A systeme of anatomy, treating of the body of man, beasts, birds, fish, insects, and plants illustrated with many schemes, consisting of variety of elegant figures, drawn from the life, and engraven in seventy four folio copper-plates. And after every part of man's body hath been anatomically described, its diseases, cases, and cures are concisely exhibited. The first volume containing the parts of the lowest apartiments of the body of man and other animals, etc. / by Samuel Collins ...

CHAP. XXIII. Of the Diseases of the Womb, and their Cures.

THe Womb being a noble Utensil, framed by Nature for the propaga∣tion of Mankind, is liable to many Diseases, various kinds of Swel∣lings, Abscesses, Ulcers, Gangrens, Cancers, &c.

The first Tumour I will treat of is an Inflamation, * 1.1 proceeding from too great a quantity of Blood, or from the grosness of it, derived from thick unassimilated Chyme, associated with Vital Liquor, impelled through the Hypogastrick and Spermatick Arteries into the substance of the Womb, in which it Stagnates, by reason the Extremities of the Hypogastrick and Sper∣matick Veins, being very small, are not able to give a reception to the ex∣uberant and gross Blood, producing a great heat and beating pain in the womb, which is more inward in the body of it; and if the Vagina be af∣fected, the outward Orifice may be discerned to be tumefied and red, as be∣set with divers turgid small Veins resembling Cobwebbs; and the Inflama∣tion of the Body and Neck of the Womb, is ever attended with a Sympto∣matick Fever.

In order to the Cure of this Disease after an Emollient Clyster hath been administred, * 1.2 Bleeding is to be celebrated in the Arm, to divert the course of the Blood from the womb, and for derivation of the Blood to the neigh∣bouring parts, Cupping-glasses may be applied under the Breasts and to the Loins.

In Cachochymick Bodies gentle Lenitives may be given, * 1.3 as Syrup of Peach-flowers, Cassia, Tamarinds, Syrup of Roses-Solutiv. Violets, Cichory with Rhubarb. The Lenitive Electuary, &c. and strong Purgatives must be forborn, lest the Flux of the Menstrua be provoked and the Vitious humours have a violent recourse to the womb, * 1.4 whereupon strong Vomitories are dan∣gerous, as making a great agitation of humours whereby the inflamed womb is highly discomposed.

Alterative and Cooling Medicines are very proper to give an allay to the high Effervescence of the Blood in reference to the Fever; * 1.5 and in want of Rest dormitive Potions may be safely advised, as giving repose and a check to the Inflamation.

This course of Physick proved very successful to the wife of a Captain relating to one of the King's Ships, * 1.6 who had a pain in her Groin and Back, accompanied with a Symptomatick Fever and other symptoms belonging to the Inflamation of the womb.

The Patient had been first treated Emperically by a Man-Midwife well versed in his own Profession, but ignorant in the practice of Physick, who first gave her a strong Vomit, which highly irritated the sharp humours, and ap∣plied Leeches to the Haemorrhoides, making a greater Flux of Blood to the parts affected, whereby the Inflamation and Fever grew higher, whereup∣on I thought it proper to draw Blood from the Ʋterus by opening a Vein above in the Arm, and also by advising Cooling and Atemperating Deco∣ctions, allaying the unkindly Fermentation of the Blood, and by prescribing proper Medicines to be injected into the Vagina Uteri; and Cataplasms may

be applied made of Purslain, Endive, Plantain, Night-shade, Water-Lil∣lies, and Vine-leaves: This method of Physick gave ease and recovered this sick Patient, who hath lived many years in health since she hath been resto∣red by the mercy of the Great Physician.

Sometimes the womb is affected in the Neck, and other times in the Body of it with a hard indolent Tumour, proceeding from gross Chymous Blood, imported by the Hypogastrick and Spermatick Arteries into the substance of the womb, where the Chymous Particles not assimilated into Vital Liquor, are concreted by Saline Particles into a hard Swelling, commonly called a Scirrhus.

A Saleman's wife being much aggrieved with a Tumor in the Vagina Uteri, easily discerned by the Finger of an Artist immitted into it, was Cured by alterative and purging Diet-drinks, cleasing and sweetning the Blood, and by Emollient Decoctions injected into the Vagina Uteri, which abated, and by degrees took away the hard Swelling.

The womb is also obnoxious to a Carnous Swelling, * 1.7 mixed with a quan∣tity of ill humours lodged in the body of the Uterus, between its Mem∣branes.

An Instance of this disaffection may be given in a Plump Woman about forty years old, who felt a great weight in the Hypogastrick Region, wherein after Death a great fleshy Tumor (upon a deep Incision made into the Cavity of the Abdomen) was discovered in the substance of the womb, which was accompanied with thick Membranes, Tendons, and other diffe∣rent Substances, lodged not in the Cavity, but in the Interstices of the Membranes encircling the body of the Ʋterus.

The Uterus is also liable to Abscesses and Ulcers, * 1.8 from a quantity of Blood lodged in the inward Substance upon the laceration of the Vessels in Women over-lifting themselves by taking up some great weight beyond their strength, whereupon a great quantity of Blood is setled in the Glandulous parts of the womb, first producing an Inflamation, and afterward an Ab∣scess terminating into an Ulcer, (which sometimes Corrodes the womb and neighbouring parts) which is easily known by a Purulent Faetide Matter, inflicting great pains on the tender Compage of the womb, which is after∣ward Excerned by the Vagina Ʋteri.

A Semstress in taking up a great weight, found something as it were to crack within her, whereupon she was sensible of a high pain about the Loins, with a great heat about the Hypogastrick Region, and after some time she avoided a quantity of Faetide discoloured Matter through the Vagina Uteri; and two or three Months after she discharged the same Matter through the Anus; This Disease got a great head, as being a sordid inveterate Ulcer, before she sent to me for my Advice, which I gave to her, gratis, as being a Woman of a mean Condition, and attempted by all probable means to re∣lieve her, but without success; so that at last she concluded her miserable Life in a comfortable Departure, as being a Person of great vertue and pa∣tience.

And afterward she being opened by a good Chyrurgeon, the posterior part of her Womb was highly Ulcered, and its substance corrupted, and the In∣testinum Rectum adjoyning to it was rendred Putrid, having a great hole in it, through which the stinking corrupt Matter was discharged through the Anus, which was formerly Excerned through the Vagina Uteri.

An Ulcer of the womb is sometimes produced by strong Purgatives en∣raging the Acrimonious humors of the Body, * 1.9 which having recourse to the Uterus, do produce an Ulcer in it.

A Gentlewoman, my worthy Friend, having her Courses suppressed, had sharp Medicines given her by a Midwife, which highly disaffected the Ute∣rus, whereupon she discharged a thick Purulent Sanious Matter, which highly tortured her, in its evacuation through the tender passage, relating to the neck of the womb, as composed of many Filaments: In order to allay this great Storm in the Uterus, caused by improper Medicines, advised by an ignorant Person; I prescribed Medicines of Sarsa Parilla, and Cooling Alteratives, which attempered and sweetned the enraged sharp Humors; and I also advised Cooling and Restringent Decoctions to be injected into the Vagina Ʋteri, which gave her Ease, and perfectly restored her to her Health. Laus Deo.

Sometimes the Womb laboureth with a Gangreen the unhappy consequent of an Inflamation, * 1.10 arising from a Contusion, Lacerating the small Hypo∣gastrick or Spermatick Vessels, whereupon so great a quantity of Blood is lodged in the Glandulous substance of the womb, that the natural heat of the womb is Suffocated, as being oppressed with too exuberant a pro∣portion of Extravasated Blood, which could not be turned into Pus, whence ensueth a Gangreen speaking sudden Death to the Patient.

Learned Thomas Bartholine giveth an Account of this sad Disease, Cent. 2. Observ. 28. Faemina Veneta an. 40, an. 1645, ex casu quodam dolores Uteri acerbissimos passa est, adeo{que} graves, ut ipsam se tunderet, mille{que} modis affli∣geret: frustra omnibus adhibitis auxiliis, causa latente, septimo die dolores cum vita cessarunt.

Cadaver apertum statim dolorum causas prodidit, Ʋterus quippe capitis pue∣rilis magnitudine in tumorem carnosum degeneraverat, Gragraenosum sine exulce∣ratione, ut discissus Pilam aemularetur Carnosam: Cavitas angusta vix aureum numerum ••episset plenum Concreto sanguine: Praeterea omentum Ligamenti vicem sustinens firmissime externo Uteri fundo, alligatum erat, à quo sursum tracto do∣lores forsan aborti.

A Cancer sometimes assaults the womb, * 1.11 derived from a high Scorbutick Indispostion, infecting the mass of Blood with a Venenate Nature, which being carried by the Uterine Arteries into the Glands of the womb, pro∣duceth a hard painful Tumor, ending sometimes in a fordid Ulcer, Corro∣ding the Membranes encompassing the bosom of the womb.

Sometimes in an ill Constitution of Body abounding with hot and acide Recrements, * 1.12 degenerating into a corroding poysonous Disposition, upon a suppression of the Menstrua, an Inflamation first ariseth, and afterward a sordid Faetide Carnous Ulcer of the womb, attended with a great pain and an evacuation of stinking Matter, thrown out by the Vagina Uteri, which is rendred Carnous.

Fabritius Hildanus giveth a memorable Instance of this case, in a Person of Honour, C. 2. Obs. 63.

An. 1586, Cum nobilis quaedam Matrona Lausannae suppressione mensium tri∣mestri spatio laborasset, tandem exortus est dolor & inflammatio partium genita∣lium: Morbo propter verecundiam neglecto, abscessus & ulcus in collo Matricis sequutum est, cui multa abs{que} fructu à variis adhibita fuere: Biennio post cum D. D. J. Auberto Vindone, ut de curatione instituenda consultaremus vocatus fui. Adhibito Matricis speculo, ulcus Callosum, Faetidum, inaequale lividum{que} & ut verbo dicam, Cancrosum, invenimus, quod minime nobis tangendum Judica∣vimus.

Vocatus postea Empiricus mira pollicitus est, sed adhibitis medicamentis acribus auctus est dolor, aucta & Febris, Inflammatio, Vigiliae, cibi Fastidium & Syncope, ut deinde paucos post dies è vita discederet, accersitus denuo cum dicto Medico, dissecaremus cadaver, totum collum Matricis, plane Cancrosum & exulceratum offendimus.

The Womb also, as well as the Liver, Bladder of Gall, * 1.13 and other parts of the Body is infested with Stones, proceeding from the Serous parts of the Blood, (ousing out of the secret Pores of the inward Coat of the womb) impregnated with Saline, and mixed with Earthy parts, which are concreted into Stones lodged in the Cavity of the Uterus.

The womb also is incident to a Dropsy, * 1.14 derived from Serous Recrements of the Blood, passing down the descendent Trunk of the Aorta, and after∣ward through the Hypogastrick and Spermatick Arteries into the Glandulous substance of the womb, wherein the watry humours being severed from the Blood, are carried in a large quantity by degrees through the secret passages of the inward Coat into the Cavity of the womb, whereupon it groweth much distended, called vulgarly a Dropsy of the womb.

A German Emperess being afflicted with divers disaffections of the womb, * 1.15 did complain of a great weight about the Share-bone, as if she had been with Child, and after Death her Body being opened; her Womb was discovered to be highly Tumefied, into which an Incision being made, a great quan∣tity of gross Faeculencies gushed out, and about its sides and body appeared many Tumours, consisting of a white mucous Matter, resembling Nervous concreted Liquor.

Crucius de Quaesitis Cent. 1. p. 21. giveth the more full History of this Case August. Imperatrix. M. omnia signa verae gestationis tribus fere annis ante obitum habuit, ut omnes Doctissimos Medicos, & expertissimas Mulieres decepe∣rit us{que} ad nonum mensem, cum motus non ita fortis, ut par esse videbatur, de∣sideraretur, & lac in mamillis, quibus de causis post decimum exactum mensem, licet optima si qua alias frueretur valetudine, ad sanguinis missionem (ipsa qui∣dem invitissima, cum omnino crederet se gestare) & ad alia oportuna remedia de∣ventum sit, sicut & reliquo tempore cum doloribus ventris per plures dies torqueretur, & aliis Symptomatibus quibus pro necessitate varia Medicamenta fuerunt praescripta us{que} fert ad secundum annum, quo tempore à pluribus communicatis consiliis ad for∣tiora Medicamenta, pro mali expulsione properavimus, demum serenissima Augusta, jam ab anno ante obitum satis manifestam corporis maciem, excepto ventre, excepit, cum alias esset satis pinguis: Post istam corporis maciem, & pulcherrimae figurae jacturam, frequentibus Lypothymiis, laboravit, ventris doloribus, Uteri affecti∣bus, gravitate circa pubem, mensium suppressione, stomachi torsionibus & Car∣dialgia, Convulsionibus plerum{que} & aliis symptomatibus fuit saepe correpta, una cum vomitu frequentiore materiae phlematicae & biliosae; & hujus per unum aut alterum mensem ante obitum, post magna animi deliquia, post magnum Stomachi ardorem, & inexplebilem sitim, per vomitum ad libras fere quindecem pluribus vicibus fuisse rejectas referunt; mensium suppressionem passa diu fuit. * 1.16

Hujus defunctae aperto thorace, Pulmones reperti flaccidi & semiputridi, ac sanguine atro referti: in Cordis Ventriculo dextro repertum fuit corpus Glandu∣losum separatum omnino à circumstante substantia Cordis, oblongum ad ovi co∣lumbini longioris Crassitiem, foris obductum pinguedine, intus vero contineba∣tur sua Membrana Glandulosa substantia alba satis & mollis; reliquam capa∣citatem Ventriculorum occupabat sanguis ater Concretus ad uncias quatuor: Sep∣tum transversum sublividum erat, & quasi totum corrosum: Fellis Vesicula satis magna erat, cum multa bile, & duobus Lapillis durae & Tartareae substantiae,

qui casu confracti splendebant: Unus superabat magnitudinem ciceris, alter aequa∣bat, Hepar erat satis magnum, coloris subrubri, aut potius livescentis: Lien erat satis magnus, sed substantia naturalis erat: Per ejus vero longitudinem substernebatur Vesicula plena humore flavo, crasso; Intestina naturaliter se ha∣bebant, sed Mesenterium fere totum computrescens visebatur; & quasi Succubus cum longo collo Utero incumbens, oppletus magna copia Phlegmatis Crassissimi, Lividi, non valde faetentis, quod etiam totam regionem hepatis, & latus dex∣trum Offarciebat; Cavitas Abdominis etiam oppleta humore ichoroso flavo, qui una cum supradicto Phlegmate ascendit ad Lib. 24. Uterus vero erat valde mag∣nus, plenus humore Crassissimo, albo: Circa ejus latera & corpus, substantiae ejus adhaerebant quin{que} corpora satis magna, ex substantia quadam Mucosa Ner∣veam materiam referente, valde Concreta & satis solida, ita ut Complicationes Nervorum viderentur habere: In Uteri vero capacitate, inter dictam materiam, & humorem Crassissimum innatabat, ut ita dicam, quaedam substantia alba Nerve∣am materiam albam referens & similis supra dictis quin{que} Corporibus.

In this case are recited many sad Symptoms of Convulsive motions of the Stomach, and great Gripes of the Belly, and fainting Fits, attended with violent Vomitings, the plain expresses of different parts disaffected, proce∣ding primarily from obstructions of the womb, hindring the Flux of the Menstrua, which tainted the mass of Blood and Nervous Liquor, and spoiled the Ferments of the Stomach and Guts, as mixed with sharp acide Recre∣ments, causing Convulsions and Vomitings in the Stomach, and great pains of the Guts; whereupon the Chyle being ill Concocted, and gross, could not be assimilated into Blood, which passing through the Ventricles of the Heart, was Concreted into a Polypus, whence frequent Lypothymies did arise from the gross Blood ready to Stagnate in the chambers of the Heart, and the Lungs grew Flaccide, and ready to be Putrefied upon sharp Corroding humors, and the Liver was despoiled of its native Array, and put on a mourning deep Purple or Livide Colour, caused by a vitiated mass of Blood; upon the same account the Midriff grew discoloured, and Coa∣ted with a Livide hue, and last of all, the Blood accompanied with gross Chyme, had a recourse to the womb by the Hypogastrick and Spermatick Arteries, which carried the unassimilated Chyme into the substance of the womb, where the Menses being stopped, the gross Serous and Chymous Liquor being Concreted, did Tumefy the Uterus and parts adjacent, where∣upon divers Protuberancies did arise, and the more thin parts of the Chy∣mous and Crystalline liquors of the Blood being Secerned from it in the Ute∣rine Glands, did insinuate through the secret Ducts of the inward Coat in∣to the Cavity of the womb, where it being extravasated, grew more thick, and as it were Concreted, and being much in quantity, did highly distend the womb, causing a Dropsy in it.

Many of the Antients had a fancy that the womb doth very much ascend above its natural Sphaere in Hysterick Fits or Suffocations of the womb, * 1.17 at∣tended as they conceived, with violent Convulsive Motions, of which the Mesenterick Plexes, the Pancreas, Stomach, Intestines, are guilty, and not the Uterus.

And I cannot gain so much upon my self as to believe the Uterus to climb up to the Hypocondres; Though Hypocrates did affirm that a dry womb was elevated to the Liver the Fountain of a select Liquor. And Fernelius doth back this Opinion with his Suffrage, asserting, That he hath discerned by his touch, that the womb was carried up toward the Stomach, where it appeared like a small Globe, which I conceive, was a round Tumor of the

Mesentery, proceeding from the Convulsive Motions of the Mesenterick Plexes of Nerves, and not from the extravagant motion of the Womb, which hath not the liberty of playing upward, as affixed to its proper station of the lower Region of the Hypogastrium, by the mediation of the round and broad Ligaments; As also tied to the Intestinum Rectum, Bladder of Urine, and Pudendum, by the Interposition of the Vagina.

Again, it may be farther urged that the Uterus is not capable of extend∣ing it self so high as the Stomach, by reason of its small Dimensions, which do not exceed the bigness of a Goose Egg, or thereabouts, and can by no means, when the Body is opened by Dissection, be forced up by strength of the Hand to reach to the Midriff, as some imagine it to ascend in Hy∣sterick disaffections. And in opened Bodies, the Globe which is felt about the Stomach or Navil, is not the Womb nor the Testicles or deferent Ves∣sels; which Learned Riolan conceiveth to be swelled with putrefying Seed, whereupon the Ovaries and Tubes are hurried up and down with impetuous motions: But my apprehension is, That this Orbicular swelling is derived either from some malignant Vapour affecting the Nerves and Membranes of the Mesentery, or from great distention of the Intestines, caused by some high Flatus puffing them up. * 1.18

And farther, I humbly conceive, That many Convulsive Motions and Hysterick Fits are attributed to the Pancreas, as proceeding from its Vitiated Juice; which Hypothesis Learned Sylvius seemeth to assert, which highly opposeth Autopsy, by reason many persons labouring with these sad Di∣stempers, are no ways guilty of any Disease belonging to the Pancreas or its ill-affected Liquor; of which Learned Diemerbroeck giveth an account, Lib. 1. Anatomes, Cap. 24. p. 236. Ait ille, Hic obiter notandum, quod Fr. de le Böe Sylvius modo dictam Hystericae Suffocationis causam non agnoscat, sed longe aliam commentus sit, scilicet succi Pancreatici peculiare vitium, & ab eo Hy∣sterica symptomata modo dicta suscitari doceat sic{que} hac de re Dogmata omnium antiquorum satis animose rejiciat, uterum{que} & partes spermaticas à talium Symp∣tomatum inductione humaniter excuset. Verum etsi multoties symptomata quaedam, cum hystericis aliquibus symptomatibus quasi similitudinem aliquam habentia, vi∣tio quodam Succi Pancreatici induci posse negare nolim (quamvis attenta obser∣vatione satis ab his distingui queant) ea{que} ego ipsemet subinde, in viris non mi∣nus quam in faeminis, animadverterim, tamen super hac re Misellum Pancreas semper accusare, nimis durum ac iniquum videtur, cum à me aliis{que} instituta ca∣daverum Mulierum Sectio multoties docuerit, Pancreas ab Hystericis affectioni∣bus prorsus insons extitisse, optime{que} valuisse, at{que} interea in testibus, modo valde tumidis (interdum alterutrum, raro utrum{que} ad semi ovi magnitudinem intumu∣isse, demonstravimus) modo male coloratis, virulento{que} liquore repletis, tanto∣rum symptomatum causam latuisse.

Whereupon it may be inferred with good reason, That Hysterick Fits cannot be derived from the disaffections of the Pancreas and its Liquor, but from indispositions of the obstructed Uterus in suppressed Menstruous Purga∣tions, and from the Vesicles of the Testicles or Ovaries, Turgid with too great a quantity, or from ill qualified Seminal Liquor which is most frequent in Hysterical distempers, accompanied with violent Convulsive Motions.

Notes

• * 1.1

  The inflama∣tion of the Womb.
• * 1.2

  Pleeding is proper in an inflamation of the Womb.
• * 1.3

  In Cachochy∣mick bodies Purgatives may be admi∣nistred.
• * 1.4

  Vomitories are not safe in the inflama∣tion of the Womb.
• * 1.5

  Alterative and Contem∣perating Me∣dicines are good in this Distemper.
• * 1.6

  A course of Physick given in ••an Infla∣mation of the Womb.
• * 1.7

  The Carnous Tumor of the Womb.
• * 1.8

  The Abscesses and Ulcers of the Womb.
• * 1.9

  An Ulcer of the Womb produced by strong Purga∣tives.
• * 1.10

  The Gangreen of the Womb.
• * 1.11

  A Cancer of the Womb.
• * 1.12

  The Cancer in the neck of the Womb, proceeding from Corro∣ding Venenate humors.
• * 1.13

  Stones ledged in the Womb.
• * 1.14

  The Dropsie of the Womb.
• * 1.15

  An Instance of a Dropsie and other diseases of the Womb.
• * 1.16

  Many diseases accompany∣ing the disaf∣fections of the Womb.
• * 1.17

  The Womb doth not move upward in Hy∣sterick Fits.
• * 1.18

  Hysterick Fits attributed by Sylvius to the Pancreas.