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I. PRolapsus seu procidentia Ʋ∣teri, is next to be consi∣dered: But the Womb does not easily fall down by Relaxation, much less by Laceration of its broad Ligaments, as most Au∣thors imagin.
II. But by hard Labour, or a violent and unskilful bringing a∣way of the Afterbirth; it has been of ten seen, that the bottom of the Womb has been plainly in∣verted, so as the most inward Parts have shewed themselves outwards.
III. Or rather, the wrinkled part of the Sheath, whose inner∣most wrinkled Tunicle, by Re∣laxation, may fall down, which is often taken for the Womb it self.
IV. The Causes. They are, 1. External, from the Rash laying hold of it by the Midwife, mi∣staking it either for the Child or the Afterbirth, and so draw∣ing it strongly, causes it to re∣cede from its proper place.
V. 2. Internal, by the vehe∣mency of the Pangs, or the Childs Head being bigger than ordinary, displacing it; which happens in diseased Bodies, and where there is much weakness, and a great Flux of moist, watery, slippery and slimy Humours, flowing to it; whereby it is made to sink more and more, till at length by its bigness, it comes forth of the Body.
VI. It is known by sight, and feeling of the Part, with the Hand of the Midwife, or the Patients own hand.
VII. The Prognosticks. In the beginning some think it to be easily cured, by Astringents used for a Month, the part being put up for a Month: But this is very rare to be seen; for though ta∣ken in the beginning, the Cure is very difficult to be perform∣ed.
VIII. If it is great, and the Protrusion far out, and of long con∣tinuance, it can never be cured; but being replaced, it may be kept up with a Pessary.
IX. If it cannot be put up, by reason of its bigness, but shall chance to Gangrene, it is to be cut off; which you may do thus: Draw out the hanging part, so far as to tie it with a Tape, or Silk string, to hinder bleeding; which done, cut it off at once with a Knife, which will be with little effusion of Blood: Then it is to be healed with such things as digest, cleanse, and resist Pu∣trifaction.
X. That this thus cut off, is not the Womb, appears from these Words of Barbett. We have found (says he) especially in those who were subject to Costiveness or Belly-ach, that the Membranes of the Pu∣denda, or Vagina, were so far stretched out, that the Ʋnskilful had taken it for the Womb it self, and do so still. But though many Authors have dared to write, that the Womb may be cut off, without danger of Life, seems altogether Impossible to a Skilful Anatomist.
XI. To reduce it, lay the Pa∣tient on her Back, her Knees high, and Legs asunder, and so, if pos∣sible, put it up gently with your Hand; if it be tumified or in∣flamed, so as it will not go up, follow our Directions for a Rup∣ture, Sect. 16. Ch. 8. aforegoing. Then reduce it; putting up a Pessary, that may in bigness and proportion answer the end.
XII. Make it with Cork, which cover, with Wax, mixed with a little Castoreum and Assafoetida: Let it not be too thick, but perforated long ways for the Humour to pass through: This continue there, and let it be kept with a fitting Bandage, ap∣plying over the Belly Empla∣strum ad Herniam, Catagmaticum, or that of Schroder.
XIII. Let the Patient be still for ten or twelve days, with her Legs a cross, forbear loud speaking, and as much as may be Coughing or Sneering, or whatever may occa∣sion violent Expulsion. Inward∣ly observe the Method in Rup∣tures, except in the time of the Courses.
XIV. Barbett, after he has advised the Patient to be laid on her Back, as before directed, or∣ders to take a Wax Candle of a competent thickness, and to mix therewith some Castoreum, or Assaf••etida, and with it gent∣ly to press the Womb inwards; and having fastned the Candle with a Bandage, to apply out∣wardly to the Belly Emplastrum Barbarum, or this following: ℞ Roots of Cypress, Bistort a. ʒi. Galls, Acacia a. ʒss. Cypress-nuts, D••te-stones, Myrtle-berries a. ʒi. Pitch, Colophony a. q.s. mix and make a Plaster.
XV. Great care is also to be taken, that your Wax-Candle be not too thick: lest by its conti∣nual Friction it should cause the Whites, and so weaken the Body.
XVI. Others advise (after it is put up with the Hand) to sup∣port it with a Ball of the bigness of a Ducks Egg, or bigger, dipt twice or thrice into some streng∣thening Emplaster, in which there may be a hole to discharge the Menses; through which may also be put a Copper Wire, with a string fastned to it, to draw it the more easily out of the Body.
XVII. But that which exceeds all these things, almost a thousand fold, is a Ring which may be made of Silver, Pewter, or Wood, as of Box, Cocus or Elder-wood, from an Inch and half to two Inches and a quarter in Diameter, from out∣side to outside; and the turned Substance of the Limb of the Ring, ought to be as thick as the round part of the largest Swans Quill, or rather thicker.
XVIII. This Ring thus made, may be smeared with some proper Emplaster, and so put up: It is without trouble; nor will it fret or gall the Part, or obstruct the Act of Generation, and withal may easily be taken forth when the Patient pleases. See the Third Edition of Our Sy∣nopsis Medicinae, Lib. 5. Cap. 72. throughout.
XIX. This (though the Cure is never performed) so absolutely serves the Patient, that she goes up and down, and performs all her other Duties, and lives as much at Ease, as if she ailed no∣thing at all, and answers all the Ends and Intentions of any pre∣scribed Medicine whatsoever: So that now, it would be labour lost to use them.