying, by the shock
and continual drain upon the vein. To prevent this shave off the hair
from the coronal commissures, and apply the following plaster to the
place.

Take half an ounce of resin, a drachm of laudanum, a drachm each of
citron peel, lignaloes and galbanum, with a sufficient quantity of
liquid and dry styrax. Dissolve the gum in vinegar and make a plaster,
and at night let her inhale the fumes of these lozenges, thrown upon
bright coals. Take also a drachm and a half each of frankincense, styrax
powder and red roses: eight drachms of sandrich, a drachm each of
mastic, benjamin and amber; make into lozenges with turpentine, and
apply a cautery to the nape of the neck. And every night let her take
the following pills:--Half an ounce each of hypocistides, terrae
sigilatae and fine bole; two drachms each of bistort, alcatia, styrax
and calamint, and one drachm of cloves, and make into pills with syrup
of myrtles.

In pregnant women, a corrupt matter is generated which, flowing to the
ventricle, spoils the appetite and causes sickness. As the stomach is
weak, and cannot digest this matter, it sometimes sends it to the bowels
which causes a flux of the stomach, which greatly adds to the weakness
of the womb. To prevent all these dangers the stomach must be
strengthened by the following means:--Take one drachm each of lignaloes
and nutmeg; a scruple each of mace, cloves, mastic, laudanum; an ounce
of oil of spikenard; two grains of musk, half an ounce each of oil of
mastic, quinces and wormwood, and make into an ointment for the stomach,
to be applied before meals. Instead of this, however, you may use
cerocum stomachile Galeni. Take half an ounce each of conserve of
borage, buglos and atthos; two drachms each of confection of hyacinths,
candied lemon peel, specierum, diamarg, pulo. de genunis: two scruples
each of nutmeg and diambra; two drachma each of peony roots and
diacoratum, and make into an electuary with syrup of roses, which she
must take twice a day before meals. Another affection which troubles a
pregnant woman is swelling of the legs, which happens during the first
three months, by the superfluous humours descending from the stomach and
liver. To cure this, take two drachms of oil of roses, and one drachm
each of salt and vinegar; shake them together until the salt is
dissolved, and anoint the legs with it hot, rubbing it well in with the
hand. It may be done without danger during the fourth, fifth and sixth
months of pregnancy; for a child in the womb is compared to an apple on
the tree. For the first three months it is a weak and tender subject,
like the apple, to fall away; but afterwards, when the membranes become
strengthened, the fruit remains firmly fastened to the womb, and not
subject to mischances, and so it remains, until the seventh month, until
when it is near the time, the ligaments are again relaxed (like the
apple that is almost ripe).

They grow looser every day, until the appointed time for delivery; if,
therefore, the body is in real need of purging, the woman may do it
without danger in the fourth, fifth or sixth month, but neither before
nor after that unless in the case of some violent illness, in which it
is possible that both mother and child may perish. Apply plasters and
ointments to the loins in order to strengthen the fruit in the womb.
Take one drachm each of gum Arabic, galangale, bistort, hypocistid and
storax, a drachm and a half each of fine bole, nutmeg, mastic, balaust,
dragon's blood and myrtle berries, and a sufficient quantity of wax and
turpentine and make into a plaster. Apply it to the loins in the winter,
and remove it every twenty-four hours, lest the loins should become
overheated by it. In the interim, anoint the private parts and loins
with _countess' balsam_ but if it be summer time and the loins hot, the
following plaster will be more suitable. Take a pound of red roses, two
drachms each of mastic and red Sanders, one drachm each of bole ammoniac
and red coral, two drachms and a half each of pomegranate seed and
prepared coriander seed, two scruples of barberries, one ounce each of
oil of mastic and of quinces, and plantain-juice.

Anoint the loins also with sandalwood ointment, and once a week wash
them with two parts of rose-water and one of white wine mixed together
and warmed at the fire. This will assuage the heat of the loins, get rid
of the oil of the plaster from the pores of the skin, and cause the
fresh ointment or plaster to penetrate more easily, and to strengthen
the womb. Some think that a load-stone laid upon the navel, keeps a
woman from abortion. The same thing is also stated of the stone called
_aetites_ or eagle-stone, if it is hung round the neck. Samian stone has
the same virtue.

* * * * *




CHAPTER XV

_Directions for Women when they are taken in Labour, to ensure
their safe Delivery, and Directions for Midwives._


Having thus given the necessary directions to pregnant women, how to
manage their health during their pregnancy, I will now add what is
necessary for them to do, in order that they may be safely delivered.

When the time of birth draws near, the woman must be sure to send for a
skilful midwife, and that rather too soon than too late. She must have a
pallet bed ready to place it near the fire, so that the midwife and
those who are to help her, may be able to pass round it, and give
assistance on either side, as may be required. A change of linen must be
in readiness, and a small stool to rest her feet against, as she will
have more power when her legs are bent, than when they are straight.

When everything is thus ready, and when the woman feels the pains coming
on, if the weather be not cold, she should walk about the room, rest on
the bed occasionally, waiting for the breaking of the waters, which is a
fluid contained in one of the outward membranes, and which flows out
thence, when the membrane is broken by the struggles of the child. There
is no special time for this discharge, though it generally takes place
about two hours before the birth. Movements will also cause the womb to
open and dilate, and when lying long in bed will be uncomfortable. If
she be very weak she may take some mild cordial to give her strength, if
her pain will permit her; and if the labour be tedious, she may be
revived with chicken or mutton broth, or she may take a poached egg; but
she must be very careful not to eat to excess.

There are many postures in which women are delivered; some sitting in a
chair, supported by others, or resting on the bed; some again upon their
knees and resting on their arms; but the safest and most commodious way,
is in the bed, and then the midwife ought to observe the following
rules:--Let her lay the woman upon her back, with her head a little
raised by means of a pillow, with similar supports for her loins and
buttocks, which latter should also be raised, for if she lies low, she
cannot be delivered so easily. Then let her keep her knees and thighs as
far apart as she can, her legs bent inward towards each other, and her
buttocks, the soles of her feet and her heels being placed upon a small
rest, placed for the purpose, so that she may be able to strain the
stronger. In case her back should be very weak, a swathing band should
be placed under it, the band being doubled four times and about four
inches broad. This must be held by two persons who must raise her up a
little every time her pains come on, with steady hands and in even time,
but if they be not exact in their movements, they had better leave her
alone. At the same time two women must hold her shoulders so that she
may strain out the foetus more easily; and to facilitate this let one
stroke or press the upper part of her stomach gently and by degrees. The
woman herself must not be nervous or downhearted, but courageous, and
forcing herself by straining and holding her breath.

When delivery is near, the midwife must wait patiently until the child's
head, or some limb, bursts the membranes, for if the midwife through
ignorance, or through haste to go to some other woman, as some have
done, tears the membrane with her nails, she endangers both the woman
and the child; for by lying dry and lacking that slipperiness which
should make it easy, it comes forth with severe pains.

When the head appears, the midwife must hold it gently between her
hands, and draw the child, whenever the woman's pains are upon her, but
at no other times; slipping her forefingers under its armpits by
degrees, and not using a rough hand in drawing it out, lest the tender
infant might become deformed by such means. As soon as the child is
taken out, which is usually with its face downwards,--it should be laid
upon its back, that it may receive external respiration more freely;
then cut the navel string about three inches from the body, tying the
end which adheres to it with a silk string, as closely as you can; then
cover the child's head and stomach well, allowing nothing to touch its
face.

When the child has been thus brought forth, if it be healthy lay it
aside, and let the midwife attend to the patient by drawing out the
afterbirth; and this she may do by wagging and stirring it up and down,
and afterwards drawing it out gently. And if the work be difficult, let
the woman hold salt in her hands, close them tightly and breathe hard
into them, and by that she will know whether the membranes are broken or
not. It may also be known by making her strain or vomit; by putting her
fingers down her throat, or by straining or moving her lower parts, but
let all be done immediately. If this should fail, let her take a draught
of elder water, or the yolk of a new laid egg, and smell a piece of
asafoetida, especially if she is troubled with a windy colic. If she
happen to take cold, it is a great obstruction to the afterbirth; in
such cases the midwife ought to chafe the woman's stomach gently, so as
to break, not only the wind, but also to force the secundine to come
down. But if these should prove ineffectual, the midwife must insert her
hand into the orifice of the womb and draw it out gently.

Having thus discussed common births, or such as are generally easy, I
shall now give directions in cases of extremity.

* * * * *




CHAPTER XVI

_What ought to be done in cases of extremity, especially in women
who, in labour, are attacked by a flux of blood, convulsions and
fits of wind._


If the woman's labour be hard and difficult, greater care must be taken
than at other times. And, first of all, the situation of the womb and
her position in lying must be across the bed, and she must be held by
strong persons to prevent her from slipping down or moving during the
surgeon's operations. Her thighs must be put as far apart as possible,
and held so, whilst her head must rest upon a bolster, and her loins be
supported in the same manner. After her rump and buttocks have been
raised, be careful to cover her stomach, belly and thighs with warm
clothes, to keep them from the cold.

When the woman is in this position, let the operator put up his or her
hand, if the neck of the womb be dilated, and remove the coagulated
blood that obstructs the passage of the birth; and by degrees make way
gently, let him remove the infant tenderly, having first anointed his
hand with butter or some harmless salve. And if the waters have not come
down, they may then be let out without difficulty. Then, if the infant
should attempt to come out head foremost, or crosswise, he should turn
it gently, to find the feet. Having done this, let him draw out one and
fasten it with ribbon and then put it up again, and by degrees find the
other, bringing them as close together and as even as possible, and
between whiles let the woman breathe, and she should be urged to strain
so as to help nature in the birth, that it may be brought forth. And to
do this more easily, and that the hold may be surer, wrap a linen cloth
round the child's thighs, taking care to bring it into the hand face
downwards.

In case of flux of blood, if the neck of the womb be open, it must be
considered whether the infant or the _secundine_, generally called the
afterbirth, comes first, and as the latter happens to do so
occasionally, it stops the mouth of the womb and hinders the birth, and
endangers both the woman's and the child's life. In this case the
afterbirth must be removed by a quick turn. They have deceived many
people, who, feeling their softness, have supposed that the womb was not
dilated, and by that means the woman and child, or at least the latter,
have been lost. When the afterbirth has been removed, the child must be
sought for and drawn out, as directed above; and if the woman or the
child die in such a case, the midwife or the surgeon are blameless
because they have used their best endeavours.

If it appears upon examination that the afterbirth comes first, let the
woman be delivered as quickly as possible, because a great flow of blood
will follow, for the veins are opened, and on this account two things
have to be considered.

_First_:--The manner in which the afterbirth advances, whether it be
much or little. If the former, and the head of the child appears first,
it may be guided and directed towards the neck of the womb, as in the
case of natural birth, but if there appears any difficulty in the
delivery, the best way is to look for the feet, and draw it out by them;
but if the latter, the afterbirth may be put back with a gentle hand,
and the child taken out first. But if the afterbirth has come so far
forward that it cannot be put back, and the child follows it closely,
then the afterbirth must be removed very carefully, and as quickly as
may be, and laid aside without cutting the entrail that is fastened to
it; for you may be guided to the infant by it, which must be drawn out
by the feet, whether it be alive or dead, as quickly as possible; though
this is not to be done except in cases of great necessity, for in other
cases the afterbirth ought to come last.

In drawing out a dead child, these directions should be carefully
followed by the surgeon, viz.--If the child be found to be dead, its
head appearing first, the delivery will be more difficult; for it is an
evident sign that the woman's strength is beginning to fail her, that,
as the child is dead and has no natural power, it cannot be assisting in
its own delivery in any way. Therefore the most certain and the safest
way for the surgeon is, to put up his left hand, sliding it into the
neck of the womb, and into the lower part of it towards the feet, as
hollow in the palm as he can, and then between the head of the infant
and the neck of the womb. Then, having a forceps in the right hand, slip
it up above the left hand, between the head of the child and the flat of
the hand, fixing it in the bars of the temple near the eye. As these
cannot be got at easily in the occipital bone, be careful still to keep
the hand in its place, and gently move the head with it, and so with the
right hand and the forceps draw the child forward, and urge the woman to
exert all her strength, and continue drawing whenever her pains come on.
When the head is drawn out, he must immediately slip his hand under the
child's armpits, and take it quite out, and give the woman a piece of
toasted white bread, in a quarter of a pint of Hippocras wine.

If the former application fails let the woman take the following potion
hot when she is in bed, and remain quiet until she begins to feel it
operating.

Take seven blue figs, cut them into pieces and add five grains each of
fenugreek, motherwort and rue seed, with six ounces each of water of
pennyroyal and motherwort; reduce it to half the quantity by boiling and
after straining add one drachm of troches of myrrh and three grains of
saffron; sweeten the liquor with loaf sugar, and spice it with
cinnamon.--After having rested on this, let her strain again as much as
possible, and if she be not successful, make a fumigation of half a
drachm each of castor, opopanax, sulphur and asafoetida, pounding them
into a powder and wetting the juice of rue, so that the smoke or fumes
may go only into the matrix and no further.

If this have not the desired effect, then the following plaster should
be applied:--Take an ounce and a half of balganum, two drachms of
colocynth, half an ounce each of the juice of motherwort and of rue, and
seven ounces of virgin bees' wax: pound and melt them together,
spreading them on a cere-cloth so that they may spread from the navel to
the os pubis and extending to the flanks, at the same time making a
pessary of wood, enclosing it in a silk bag, and dipping it in a
decoction of one drachm each of sound birthwort, savin colocinthis,
stavescare and black hellebore, with a small sprig or two of rue.

But if these things have not the desired effect, and the woman's danger
increases, let the surgeon use his instruments to dilate and widen the
womb, for which purpose the woman must be placed on a chair, so that she
may turn her buttocks as far from its back as possible, at the same time
drawing up her legs as close as she can and spreading her thighs open as
wide as possible; or if she is very weak it may be better to lay her on
the bed with her head downwards, her buttocks raised and both legs drawn
up. Then the surgeon may dilate the womb with his speculum matrices and
draw out the child and the afterbirth together, if it be possible, and
when this is done, the womb must be well washed and anointed, and the
woman put back to bed and comforted with spices and cordials. This
course must be adopted in the case of dead children and moles,
afterbirths and false births, which will not come out of themselves, at
the proper time. If the aforementioned instrument will not widen the
womb sufficiently, then other instruments, such as the drake's bill, or
long pincers, ought to be used.

If any inflammation, swelling or congealed blood happens to be
contracted in the womb under the film of these tumours, either before or
after the birth, let the midwife lance it with a penknife or any
suitable instrument, and squeeze out the matter, healing it with a
pessary dipped in oil of red roses.

If the child happens at any time to be swollen through cold or violence,
or has contracted a watery humour, if it is alive, such means must be
used as are least injurious to the child or mother; but if it be dead,
the humours must be let out by incisions, to facilitate the birth.

If, as often happens, the child is presented feet foremost, with the
hands spreading out from the hips, the midwife must in such a case be
provided with the necessary ointments to rub and anoint the child with,
to help it coming forth, lest it should turn into the womb again,
holding both the infant's arms close to the hips at the same time, that
it may come out in this manner; but if it proves too big, the womb must
be well anointed. The woman should also take a sneezing powder, to make
her strain; the attendant may also stroke her stomach gently to make the
birth descend, and to keep it from returning.

It happens occasionally, that the child presenting itself with the feet
first, has its arms extended above its head; but the midwife must not
receive it so, but put it back into the womb, unless the passage be
extraordinarily wide, and then she must anoint both the child and the
womb, and it is not safe to draw it out, which must, therefore, be done
in this manner.--The woman must lie on her back with her head low and
her buttocks raised; and then the midwife must compress the stomach and
the womb with a gentle hand, and by that means put the child back,
taking care to turn the child's face towards the mother's back, raising
up its thighs and buttocks towards the navel, so that the birth may be
more natural.

If the child happens to come out with one foot, with the arm extended
along the side and the other foot turned backwards; then the woman must
be immediately put to bed and laid in the above-described position; when
the midwife must immediately put back the foot which appears so, and the
woman must rock herself from side to side, until she finds that the
child has turned, but she must not alter her position nor turn upon her
face. After this she may expect her pains and must have great assistance
and cordials so as to revive and support her spirits.

At other times it happens that the child lies across in the womb, and
falls upon its side; in this case the woman must not be urged in her
labour; therefore, the midwife when she finds it so, must use great
diligence to reduce it to its right form, or at least to such a form in
the womb as may make the delivery possible and most easy by moving the
buttocks and guiding the head to the passage; and if she be successful
in this, let the woman rock herself to and fro, and wait with patience
till it alters its way of lying.

Sometimes the child hastens simply by expanding its legs and arms; in
which, as in the former case, the woman must rock herself, but not with
violence, until she finds those parts fall to their proper station; or
it may be done by a gentle compression of the womb; but if neither of
them avail, the midwife must close the legs of the infant with her hand,
and if she can get there, do the like by the arms, and so draw it forth;
but if it can be reduced of itself to the posture of a proper birth it
is better.

If the infant comes forward, both knees forward, and the hands hanging
down upon the thighs, then the midwife must put both knees upward, till
the feet appear; taking hold of which with her left hand let her keep
her right hand on the side of the child, and in that posture endeavour
to bring it forth. But if she cannot do this, then also the woman must
rock herself until the child is in a more convenient posture for
delivery.

Sometimes it happens that the child presses forward with one arm
extended on its thighs, and the other raised over its head, and the feet
stretched out at length in the womb. In such case, the midwife must not
attempt to receive the child in that posture, but must lay the woman on
the bed in the manner aforesaid, making a soft and gentle compression on
her belly, oblige the child to retire; which if it does not, then must
the midwife thrust it back by the shoulder, and bring the arm that was
stretched above the head to its right station; for there is most danger
in these extremities; and, therefore, the midwife must anoint her hands
and the womb of the woman with sweet butter, or a proper pomatum, and
thrust her hand as near as she can to the arm of the infant, and bring
it to the side. But if this cannot be done, let the woman be laid on the
bed to rest a while; in which time, perhaps, the child may be reduced to
a better posture; which the midwife finding, she must draw tenderly the
arms close to the hips and so receive it.

If an infant come with its buttocks foremost, and almost double, then
the midwife must anoint her hand and thrust it up, and gently heaving up
the buttocks and back, strive to turn the head to the passage, but not
too hastily, lest the infant's retiring should shape it worse: and
therefore, if it cannot be turned with the hand, the woman must rock
herself on the bed, taking such comfortable things as may support her
spirits, till she perceives the child to turn.

If the child's neck be bowed, and it comes forward with its shoulders,
as it sometimes doth, with the hands and feet stretched upwards, the
midwife must gently move the shoulders, that she may direct the head to
the passage; and the better to effect it, the woman must rock herself as
aforesaid.

These and other like methods are to be observed in case a woman hath
twins, or three children at a birth, which sometimes happens: for as
the single birth hath but one natural and many unnatural forms, even so
it may be in a double and treble birth.

Wherefore, in all such cases the midwife must take care to receive the
first which is nearest the passage; but not letting the other go, lest
by retiring it should change the form; and when one is born, she must be
speedy in bringing forth the other. And this birth, if it be in the
natural way, is more easy, because the children are commonly less than
those of single birth, and so require a less passage. But if this birth
come unnaturally, it is far more dangerous than the other.

In the birth of twins, let the midwife be very careful that the
secundine be naturally brought forth, lest the womb, being delivered of
its burden, fall, and so the secundine continue longer there than is
consistent with the woman's safety.

But if one of the twins happens to come with the head, and the other
with the feet foremost, then let the midwife deliver the natural birth
first; and if she cannot turn the other, draw it out in the posture in
which it presses forward; but if that with its feet downward be
foremost, she may deliver that first, turning the other aside. But in
this case the midwife must carefully see that it be not a monstrous
birth, instead of twins, a body with two heads, or two bodies joined
together, which she may soon know if both the heads come foremost, by
putting up her hand between them as high as she can; and then, if she
finds they are twins she may gently put one of them aside to make way
for the other, taking the first which is most advanced, leaving the
other so that it do not change its position. And for the safety of the
other child, as soon as it comes forth out of the womb, the midwife must
tie the navel-string, as has before been directed, and also bind, with a
large, long fillet, that part of the navel which is fastened to the
secundine, the more readily to find it.

The second infant being born, let the midwife carefully examine whether
there be not two secundines, for sometimes it falls out, that by the
shortness of the ligaments it retires back to the prejudice of the
woman. Wherefore, lest the womb should close, it is most expedient to
hasten them forth with all convenient speed.

If two infants are joined together by the body, as sometimes it
monstrously falls out, then, though the head should come foremost, yet
it is proper, if possible, to turn them and draw them forth by the feet,
observing, when they come to the hips, to draw them out as soon as may
be. And here great care ought to be used in anointing and widening the
passage. But these sort of births rarely happening, I need to say the
less of them, and, therefore, shall show how women should be ordered
after delivery.

* * * * *




CHAPTER XVII

_How child-bearing Women ought to be ordered after Delivery._


If a woman has had very hard labour, it is necessary that she should be
wrapped up in a sheep's skin, taken off before it is cold, applying the
fleshy side to her veins and belly, or, for want of this, the skin of a
hare or coney, flayed off as soon as killed, may be applied to the same
parts, and in so doing, a dilation being made in the birth, and the
melancholy blood being expelled in these parts, continue these for an
hour or two.

Let the woman afterwards be swathed with fine linen cloth, about a
quarter of a yard in breadth, chafing the belly before it is swathed,
with oil of St. John's wort; after that raise up the matrix with a linen
cloth, many times folded: then with a linen pillar or quilt, cover the
flanks, and place the swathe somewhat above the haunches, winding it
pretty stiff, applying at the same time a linen cloth to her nipples; do
not immediately use the remedies to keep back the milk, by reason the
body, at such a time, is out of frame; for there is neither vein nor
artery which does not strongly beat; and remedies to drive back the
milk, being of a dissolving nature, it is improper to apply them to the
breasts during such disorder, lest by doing so, evil humours be
contracted in the breast. Wherefore, twelve hours at least ought to be
allowed for the circulation and settlement of the blood, and what was
cast on the lungs by the vehement agitation during labour, to retire to
its proper receptacles.

Some time after delivery, you may take a restrictive of the yolks of two
eggs, and a quarter of a pint of white wine, oil of St. John's wort, oil
of roses, plantain and roses water, of each an ounce, mix them together,
fold a linen cloth and apply it to the breast, and the pains of those
parts will be greatly eased.

She must by no means sleep directly after delivery; but about four hours
after, she may take broth, caudle or such liquid victuals as are
nourishing; and if she be disposed to sleep it may be very safely
permitted. And this is as much, in the case of a natural birth, as ought
immediately to be done.

But in case of an extremity or an unnatural birth, the following rules
ought to be observed:--

In the first place, let the-woman keep a temperate diet, by no means
overcharging herself after such an extraordinary evacuation, not being
ruled by giving credit to unskilful nurses, who admonish them to feed
heartily, the better to repair the loss of blood. For that blood is not
for the most part pure, but such as has been retained in the vessels or
membrane better voided, for the health of the woman, than kept, unless
there happen an extraordinary flux of the blood. For if her nourishment
be too much, which curding, very often turns to imposthumes.

Therefore, it is requisite, for the first five days especially, that she
take moderately panado broth, poached eggs, jelly of chickens or calves'
feet or fresh barley broth; every day increasing the quantity a little.

And if she intend to be a nurse to the child, she may take something
more than ordinary, to increase the milk by degrees, which must be of no
continuance, but drawn off by the child or otherwise. In this case
likewise, observe to let her have coriander or fennel seeds boiled in
barley broth; but by all means, for the time specified, let her abstain
from meat. If no fever trouble her, she may drink now and then a small
quantity of pure white wine or of claret, as also syrup of maidenhead or
any other syrup that is of an astringent quality, taken in a little
water well boiled.

After the fear of fever or contraction of humour in the breast is over,
she may be nourished more plentifully with the broth of capons, pullets,
pigeons, mutton, veal, etc., which must not be until after eight days
from the time of delivery; at which time the womb, unless some accident
binds, has purged itself. It will then likewise be expedient to give
cold meats, but let it be sparingly, so that she may the better gather
strength. And let her, during the time, rest quietly and free from
disturbance, not sleeping in the day time, if she can avoid it.

Take of both mallows and pellitory of the wall a handful; camomile and
melilot flowers, of each a handful; aniseed and fennel of each two
ounces; boil them in a decoction of sheep's head and take of this three
quarts, dissolving in it common honey, coarse sugar and fresh butter and
administer it clysterwise; but if it does not penetrate well take an
ounce of catholicon.

* * * * *




CHAPTER XVIII

_Acute Pains after Delivery._


These pains frequently afflict the woman no less than the pain of her
labour, and are, by the more ignorant, many times taken the one for the
other; and sometimes they happen both at the same instant; which is
occasioned by a raw, crude and watery matter in the stomach, contracted
through ill digestion; and while such pains continue, the woman's
travail is retarded.

Therefore, to expel fits of the cholic, take two ounces of oil of sweet
almonds, and an ounce of cinnamon water, with three or four drops of
syrup of ginger; then let the woman drink it off.

If this does not abate the pain, make a clyster of camomile,
balm-leaves, oil of olives and new milk, boiling the former in the
latter. Administer it as is usual in such cases. And then, fomentation
proper for dispelling the wind will not be amiss.

If the pain produces a griping in the guts after delivery, then take of
the root of great comfrey, one drachm, nutmeg and peach kernels, of each
two scruples, yellow amber, eight drachms, ambergris, one scruple;
bruise them together, and give them to the woman as she is laid down, in
two or three spoonfuls of white wine; but if she be feverish, then let
it be in as much warm broth.

* * * * *




THE

FAMILY PHYSICIAN

* * * * *

BEING

CHOICE AND APPROVED


 


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