The practice of physick in seventeen several books wherein is plainly set forth the nature, cause, differences, and several sorts of signs : together with the cure of all diseases in the body of man / by Nicholas Culpeper ... Abdiah Cole ... and William Rowland ; being chiefly a translation of the works of that learned and renowned doctor, Lazarus Riverius ...

Chap. 11. Of the falling down of the Womb.

WHen the womb loseth its Natural Scituation, and fals towards the Water-Gate, the Disease is termed, the falling down, or slipping forward of the womb.

Many Differences there are of this Disease, differing only in degrees: For somtimes only the in∣ner neck falls down into the Water-gate: somtimes the whol body of the womb fals downwards, but does not appear without the Water-Gate, in the threshold whereof appears the inner mouth of the womb, in likeness of a mans Yard, or a Goose Egg with an hole in it. Other whiles with the bottom turned out, it hangs without the Water-gate like a mans Cod, or an Ostridges Egg, save that it is rug∣ged, and hath an uneven surface: and it is in a word, somtimes so reluxed, that it falls so far out as to reach the Patients Thighs.

The immediate Cause of the falling down of the womb, is the Rupture, or Relaxation of those Ligaments, which are wont to retain it, and its Neck in their proper place.

A Rupture of the foresaid Ligaments may proceed from all violent Causes, as a blow, a fall, dancing and leaping, lifting some heavy burden, or carrying the same, violent compression of the Abdomen, vehement Coughing which dures long, violent neezing, especially in Child-bed, hard straining to stool, difficult Travel, violent extraction of the Child out of the womb, or of the After∣birth; vehement endeavor of the womb to cast out somwhat offensive thereunto, as a dead Child, a Mole, or an After-birth: for then, according to Galen, in his Third Book of Natural Faculties, the same thing betides the womb, which is wont to happen to two wrastlers who endeavor to throw one the other upon the ground, till both fall together. Hereunto add, frequent setting of Cupping-Glasses upon the Thighs, and very vehement agitation of Body, or of Mind.

Relaxation or slackening of the Ligaments is caused likewise by divers causes, as by a long-lasting Catarth, divers Crudities, which are cast out into the womb, as the sink of the whol Body. Whence it is that women long troubled with the Whites, can scarce avoid this Disease, especially elderly wo∣men which are most of all troubled therewith. Add hereunto external causes, as over-frequent bathing, especially in cold water; Southern and moist Air, especially being received into the womb after Child birth; moist Diet, much drinking; Idleness, long sleep, and all other causes, which may decrease flegm, and cause its flux into the womb.

The Signs whereby to know this Disease are evident to the sence. For the womb is found sticking in the Water-gate like an Hens or Gooses Egg, or like a Clew of Thrid, with the perceivance of a weight pressing upon the Water-Gate, when the Patient stands upright. And while they sit or go to stool, a vehement pain is felt about the privy Parts, and the Region of O sacrum, or the Hanch∣bone. If it hang far out, the greater pain and heat is felt, the urine comes away by little and little, and makes the womb smart as it passeth.

The Causes procuring this Falling-down of the womb, may be thus distinguished. If it proceed from loosness or slackness of the Ligaments, it comes by little and little, hath the less pain, and white Purgations have preceded, or other Causes moistening the womb, and relaxing the Ligaments thereof. But if it proceed from a breaking of the Ligaments, the pain is more vehement, and blood somtimes breaks forth; and such Causes have preceded which have been able to break with violence the Liga∣ments.

As for the Prognosticks belonging to this Disease. The Disease of it self is not dangerous; yet is it very unhandsom and troublesom, hindering the Patient from freedom to go and walk at will; also from Conception and convenient expurgation of her Courses.

Yet may it somtimes occasion death, if pains, Feavers, convulsions, or other grievous Symptomes be joyned therewith.

Also the womb in this Case is somtimes corrupted through distemper of the Air, or by violent im∣pulsion, and becomes Gangraenated, which necessitates it to be cut off.

The Disease being fresh, and the womb coming not far out, is more easily cured than when it is an old Infirmity, and the womb comes far out.

In yonger women, the womb is more easily restored to its place than in Elderly women.

Falling down of the womb, by reason of the Ligaments being broken, is incurable.

To come to the Cure. The womb is to be thrust back into its Natural place, and to be detained there; and the fault of its Bands or Ligaments must be corrected; If they be broken, by things that do glue and sodder together; if they be relaxed or slackened, with things drying, aftringent, and strengthening. All which may be done by the following Medicaments.

In the first place therefore, That the womb may more easily be restored to its place, the Guts and Bladder must be disburdened, left pressing the Neck of the womb, they should hinder its reduction; forasmuch as the neck of the womb rests upon the streight Gut, and the bladder rests upon the neck of the womb.

VVhen the Gutts and Bladder are discharged of their Excrements, let the woman lie along upon her Back, with her thighs wide asunder, and her knees drawn upwards, and let her with her hands thrust her womb inwards; and force it still upwards into the neck, so as to turn it inwards as it goes, till all is returned within the cavity of the Belly which should contain the womb. Or if she is not able to do it her self, let her do it by help of the midwife; or use a thick blunt ended stick with Cloaths wrapt about it, by which it may be forced further into the Cavity of the Belly, than is possible by the hands to drive it. Or, for fear of hurting her Body, a Pessary may be made of Lin∣nen Cloth often doubled and rowled together with a string tied fast thereunto, and accommodated to this service of thrusting up of the womb.

But if the womb fallen from its place shall, swell, so that it cannot enter into the cavity of the Belly, the swelling must in the first place be removed. And if there be an inflamation, such things must be applyed as are sit to heal the same. If otherwise it be blown up, such things must be used

as will discuss the inflation. Rodericus a Castro washes the swollen womb with a Decoction of Beets, and then sprinkles it with vineger and salt, and so when the swelling is aborted, he reduceth the same.

The same Rodericus a Castro writes, that it is very good towards restoring the fallen womb, for a Physitian or a Chyrurgion to come with burning red hot Iron in his hand and to make as if he would thrust it into the womb. by that means nature contracts her self, and the womb with her, and any other part that sticks out of the Body. For he relates that a certain very expert Chyrurgion did by this stratagem force Back a mans Gutts, that were ready to come out at a wound in his belly, when other remedies did no good. For holding a great red hot Iron in his hand, the Patient looking on, he made as if he would Clap it upon the wound. VVith the sudden fright whereof the Gutts were presently drawn back into their place.

Avenzoar in his Second Theizir, Tract 5 Chap. 4. Propounds some such thing as this. When this disease (saith he) begins first to appear, the Physitian may gently cure the same. And it is reduced all these wayes, viz. by your hand If you please; and if not make her he on her Back and let some Body sit upon her brest, and another upon her thighes; and then cause her to be frighted putting some creeping Vermin upon her Leggs, such as Mice, Efts, frogs and such like; by which let her be so frighred as to endeavour to get away by drawing her Leggs and thighs up to her; where∣by all her Members and her whol Body may at once be contracted: by which meanes the Womb will return unto its own place.

Zacutus Lusitanus following Avenzoar relates the following story in the 66 observation of his Second Book. Coming to a woman (saies he) Which had her Womb fallen down the space of a year & an half, with extream hardness; it seemed very hard by reason of its stretching out to be reduced to its place; especially seeing Avenzoar saies, that this work must be done before the Womb be grown hard. I devised many remedies for this disease; astringent Insessions, Pessaries, Plasters, Confections. At last, having wrastled stoutly with the disease, I could do no good. I betook my self to this stra∣tagem. I put Mice tied by the tailes, between the womans Leggs. Which running up her Thighs, the woman is mightly frighted, and forthwith (a strang thing to see) her Womb is reduced into its proper place. This done, The Plaster against Ruptures being laid upon the Region of the Womb and to the Groynes, she remained for the time to come free from that Disease.

Before the VVomb be reposed in its place, it must be anointed with the Mucilage of comfrey Roots, or with an infusion of Gum Tragacanth. Then are pouders to be sprinkled thereupon, which have no asperity or sharpness, least they hurt the VVomb or its neck; but of quality rather gluing than astringent or binding. Such an one may be thus made.

Take Frankincense, Mastick and Sarcocolla nourished (that is, well steeped so as to drink up as much of the Milk as it can hold) with Brest-Milk, of each one dram. Mummy, Gum-arabick, Acacia, Hypocistis, of each half a dram. Make all into a most fine Pouder, to be sprinkled as aforesaid.

The same Pouder may be applied in form of an Oyntment, if it be mixed with the aforesaid mu∣cilages, or Oyle of Saint Johns wort, or some other consolidating thing.

After the VVomb is conveniently replaced, all art must be used to retain the same in its place, the woman lying in her bed, a little bending, with her thighes gently stretched out and the one resting upon the other. And let her abide some daies in this posture, and put in at the Water-gate a little wooll, cotton, or spunge wet in harsh red VVine, or in Rosewater wherein Acacia or Hypocistis hath been dissolved.

To further this Retention of the VVomb in its place, Cupping-Glasses with much flame are frequently to be fastened under her Duggs and upon her Navel.

Likewise sweet savors are be presented to her Nose, and stinking things to be applied to her Ge∣nitalls, unles she be subject to sits of the Mother.

Let the said Parts be somented with a Decoction of astringent things made in red VVine and the VVater of a Smyths Forge.

Also Practitioners use a Bath to sit in, made of the Same Decoction. In which there needs cau∣tion. For it is to be feared, least in that posture, the VVomb should again fall from its place, especially at the beginning, while the Disease is yet fresh. But when it hath held the Patient long, and she is provided of a convenient kind of Truss, such a bath will do much good.

After the said Bath a Fumigation will likewise be very good, of Frankincense, Mastich, San∣darach, red Roses. Others indeed do commend a Fumigation on made of a salted Eel-skin.

Injections into the VVomb will work much more effectually than those remedies which are out∣wardly applied: they may be compounded of the Decoction for the Fomentation or Sitting Bath aforesaid,

Oyntments and plasters will likewise be good in this case such as were described in the Immoderate flux of Courses and in the VVhites; and as shall hereafter he propounded to prevent Abortion.

The Retention of the Womb in its place may likewise be holpen, by astringent and strenghening Medicaments taken in at the Mouth. And among the rest, the following Pouder frequently taken is very proper for this Disease.

Take Mullein two drams: Myrtle Leaves, Garden Parsnep Seeds of each one dram: Shavings of Harts-Horn, half a dram: Ashes of Cockle-shells one dram: red Coral two drams: Make all into a Pouder. The Dose is one dram with harsh red Wine.

Touching these astringent Medicaments both internal and external it is to be observed: that they must be warily used, it the womans courses do still flow at their seasons, least they being sup∣pressed may cause more grievous Diseases to follow. The best season for these Medicaments, is when the Patients courses are past.

These Remedies are to be contained twelve or Fifteen daies together. Also care is at the same time to be taken, that the Patient be neither costive nor loose. For if the Excrements be hard, the Womb is easily thrust out by the Patients straining at stool; and a loose Belly doth relax or slacken the bands or Ligaments of the Womb.

While the foresaid Remedies are used, we must resist the Antecedent Cause, by such things as shall purge out and discuss those flegmatick humours which relax and slacken the Ligaments of the Womb.

And first convenient Purgations must be ordered; which must not be violent in their operation and disturbing, least the Womb out of its place again, bringing abundance of humors into those parts.

Some allow of vomiting, because it draws the humors into the upper parts of the Body: and in that respect it would be profitable, if it were not to be feared in another regard: Namely because it is performed with great straining, and drives the Womb downward, as much as neezing. Yea and experience hath taught that nothing doth more effectually facilitate hard travel, and bring the Child sooner into the light, than a Vomit given to the Childing woman.

After sufficient Purgation, a Decoction of Guajacum is to be given three weeks together that every day the Patient may sweat in the morning. And in the Evening let her Belly beneath the Navel be fomented with a Decoction of Sage, Origanum, Marjaram, Time, Feaverfew, Tansie, Worm∣wood, Rue, red Roses, Cyperus Roots, Calamint, Cypress Nutts, and the like simples boyled in Smythes Forge-water and red Wine. After the Fomentation, the Fumigation and Liniment may be used which were before described.

Instead of a Sweat-driver, or after the use thereof, Bathes arising from Sulphurous Mines, will be singularly profitable, such as our Balerucan Baths; and experience hath shewn that many have bin cured by such Bathes.

And that a woman may be secure that her Womb fall not down again, which it is very apt to do; or if there be no hope of a perfect cure let her wear such a kind of truss as is called Hyppocrates his Girdle. Whereby women are so guarded and defended, that without fear of the falling down of their Wombes they may go about and do their daily businesses; also their Womb is thereby defended from the cold. They are made almost after the same manner, as trusses that are used against Rup∣tures or Burstennes.

Pessaries are likewise very profitable in desperate Fallings down of the Womb, which some do make of a good long piece of cork covered over with Wax. Others make of Wax alone, some round, others square, triangular, oval or any other fashion; which are conveighed into the Cavity of the Womb, and are never taken out, but keep the Womb in its place: so as the women notwithstanding do all their usuall enployments, conveniently are enjoyed by Men in carnal con∣junctions, do conceive, carry their big Bellies, and bring forth. VVhich is confirmed with many Examples by Franciscus Rossetus in his Book entituled De Partu Coesareo, Sect. 6. Chap. 5. and by Bauhine in his Appendix to Rossetus. All which are transcribed word for word by Schen∣kius and Sennertus, in their proper Chapters, where they are to be seen.