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. 8. Of an Ʋlcer of the Womb.

AFter a suppurated Inflamation of the Womb, follows an Ulcer, which likewise depends upon other Causes, namely, so many as may cause an Erosion, fretting, or gnawing the substance of the Womb.

The Causes therefore hereof are, An Imposthume breaking, Sharp Humors flowing into the Womb, Sharp and Corrosive Medicines conveyed into the Womb, or taken at the Mouth, as was said before touching Cantharides or Spanish Flyes.

The Antecedent Causes are all such things, which we have formerly shewed▪ have power to cause an Inflamation, as difficult Child-birth, violent and unbridled Carnal Conjunction, a long flux of Sharp Humors from the Womb, wounds, fals, and bruises, and especially a venemous Gonorrhea, and the Lechers Pocks, the infection whereof is soon communicated to the Womb, and its Neck.

The Differences of this Disease, are taken from the place, the magnitude, the figure and complica∣tion with other Infirmities.

In respect of the place, that is to say, the several parts of the Womb; the Ulcer is somtimes pos∣sessed of the Neck of the Womb, and its inner Orifice; somtimes it is in the bottom, though but sel∣dom. Somtimes, and that most frequently, it seizes the inner surface of the Womb; somtimes, but seldom, it assaults the outer surface; whence it comes to pass, that somtimes the Quittor of these Ul∣cers comes out by the Bladder or Guts, or if it settle in the Cavity of the Abdomen, Imposthumes a∣rise about the Patients Groyns, of which Hippocrates speaks in his 47. Aphor. Sect. 5.

In respect of Quantity, some are great, others smal Ulcers, according as they take up more or less space in the Womb; which if they be little and superficial, they differ little from the Scab and Itch; but if they be great, grievous, and as it were devouring, they are called by Hippocrates, Nomae, that is, eating Ulcers.

In regard of their Figure, Ulcers are called Round, Long, Hollow, or Fistulous, that is, like a Pipe.

In regard of Complication with other Infirmities, they are called Phlegmonous, Cancerous, Scir∣rhous, Painful, VVater-bloodish, Poysonous, and Infectious.

The Signs of an Ulcer bred in the VVomb, are, Pain and biting in the womb or its neck, voiding▪

of snotty Matter or Quittor out of the Womb, which Diagnosis wil be more illustrated, if the Cau∣ses producing the Ulcer, such as we have mustered up, have preceded.

If the Ulcer possess the neck of the womb, it is discerned by the sight, by help of the Womb per∣spective Instrument; also by the Midwi••es hand or in the genial Embracement, in which the Pa∣tient feels a troublesom pain, But if the Ulcer be in the bottom of the Womb, the pain is felt about the Share, and the Excrements flow more abundantly.

If the Ulcer pierce to the outward surface, the Patients Urines or Stools appear Matterish, or a Fluctuation is perceived in the Paunch, or a Swelling towards the Groyns, where it threatens to Im∣posthumate.

If the Ulcer be single and benign, the Quittor is little, white, and not stinking. But if it be ma∣lignant and eating, the Quittor will be greenish, Lead colored, and party-colored, coming away with great pain and stink.

If it shall arise of the Lechers Pox, Gonorrhoea will usher it in, or attend upon it, and other tokens of the Whore-masters Pox will appear.

For the Prognosticks of this Infirmity, Hippocrates in the first Book of Womens Sicknesses, saies, That no Ulcer in the Womb ought to be slighted, because it is in a part of exquisite feeling, which hath a fellow feeling with the principal parts of the Body, and is very much disposed to receive a flood of Excrements from them.

If the Ulcers of the VVomb prove Cancerous, Phagedenick, or VVolf-ish [such as we simple people cal the VVoolf, and tel strange tales about, how it eats flesh, &c.] hollow, or fistulous, they are for the most part incurable, and do vex the poor Patients miserably, all their life long.

Ulcers in the Neck of the VVomb are more easily cured, because Medicaments may be applied to them immediately.

In women that are recovering of this Disease, it is a token of perfect health, if they begin to con∣ceive, and conveniently to receive the Mans Sperm, or if they have their monthly Courses orderly and without pain.

The Cure of a womb Ulcer, must tend to hinder the flowing in of such Humors as either beget or cherish the Ulcer, and to clense the Ulcer, and cause it to come to a coalition. To which purpose the following Remedies may be used.

And first of all, If the Patient be over ful of blood, or the Ulcer have an Inflamation joyned there∣with, a Vein in the Arm must be opened, and repeated so often as there seems danger of a new Fluxi∣on; which is especially to be done when the Patient hath her Courses, that they may flow the less, because they are wont to supply Matter to the Ulcer, and to cause other Humors to flow unto the womb.

Also Purgation is very necessary, that the Body may be freed from evil Humors; and it ought to be procured by the gentler sort of Purgatives, as Senna, Rhubarb, Tamarinds, Myrobalans, Catholi∣cum, and such like; and Purgation is often to be repeated, that evil Humors may be diverted from the womb, and it is in this case of such moment, that Forestus witnesseth in the 48. Observation of his 28. Book, That John Tiengius, a Physitian of Amsterdam, cured a Gentlewoman of Amster∣dam of an Ulcer in her womb, to whom he gave every fourth day, five ounces of the Decoction of Senna, Epithimum, red Roses, and Indian Myrobalans sweetened with Sugar, using to cast clensing Decoctions, as Injections into her womb.

For to be ever in a readiness, This following Magisterial Syrup may be compounded.

Take of the greater Comfry Roots, and new Polypody of the Oak, of each one ounce: Citron peels dried, six drams: Leaves of Plantane, Vinca pervinca, Ladies mantle, Sorrel, Maiden-hair, of each a handful: Liquoris scraped and split, and Raisons stoned, of each one ounce: Senna clensed six ounces: Carthamus seeds bruised two ounces: Agarick newly made into Cakes and bound in a Cloth, ten drams: Musk-melone seeds, and Annis seeds, of each three drams: the Cordial Flow∣ers, Rosemary Flowers, and Epithimum, of each one pugil. Make of all a Decoction in Barley Water, in part whereof infuse of choyce Rhubarb half an ounce: Cinnamon one dram. In a pint and half of the strained Liquor, dissolve three ounces of the Syrup of Damask Roses, and as much Sugar as shall be requisite to make it into a Syrup perfectly boyled. Of this let her take two or three ounces, twice or thrice in a month with some Decoction of Agrimony and Plantane, or the Infusion of Rhubarb in Endive Water.

If the Patient be easie to vomit, a purge upwards by Vomit, is to be preferred before the other, be∣cause it draws back the Humors from the womb.

In the spaces between purging, a Vulnerary Decoction is long to be used, which may be made af∣ter this manner:

Take Leaves of Agrimony, Burnet, Knotgrass, Plantane, of each half a handful: China Roots three drams: Coriander seeds one dram: Currence half a dram: red Sanders one scruple. Boyl all in the Broth of a Chicken. Let the Patient take of the strained Liquor morning and evening▪ Or,

Take Leaves of Mugwort, Plantane, Yarrow, of each one handful: Rhaponticum half an ounce: Agnus Castus seed one dram. Boyl all in a sufficient quantity of white Wine. Sweeten the strained Liquor with Sugar; and give her two or three ounces in a morning,

If a Feaver urge, and great quantity of bloodyish Quittor be voided, Whey and Milk will be very good; let her take eight ounces or more in a morning, adding a little Honey of Roses, or Sugar.

If her flesh begin to fall a way, with tokens of an Hectick Feaver, Milk, especially Asses Milk, must be given with Sugar of Roses for a whol month.

Sweat-provoking Medicines may likewise do good where there is no Inflamation, nor hot distem∣per, to dry the Ulcer, and to revel the serous humors towards the habit of the Body.

Turpentine washed in some convenient water for the womb, as of Mugwort or Feaverfew; or in some water respecting the Ulcer, as of Plantane, and red Roses, taken now and then with Sugar of Roses, doth clense and consolidate or fil up the Ulcer.

Pils of Bdellium given to a dram at a time, or every day, or once in two daies one scruple, do very much good, and stop the blood in case it flow.

Or new Pills may be made on purpose, to be used after the same manner, thus:

Take Bdellium three drams: Mirrh, Frankinsence, of each one dram: Sarcocella, Storax, Amber, Cheb-Myrobalans, of each half a dram: red Coral two scruples. With Syrup of Poppies make a Mass fit for Pills, whereunto, in case of extream pain, a little Opium may be added.

Trochisci Alkekengi [Cakes compounded with Winter-Cherries, of which consult my London Dispensatory] with Opium, are likewise (being poudered) given to drink down, where the Pa∣tient is troubled with great pain.

Also to mitigate pain, the same Remedies may be used, which we prescribed for that intent, in our discourse of the Inflamation of the womb.

This following Pouder is very effectual to dry up the Ulcer:

Take Acacia, Juyce of Hypocistis, of each one dram: Dragons blood, fine Starch, Plantane Roots, Birthwort, or round Aristolochia Roots, of each half a dram: Bole Armoniack one dram: Mastich, Sarcocolla, of each half a dram. Make all into a most sine Pouder, whose Dose let be one dram, with Plantane water, red Rose water, or water wherein Steel hath been often quenched.

Zacutus Lusitanus in the 87. Observation, and the 88. of his second Book, propounds an Electua∣ry and a Water, wherewith he witnesseth that he had cured Ulcers of the womb judged incurable.

Any one may find the Description of them in the places above cited.

To clense, dry, and fill up the Ulcer, divers sorts of Injections are usually made; which are never∣theless, not to be used, until the Inflamation be first taken away, which is oftentimes attendant upon these kind of Ulcers; and until the pain be asswaged, which is not only very troublesom, but also by vexing the part, it is wont to encrease the flux of Humors.

In regard therefore of that same Inflamation and sharpness of Humors, let Emulsions of the cooling Seeds, VVhey of Goats Milk, or Milk it self, either alone, or mingled with the Juyce of Plantane and Shepheards-purse; or if need be, a Decoction of Poppy heads, and the tops of Mallows be first of al injected. Some Practitioners are of Opinion, that luke-warm water alone, doth very much good in these cases, if it be often injected. And there is reason for it, seeing by that means the heat and Inflamation of the womb is tempered, the pain is asswaged, and the filth adhering to the Ulcer is washed off. Valescus de Taranta, doth approve of cold water likewise, in these words: I have known (saies he) some women, who perceiving they had Ʋlcers in their wombs, did wash them with cold Water, and then wipe them clean, and dry them with linnen cloaths, which they did often pr•••• in at the Watergate. And by these means often renewed, they came many times to be perfectly cured.

The hot distemper taken away, and the pain asswaged, or for the most part diminished, we must proceed to Clensers, first using the more light and easie Clensers, and after the more strong.

The gentle Clensers are, VVhey taken with Sugar, Barley water sweetened with Sugar, or Honey of Roses, to make it more clensing; or Hydromel simple (see my Dispensatory, a mixture of water and honey boyled a while together.)

For a more strong Clenser, use the Decoction of Barley, Lintels, shaled Beans, and the Leaves of Smallage, Pellitory of the wal, Plantane, boyled together, a little Honey of Roses being added to the straining.

VVhen the Ulcer is very foul, the wound-decoction commonly called Aqua Catapultarum, is the best thing that can be used, whose Composition is thus:

Take the Roots of Gentian, Rhapontick: Zedoary, and round Aristolochia or Birthwort, of each one ounce: white Wine six pints: boyl all till a third part of the Liquor be consumed. In the

straining dissolve half a pound of white Sugar. Let it be kept for use as occasion requires.

Or the following Decoction may be provided:

Take of whol Barley, course Bran, and red Roses, of each one pugil: Leaves of Agrimony, Wormwood, Woodbind, and Smallage, of each one handful: Beans and Lentils, of each three drams: scraped Liquoris, Orice Roots of Florence, and Zedoary, of each two ounces. Boyl all in water, adding towards the end, a little white Wine.

If the Ulcers be very stinking and ful of rotten Quittor, there may be added to the Decoction, a little Ʋnguentum Aegyptiacum, Collyrium Lanfranci, or the Pouder of dulcified Mercury.

When the Ulcer shal be wel scoured and clensed, we must use drying and solidating things, made af∣ter this manner.

Take the greater Comfry Roots, Bistort Roots, of each one ounce: Leaves of Plantane, Hors∣tail, Shepheards-purse, Ladies Mantle, Mous-ear, Yarrow, of each one handful: red Rose Leavs half a handful: Boyl all in water, and make thereof an Injection.

With the which or like Injection, this following flesh-creating Pouder may be mingled.

Take the Roots of Orice, Birthwort, great Comfry, of each half an ounce: Mirrh one ounce: Aloes three drams. Make all into Pouder, of which half an ounce may be mingled with every In∣jection.

Turpentine wash'd in Plantane Water to the quantity of two drams, dissolved with Honey and the Yolk of an Egg, wil do very much good, mingled with the Injection; and the more if the flesh-creating Pouder be also added.

The Oyntment Pompholygos, de Cerusa, de Plumbo, of each six drams for a Dose, mixed toge∣ther, are likewise used in Injections. But the Egg-yolk Oyl, rubbed about with a Pestle in a Lea∣den Morter, is better than al the rest.

Fumes received through a close stool, do pierce to the deep Ulcers which are about the bottom of the Womb, and dry them: Which may be thus prepared:

Take Frankinsence, Mirrh, Mastich, Storax, Juniper, Gum, Labdanum, of each one ounce: Turpentine as much as shall be requisite. Make all into little Cakes for to be burnt under a close stool.

In a most stubborn Ulcer, Cinnabarus or Minium being added to the Fume-Cakes, bears away the Bell from al other Medicaments.

Also Baths that are drying, Sulphurous, and Allumish, are used in long Ulcers: and Physitians are wont to send their desperate Patients to those Baths, as the last Remedy.

It wil not likewise be unprofitable to apply convenient Plaisters to the Region of the Womb, seeing their vertue can pass to the innermost parts of the womb, by the invisible pores of the Body.

If an Ulcer be in the neck of the womb, it must be smeared with scouring and drying Liniments, or Oyntments. The Scourers may be made after this manner:

Take of the Juyce of Smallage two ounces: Honey of Roses one ounce and an half: Turpen∣tine half an ounce: Barley Meal as much as shall seem convenient. Boyl them all gently, and make them into the form of a Liniment or Oyntment. Or,

Take the round Birthwort half an ounce: Horehound, Centaury the smaller, Agrimony, of each half a handful. Boyl them in a sit quantity of Hydromel. To the strained Liquor add the pouder Florentine Orice Root two drams: Barley meal, and clarified Honey, of each as much as shall suffice. Make all into a Liniment or Oyntment.

And somtimes the Oyntment Pompholygos is used, adding thereto, Frankinsence, Mastich, Mirrh, Aloes, as the Nature of the Ulcer shal require.

When the Ulcer is sufficiently clensed, a drying and scar-contracting Oyntment is to be laid on, which may be thus made:

Take Tutty Pouder washed half an ounce: Litharge of Gold and Silver, Ceruss, Sareocolla, of each two drams: Oyl and Wax as much as will suffice. Make all into an Oyntment.

It falls out somtimes, That Ulcers of the Womb do penetrate unto the streight Gut, and somtimes unto the Bladder; which is known by the Quittor issuing through the Water-Gate, or the Dung-Gate.

If the Quittor or Matter come out by stool, Lenitive, Scouring, and Drying Clysters are to be used; such as we propounded in our Cure of the Bloody-flux.

But if the Quittor come away by Urine, gentle Piss-drivers and cooling wil be requisite, which may purge out the filth sent into the Bladder, and further the Cure of the Ulcer; such as are, Emul∣sions of the greater cold Seeds, after which, Turpentine must be used, and other Medicines prescribed for an Ulcer of the Bladder.

If the Ulcer degenerate into a Fistula, which chiesly fals out when it opens outwardly towards the Hip, though it may likewise happen in the Womb it self, and its Neck; it is to be considered, which

is better for the Patient, to leave that Passage free and open, to which Nature hath been accustomed, and by which she endeavors to disburden her self of manifold Excrements, or to stop the same. If it be judged best to keep it open, a palliative Cure must at least be made, by Purges frequently repea∣ted, and Sweat-provokers are to be administred twice in a yeer,; also scouring Injections, and strengthening must be used, and Emplastrum D••apalma Divinum▪ and ••uch like Plaisters, are to be laid upon it. But if there be hopes to make a perfect Cure, and heal up the Fistula, such Medicines must be applied, as are wont to be used for the cure of other Fistulaes.

If Ulcers happen in the Water-Gate, or in the Cavity of the Womb, by reason of the Lechers Pox, they cannot be Cured without the General Cure of the said Pox. In the performance of which Cure, of many waies, there is none better than Fumigations of Cinnabaris or Minium; for they do not only help to rid the whol Body of that Infection, but being received into the Cavity of the Womb, they do in a peculiar manner hasten the Cure of these kind of Ulcers. Likewise in the Cure of this Disease, by Quick-silver'd Oyntments, the said Oynt∣ments must be conveighed into the inner parts of the Womb.

In whatsoever Ulcers of the Womb, if the Neck thereof be molested with an itch, as it often falls out, by reason of a deflux of a sharp and salt Humor into that part; to pacifie the said Itch, a Pes∣sary wil be good, dipped in Ʋnguentum Enulatum cum Mercurio; or in Aegyptiacum dissol∣ved in Sea-water, or in Allum water; or in new Butter wherein Quick-silver hath been killed, with some Brimstone mingled.