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. 7. Of Inflamation of the Womb.

INflamation of the Womb, is a Tumor or swelling of that Part, springing from blood that is shed into the substance thereof.

And the said Inflamation possesses either the whol Womb, or some part thereof; and it is produ∣ced either by pure blood, and is called meerly Phlegmont, an Inflamation; or it comes from blood mingled with Choller, and it is called Phlegmone erysipelatodes, a chollerick Inflamation of kin to the Rose, or St. Anthonies fire; or it hath its original from blood mingled with flegm, and is called Phlegmone oedematodes, a flegmatick Inflamation; or it comes from blood mingled with Melanchol∣ly, and is called Phlegmone Scirrhodes, which is a Melanchollick Inflamation or Swelling.

The Causes which produce or encrease this Disease, may be divers; viz. A Sanguine Constitu∣tion over loaded with blood, or infected with choller; a natural loosness of the womb w^th wideness of the passages, air extream hot, inflaming the humors, or very cold compacting & knitting them together, and so stopping the monthly Courses flowing, or ready to flow; vehement Exercise, immoderate car∣nal Conjunctions, a blow or fall lighting upon the Wombs Quarters; Perturbations of Mind more violent than ordinary, especially wrath; acrimonious or sharp vehement meats, of a hot nature, and whatever else is taken in of a fretting and vehement operation, as Authors report of Cantharides, That they are very hurtful as well to the womb as the bladder; sharp Pessaries long time used, or purging Medicines, or strong alteratives, such as barren women are wont to take and rend from all quarters; Retention of the Courses encreasing the over fulness of blood; or over great flux of Courses relax∣ing

the Passages, and bringing the Humors from all the parts of the Body to the Womb; likewise Cupping-glas••es fastened about the privy parts, may violently draw the blood and humors unto the Region of the Womb, and there detain them. Laborsom Child-birth may cause as much; Abortion, a violent handling of the parts of Generation by an unskilful Midwise; and a troublesom inconve∣nien•• bearing of a Child in the Womb.

The Signs to know the Disease by, are, Swelling, Heat, and Pain in the Region of the Womb, with a continual Feaver. But because the strait Gut (that is, that which is united to the Dung∣gate) and the Bladder, do lodg in the same quarters with the Womb, therfore must we distinguish this Disease by other signs: such are, Suppression or diminution of the Courses, and their paleness or yellowish citrine color, with pain in their coming forth; and in the absence of the Courses certain stinking and rotten stuff sweats through the Vessels of the Womb, and bedews the VVater-Gate. Whereinto if search be made, it will plainly discover the Disease; for the inner mouth of the womb will be sound to swell, to be drawn inwards, and subject to pain if touched; the neck of the womb will appear red and inflamed, the Veins dispersed there-through, strutting with blood.

If the whol Womb be inflamed, all Symptomes will be more vehement. If the Inflamation be rather in the neck of the womb, the heat and pain is spread most towards the Groyns and the Water-Gate. If the former side of the womb do suffer, the Bladders fellow-seeing wil be the greater: If the hinder side of the Womb be inflamed, the strait Gut will be more compassionate, and the pain wil stretch itself towards the Loyns. If the right or left side of the womb be inflamed, the heat and pain wil appear most about the one Groyn; and the Thigh of the same side wil be heavy, and as it were in a sort burdened.

The Signs of the Causes are these. If the Inflamation spring from pure blood, al the Symptomes are milder; but if there be Choller mingled therewith, the Feaver is more burning, and al the Symptomes are more vehement; but if the blood be Flegmatick or Melanchollick, the Feaver wil be less acute, but the Disease more lasting, and more stubborn. And here we are to consider such Signs as may inform us what Humor is most predominant in the whol Body.

If the Inflamation turn to an Imposthume and gather Matter, the pain and Feaver are encreased, and shaking sits come without any certain course, yet commonly they take their turn about Evening. And al the other Symptomes are heightened. When Suppression is accomplished, al the Symptomes are mitigated, and Swelling rises higher, whereby somtimes the Excrement of the Guts, or Urine is stopped. But if the Inflamation be discussed without Suppuration, the Swelling lessens, and the Symptomes becomes gentler.

If it turn to a Scirrhus (that is, hard swelling) the Feaver, Pain, and other Symptomes are di∣minished; the Swelling abides, becomes harder; likewise the weight and heaviness remain, both in the womb, and the adjacent parts, so that the Patient can hardly stir her self.

A good Prognostick cannot be made of this Disease because it is very dangerous, and for the most part deadly. But more or less danger is threatened according to the greatness of the Disease, its Causes and Symptomes, as thus:

If the Inflamation possess the whol Womb, its a desperate Disease; but if only a part be inflamed, there is some hope of help.

If a VVoman with Child have a Chollerick swelling in her womb, its deadly. Hipp. Aphor. 43. Sect. 5. For the Child dies by reason of the greatness of the Inflamation, whereupon follows Abor∣tion, which coming upon the back of a grievous disease, kils the Mother. Galen in his Comments upon this Aphorism, doubts if this be not true of every Inflamation of the womb as well as of the Chollerick, and whether it be possible that a Child in such a case can live.

Inflamation of the womb easily degenerates into a Gangrene, Because the womb, as it were the Bo∣dies Close-stool, receives a mighty charge of nasty Excrements, by which the inbred heat is easily suffocated.

Ravings, turning of the womb, Hiccoughs, Coldness of the Hands and Feet, Diaphoretick sweat seizing on a woman in this Disease, do portend sudden death.

If an Inflamation of the womb come to Suppuration, its hopeful that it may be cured; but a foul Ulcer will follow, which wil make the Patient to pine away with a lingering Feaver, or to fall into the Dropsie.

If the Inflamation turn into a Scirrhus, the evil becomes lasting, and often brings a Dropsie.

To cure this Infirmity, the Course of the Blood to the Womb is to be drawn back, it is to be dri∣ven from the womb, it is to be diverted another way: that which is flown in and contained in the part, is to be resolved. And if the swelling tend to suppuration, it is to be furthered, and when it is broken, the Matter or Quittor must be voided out; Which may be done by the following Remedies.

An Emollient and cooling Clyster being premised, let Blood be drawn from the Basilick Vein of the Arm, on that side on which the Womb is most affected; or from both Arms, if the swelling be in

the whol Womb; and let the Blood-letting be repeated twice, thrice, or four times, according to the strength of the Patient, and the greatness of the Inflamation.

After sufficient Revulsion, the Disease being come to its height, when there is no longer suspition of any present flux into the Womb, the lower Veins are to be opened, to derive from the part affe∣cted. In which sence we must understand, Galen in his Book of Blood-letting, and in his 13. Book of the Method of Healing, where he teacheth, That in the Inflamation of the Womb, we must open the Veins about the Knees and Anckles. But so long as there remains any Indication of Revulsion, it is better to open the Veins of the Arm.

Also to revel or draw back the Humors, Frictions are good, and Ligatures or bindings of the uper parts, and Cupping-Glasses set upon the Shoulders, Loyns, and Back.

If vitious Humors (especially Chollerick) do abound in the Body, which are as it were the Coach of the other Humors to hurry them about the Body; they are to be evacuated with gentle Medicaments, as Syrup of Roses, and Syrup of Violets solutive, Manna, Rhubarb, Catholicon, or E∣lectuary Lenitive; for stronger Medicaments by stirring the Humors over much, would excite the Flux of Humors more abundantly to the part affected.

And vomiting Medicaments, though prescribed by Avicenna, seem no way convenient in this case: For if they be mild and gentle, they evacuate nothing to speak of: If they be stronger, they cause a great Agitation in the Body, by which means the Humors being in a Commotion, may flow more plentifully unto the part diseased.

In regard of the greatness of the Feaver, cooling Medicaments are to be used, as Juleps and Emul∣sions; whereunto, if very great wakings, pain, and tumblings and tossings do disquiet the Patient, some Narcoticks may be added, which may likewise be given by themselves.

After the First Evacuations, let outward Medicines be applied to the lower part of the Belly, be∣tween the Navel and the Share, and about the Kidneys; first of all repelling and cooling things, in the form of a Liniment, an Epithem, and Cataplasm.

The Liniment may be made of Oyl of Roses washed in Vinegar, or of Oyntment of Roses, Cera∣tum Santalinum, or Galens cooling Oyntment, with a little Vinegar added.

The Epitheme may be made of the Waters or Decoction of Plantane, Sorrel, Nightshade, the tops of white Poppies and Roses, adding a little Bole-Armoniack, Dragons Blood, and Terra Sigil∣lata.

The Cataplasm or Pultiss may be made of the Crums of fine Manchet boyled with Milk, to which a little Oyl of Roses may be added, with Juyce of Henbane. Nightshade, and the whites of Eggs; or of Barley Meal, Linseed, Fenugreek seed, with Oyl of Roses; whereunto likewise the aforesaid Plants being bruised may be added.

Injections must be made into the Womb, compounded after this manner:

Take Plantane Leaves, Water-lilly Leaves, Nightshade, and Endive, of each one handful: red Roses two pugils. Boyl all till a third part of the Water be consumed: and add to the strainings Oyl of Mirtles one ounce: Vinegar half an ounce. Make an Inje∣ction.

Of the same Herbs bruised with Oyl of Roses and Vinegar, Pessaries may be made, and put into the Womb.

Neither must Repelling, and Refrigerating Medicaments be long used, lest the Swelling harden and degenerate into a Scirrhus. Wherefore softening and discussing things are to be mingled with the repelling Simples; with this Proviso, That the longer the Inflamation is from its Infancy, the grea∣ter must be the quantity of Digestives. So that to the foresaid Medicaments may be added, Mallows, Marsh-mallows, Mugwort, Fenugreek, Chamomel Melilot; their Dose being augmented or dimini∣shed, as the case shall require.

In the mean while, if the Patient be costive, she must be helped by gentle Purgatives. Yea, and the truth is, frequent Clysters may do a great deal of good to temper the Inflamation, seeing the Womb rests upon the streight Gut, called Intestinum reotum. But let them be little in quantity, that they may be kept the longer, and that they may not compress the Womb; of which this may be an Example.

Take Marsh-mallow Roots, the Leaves of Mallows, Violets, Lettice, of each one handful: Nightshade half a handful: Violet flowers, red Roses, of each a pugil: sowr Prunes, ten: boyl them in Barley Water. In six ounces of the strained Broth mix three ounces of Oyl of Roses, and make all into a Clyster.

If the Patient be in great pain, to the aforesaid Clysters may be added, the Yolks of Eggs, the fat of an Hen, Breast-milk, Mucilage of the seeds of Fenugreek, Lin-seed, or Mallows; yea, and a little quantity of Opium, with some Saffron.

In such a case, Injections into the Womb may likewise be made, of Goats or Sheeps Milk, with O∣pium and Saffron, of each three or four grains, and a little Rose Water.

Or unto Pessaries may be added a little Opium with a little Saffron, the whites of Eggs, and Oyl of Roses. Or Pessaries may be made of Philonium Romanum with Cotton. Or a Fomentation to ease pain, may be prepared on this manner:

Take Marsh-mallows Branch and Root, Violet Leaves, of each a handful: Chamomel, Meli∣lot, Roses, of each a pugil. Boyl all for a Fomentation.

When the Disease begins to decline, Purgation is to be iterated with gentle Purgatives. And when the Disease tends to a Resolution or Conclusion (which is known by remission of the Symp∣tomes, and because the part is not so oppressed with any Heaviness) Discussives must be used in grea∣ter quantity than any of the foregoing Medicaments. Or this Cataplasm may be made.

Take Pouder of Marsh-mallow Roots one ounce: Chamomel and Melilot flowers, of each two drams: Mugwort Leaves poudered, Barley and Bean meal, of each half an ounce: boyl them a little in harsh red Wine; add new Hogs Grease, Oyl of Chamomel and Lillies, of each one ounce. Make a Pultiss or Cataplasm.

Fomentations and Baths to sit in, may likewise do good in this case.

If the swelling cannot be discussed, but seem to tend to suppuration, it is to be furthered by the following Cataplasm:

Take Marsh-mallow Roots poudered, Chamomel flowers, Melilot, Meal of Lin-seed, Fenu∣greek, of each one ounce: fat Figs, eight: boyl all to the consistence of a Pultiss. Then add the yolks of four Eggs: Saffron half a scruple: Oyl of Lillies and fresh Butter, of each an ounce. Make of all a Cataplasm.

When Matter or Quittor is made, which may be known by the abatement of heat and pain, and by a certain inundation perceivable by the touch, the Matter quaking like a quagmire, endeavor must be used to break the Imposthume by moving of the Body, by coughing, by neezing, by fastening Cup∣ping-glasses, by clensing and attenuating Injections, or by Pessaries that wil draw and break. As for Example.

Take Goose-Grease half an ounce: Turpentine two drams: Rue seeds poudered, Nitre, Orice Roots, of each half a dram. Mix all, and with Wool make a Pessary.

When the Imposthume is broke, we must endeavor to purge out the Quittor or Matter, and to clense and consolidate or close up the Ulcer, as shall be shewed in the Cure of an Ulcer of the Womb, in the Chapter immediately following.