The compleat midwife's practice enlarged in the most weighty and high concernments of the birth of man containing a perfect directory or rules for midwives and nurses : as also a guide for women in their conception, bearing and nursing of children from the experience of our English authors, viz., Sir Theodore Mayern, Dr. Chamberlain, Mr. Nich. Culpeper ... : with instructions of the Queen of France's midwife to her daughter ... / by John Pechey ... ; the whole illustrated with copper plates.

Of the Ulcers of the neck of the Womb.

THE signs of these Ulcers is a pain, and perpe∣tual twinging, which increases, if any thing that hath an abstersive quality be cast in; the issuing out of putrid humours, and matter with blood, if the Ulcer be great, or the Flowers come down; often ma∣king water, and the water hot; as also a pain in the fore-part of the head toward the roots of the eyes; as also some kind of gentle Fever.

The Cure of this is hard, because of its being in a place of so exquisite sense, and moist, and having such a sympathy with other parts of the Body: For the ea∣sing of the pain, Chalybeated milk is very much con∣ducing; and to the drying of them up, drying baths

are the best and most prevalent remedy. These differ much, coming either from external causes, as rash Phy∣sick, hard labours, and violent coiture; or from internal causes, as the corruption of the Secondines, the Courses retained, and the Urine flux, a virulent Gonorrhea the Pox, inflammations turned into Apostems, humors flowing from other parts of the body, and there setling; all which must be duly considered in the Cure. O∣thers are in the outward part, and may be easily come at with Medicines; others deep, and must be come at only with injection; for which purpose, use this fol∣lowing.

Take whites of four Eggs, beat them well, and put to them an equal quantity of Rose water, and Plan∣tain-water, as much in quantity as they come to, C••m∣phire, Ceruse, Litharge of Gold, and Bole-Armoni••ck of each a like quantity, green Copperas, half as much as of any of them, beat all to powder, mix it, and strain it through a cloth, and make your injection 'till the part infected be whole; and if there be any pain, sometimes inject a little new warm milk.

Others are more gentle, with a little stinking mat∣ter flowing from them. For the cure of which, gen∣tle abstersives are profitable, as Honey of Roses with Barly-water, Whey with Sugar, and the decoction of Lentiles: after these, gentle astringents must be ap∣plied. Others are sordid, with much matter slowing from them: In which case stronger Medicines must be applied. Others do eat into the Flesh, having a co∣loured, green, and stinking matter flowing from them. For the cleansing of which, Aloes and Wormwood are very much commended, or the foresaid injection.

There are another sort of Ulcers, little and long, which eat the skin of the neck of the Womb; they are known by the pain and blood which they produce im∣mediately

after congression; they are seen also by looking into the neck of the Womb, being much like chilblains that come upon the hands in Winter time. They are caused divers ways, either by a difficult Ly∣ing in, or by a violent coiture, and cured by an astrin∣gent Clyster: or they are produced by some Inflam∣mation, or Flux of sharp humours; Purgations are here needful, before Topicks be applied, among which is much commended the grease that fries out of wood∣en ladles, much used in Kitchens being held to the fire; as also the Oyntment called Pomatum

The Cure of the Ulcer must be perform••d by stop∣ping the defluction of acrid humours, and by cleansing and conglutinating the Ulcer. And first, if the body be Plethorick, or if the Ulcer be accompanied with an inflammation, a vein must be open'd in the arm, and bleeding must be repeated as often as there is danger of a new Fluxion, especially at the time of the Courses, to lessen them, which are wont to increase the matter of the Ulcer, and to promote the Flux of other hu∣mors to the Womb. Purging is also very necessary to cleanse the body from ill humors, but it ought to consist of gentle Catharticks, as of Sena, Rhubarb, Tamarinds, Myrobalans, and the like; it must be often repeated, that the vitious humors may be di∣verted; and this is of so great moment that a Noble Matron was cur'd of an Ulcer of the Womb, by ta∣king every day five ounces of a decoction of Sena, dodder of Thyme, red Roses. Indian Myrobalans sweetned with Sugar, and by injecting a cleansing de∣coction into the Womb.

If the Sick vomits easily, a Vomit is most useful; for it m••kes a revulsion of the humors from the Womb, and the days the sick does not purge, a vulnerarary de∣coction

must be used a long while, made in the fol∣lowing manner.

Take of the leaves of Agrimony, Knot-grass, Bur∣net and Plaintain, each half an handful, of the roots of China three drams, of Coriander-seed one dram, of Raisins half an ounce, of red Sanders one Scruple, boyl them in Chicken Broth, strain it, let the sick take of it Morning and Evening.

If the Fever be violent, and if a great quantity of Sanies be evacuated, Whey is very proper, half a pint or more being taken in a morning with a little honey of Roses. If the Body begins to w••ste, and there is a Hectick Fever, Asses milk must be taken with Sugar of Roses for a whole Month, Sudor••••••ks may also do good to dry the Ulcer; and to drive the serous humour towards the habit of the body, if the••e be no inflammation or hot intemperies, Turpen••ine washed in some proper water for the Womb, as in Mugwort, or Feverfew-water, or in some water pro∣per for the Ulcer, taken with Sugar of Roses by inter∣vals, cleanses and heals the Ulcer, Pills of Bdellium taken dayly, or every other day, are also very good.

Take of Bdellium three drams, of Myrrh and Frank∣incense, each one dram, of Sarc••coal, Amber, S••o∣rax, and Myrobalans call'd Chebule, each one dr••m, of red Coral two Scruples, with Syrup of Poppi••••, make a mass for Pills, to which, when the pain is vio∣lent, may be added a little Opium. Troches of Al••••∣kengy with Opium may be also used, when the pain is violent. The following powder is also very e••••e∣ctual to dry the Ulcer.

Take of Acatia, and Hypocistis, each one dram, of Dragons-blood, white Starch, the roots of Pl••ntai••, and of round Birthwort, each half a dram, of Bole Ar∣moniack one dram, of Mastich and Sarcacoal, each half

a dram of these make a fine Powder. The Dose is one dram in Plantain•• or Rose-water, or in some Chalybe•••• Water.

To cleanse, heal, and dry the Ulcer, various In••e∣ctions are prepared; but they must not be used 'till the inflammation is taken off▪ and 'till the pain is e••sed▪ and therefore upon account of the inflammation and acrimony, Emulsions of the cold seeds, the whey of Goats Milk, or the Milk it self, or mixed with the juyce of Plantain, or Shepherd's-Purse, may be in∣jected first If necessity requires, a decoction of Poppy heads, and tops of Mallows may be injected. Some Practitioners say, the Sick may be much relieved by injecting frequently warm water.

The hot intemperies, and the pain being quieted, at least diminish'd, such things must be used as cleanse, beginning with the gentle, as Whey with Sugar, a d••coction of B••rly with Sugar, or hony of Roses; but simple Hydr••mel cleanses more. A decoction will be a little stronger made with Barly, Lentils, Beans not excorticated, of the leaves of Smallage, Plantain, and Pellitory a little hony of Roses may be added. When the Ulcer is very sordid, the following decoction may be used.

Take of the roots of Gentian, Rhaponticum, Ze∣doary, and round Birthwort, each one ounce, of white Wine three pints, boyl them to the consumption of a third part; in the strain'd Liquor dissolve half a pound of Sugar, and keep it for use.

If the Ulcer be very faetid, a little Aegyptiac Oynt∣ment may be added to the decoction; when the Ulcer is well cleansed, you must use such things as dry and consolidate.

Take of the Roots of Comfry, and Bistort, each one ounce, of the leaves of Plantain, Horse-tail, Shepherds-purse,

Sanicle, Mouse-ear, Milfoil, each one handful, of red Roses half an handful; boil them in a measure of Water for an injection. The following sarcotic pow∣der may be added to it.

Take of the Roots of Orris, Birthwort, and Comfry, each half an Ounce, of Myrrh one ounce, of Aloes three drams, make a Powder, whereof let half an ounce be mingled with every injection.

Take of Turpentine washed in Plantain-water, two Drams, dissolve it with Honey and the Yolk of an Egg, and mingle it with the injection. This is very effectual, and is more so, if the Sarcotic Powder be al∣so added.

Fumes must be used for deep Ulcers, for they pene∣trate to the bottom of the Womb, and dry the Ulcers.

Take of Frankincense, Myrrh, Mastick, Gum of Ju∣niper, Labdanum, each one ounce, with a sufficient quantity of Turpentine, make troches for a fume.

When the Ulcer is very obstinate, Cinnabar must be added, which is of excellent use. The Bath-waters have cured some Women, when all other Medicines have bin ineffectual. After you have sufficiently cleansed the Ul∣cer, you must apply a drying and cicatrizing Ointment. Take of Tutty washed half an ounce, and of Litharge, Ceruse, and Sarcacoal, each two drams, of Oyl and Wax a sufficient quantity, make an Ointment. Some∣times the Ulcer penetrates the right gut, and sometimes the bladder, which may be known by the matter eva∣cuated by those parts; if it flow by the right gut, leni∣tive, cleansing, and drying Glisters must be injected; but if it flow from the Bladder, gentle and cooling di∣ureticks must be used, as an emulsion of the greater cold Seeds, Turpentine, and the like. If the Ulcer turn to a Fistula, which chiefly happens, when it is opened outwardly towards the Hip, tho' it may happen in the

womb it self, or in the neck of it. In this case we must consider, whether it be best to leave the accustomed pas∣sage untouched, thro' which nature endeavours to e∣vacuate various Excrements, or to undertake the ••ure of it: But if that be thought most proper for the sick, a Cure that is call'd palliative, must be instituted by purges frequently-repeated, and by sweatlng twice a Year, and by cleansing and strengthening in∣jections, and by applying over a plaister of Dia∣palma, or the like; but if there be any hopes of a Cure, the same Remedies must be used, which are proper for other Fistula's. If the Ulcer be occasion'd by the French Pox, it cannot be cured without an univer∣sal Cure; in performing which, the fumes of Cinna∣bar receiv'd thro' a Tunnel into the womb, are peculi∣arly proper. Also the anointing the inner parts of the womb with a Mercurial Ointment

In all Ulcers of the womb if there be a troublesome itching about the neck, as it frequently happens, by reason of a defluxion of an acid and Salt Humour to the part, a pessary must be made to qualifie it, dipt in the ointment of Elecampane with Mercury, or in Aegyp∣tiacum dissolved in Sea or Allom-water, or in fresh Butter, wherein Quick-Silver has been extinguished, to which must be added Sulphur.