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OF THE NATURE OF WOMAN. - Hippocrates, The Writings of Hippocrates and Galen [1846]

Edition used:

The Writings of Hippocrates and Galen. Epitomised from the Original Latin translations, by John Redman Coxe (Philadelphia: Lindsay and Blakiston, 1846).

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OF THE NATURE OF WOMAN.

DE NATURA MULIEBRI,FŒSIUS, Treat. v. p. 563.
DE NATURA MULIEBRI,HALLER, iii. p. 331.
DE LA NATURE DE LA FEMME,GARDEIL, iv. p. 9.

Haller says this treatise is nearly the same with the books entitled “De Morbis Muliebribus.” Numerous diseases are stated in the Gnidian manner. A detail of an infinite number of cases of change of situation of the os uteri, its obliquity and induration, &c.; as in the second of the books referred to. The farrago of remedies, from the three kingdoms of nature, is not at all diminished.

It is divided into three sections by Haller, but not into chapters.

In reading this treatise, it will be seen, says Gardeil, that it might be remodelled with great advantage, and reduced at least one-third. Had its author revised it, undoubtedly he would have erased the many repetitions of the same cases, that are spread throughout. He would likewise have located it after the treatise of the diseases of females, of which it is a mere abridgment, augmented with some formulæ of remedies, of little importance. Gardeil makes no less than one hundred and seventy-five paragraphs.

I. Some general remarks as to what constitutes that disposition in females which renders them liable to certain complaints that are peculiarly their own.

Here the author commences, by stating, that, as to what appertains to the nature of women and their diseases, he thinks, in the first place, that all human affairs are in the hands of the Deity; and, secondly, that such and such circumstances contribute to their particular ills; and, therefore, that in discussing this subject, it is essential, primarily, to look up to heaven, and then to study the subordinate causes, such as the temperaments and the ages of women, the seasons, and the places in which they reside.

II. Treats of the moisture of females, and of its influence on menstruation, in diminishing or suppressing the discharge. The symptoms ensuing are noticed, and the treatment pointed out; among the remedies is a pessary of cantharides, or into which it enters.

III. Here, and in several following paragraphs, are noticed the cases in which the uterus is presumed to move its situation.

1. Where it rises towards the liver; a state said to be more common in virgins in advanced life, or in young widows. The treatment is given, and a recommendation of marriage for virgins.

2. When the uterus descends, and appears externally, which is not uncommon after delivery, if the sexual intercourse is too much permitted. In the cure, this, therefore, as well as bathing, is strictly prohibited. 3. In case of complete external descent or prolapsus, which is said to occur from coition after lying-in, and during the discharge of the lochiæ; various measures are mentioned for its reduction and retention. If unsuccessful in replacing it, it is recommended to employ “la sacade de l’échelle la téte en bas,” p. 14.a A large (dry) cupping-glass (σιϰυην) to the upper part of the thigh is also commended.

VI. In case of adhesions between the uterus and other parts, indurations, suppuration of the womb, and ulcers, sometimes arise, or discharges which prove fatal if not attended to; fomentations of urine are among the measures recommended. The usual effect of this state is said to be sterility.

VII. In case of the mouth of the uterus doubling or being inverted on itself, the menses are impeded; here, we find fomentations of the urine of a man commended. This is also stated as a cause of sterility.

VIII. When the uterus falls upon the ischium, menstruation is impeded; here we have a drink recommended, formed with different articles, among them are four cantharides, from which the feet, the wings, and the head are removed.

IX. If the lochia do not flow after delivery, after other measures, tar-water is ordered as a drink, (forestalling Bishop Berkeley,) and copious unction of the mouth of the uterus.

X. When fluor albus occurs (menses albi pituitosi), the treatment varies, as there is, or is not, accompanying sharpness and excoriation; in the latter case the fluxion is from the head, in the former from the stomach.

XI. Inflammation of the womb; its symptoms, sometimes similating pregnancy, and followed by dropsy.

XII. Erysipelas of the uterus, its symptoms, &c.; these resemble in a great degree those accompanying the milk-leg. When occurring in pregnancy, it is said to be fatal, and at all times difficult of cure.

XIII. Too great dilatation of the os uteri, its symptoms, &c.; it is said to be fatal.

XIV. The womb retiring towards the middle of the loins; here, syncope is mentioned among the symptoms, in which state it is directed to introduce into the uterus a tube, through which to inflate it. Sterility and lameness are said to result.

XV. Fluor albus; resembling the urine of an ass; among other means, the use of asses’ milk for forty days is ordered, with some singular directions in its employment.

XVI., XVII. Of cases in which the female is subject to abortion; means of obviating.

XVIII. Of difficult menstruation, symptoms and treatment; among which the pessary containing cantharides is employed, and also the drink with cantharides.

XIX. Of abortion at the end of the first or second month; one case of which is said to depend on the pressure of an enlarged omentum on the womb.

XX. Induration of the orifice of the uterus, and its displacement.

XXI. Incapacity to conception; singular process previous to purging, in order to ascertain whether the patient is bilious or pituitous.

XXII. Total suppression; a too humid state of the os uteri, and treatment of.

XXIII. Falling of the uterus on the ischium (see viii.); a different treatment.

XXIV. Pressure or suffocation (πνιγωσιν) of the womb; probably hysteria, as fetids are profusely ordered.

XXV. to XXX. inclusive. Of apprehended inflammation of the womb at delivery; of debility of the uterus; of apprehended cancer, &c. In one of the cases (resembling viii. and xxiii.), we are directed to employ a large suppository of sulphur, bitumen, and honey; a pessary of the same is also ordered.

Here follow, from XXXI. to LXXIII., a vast assortment of pessaries and other remedies, appropriate to female complaints. A drink, having in its composition five cantharides; a pessary of cantharides and elder juice; an infusion of the root of the croton; pessaries to excite a discharge of blood, formed of five cantharides and other articles; others with large amount of elaterium; sections of the squill, &c. In short, pessaries of every presumed character, emollient, astringent, &c.

LXXIV. to LXXXV. are taken up with the statement of lotions, fumigations, and fomentations of various kinds, including some ointments for various intentions.

LXXXVI. to CI. Here the author returns to the consideration of cases already noticed, and gives others of analogous character. Dropsy of the uterus, its causes and treatment, in which the introduction of a tin sound (specillum stanneum, speculum uteri?) is mentioned. Induration of the womb, its neck and orifice; displacement of the uterus;—a milk diet largely used for forty days. Entire closure of the os uteri, in which again the sound is recommended; obliquity of the os uteri; inflated uterus; grumous and clotted blood in the womb, for which, among other means, something to scrape out the clots is recommended; frequent change of its situation;—a pomegranate filled with pitch softened with wine, is here employed as a pessary; a too great enlargement of the os uteri; a softened state of the womb; its tending towards the belly, or the head, or when it acts upon the legs and feet, or from pain, induces loss of appetite, &c.: in all these cases irregular menstruation exists, and inability to conception.

CII., CIII. The author here adverts to several evils subsequent to delivery,—as diarrhœa, vomiting of blood; in this last, asses’ milk for five days, and to be succeeded by that of a black cow, fasting, for forty days.

CIV. Retardation of the menses;—of purgation of the uterus.

CVI. Constipation from the uterus tending towards the anus; inflammation or ulceration of its mouth; retention of the afterbirth; inflamed uterus, &c.; the catamenia not appearing at their regular period; excoriation of the pudenda; difficulty of making water; choking or difficulty of breathing; chills subsequent to delivery or abortion; flatulence; fetor, and carnosities of the pudenda, ulcers and pruritus;—all these, and more, are noticed, and remedies pointed out for them.

CXIX. Inaptitude to conception, from not menstruating naturally; either from the obstruction of a membrane, [supposed to be a modern discovery!] or other cause, discoverable by the finger.

CXX. to CXLV. Abridgment in a great measure of the preceding numbers, at least as to the measures prescribed.

CXLVI. Various recommendations when the woman loses her milk.

CXLVII. Directions as to the measures to promote conception.

CXLIX. A medicine employed as a pessary, to ascertain if conception will ensue. Various other means are scattered through this book, as to this and other particulars relating to conception, and perhaps equal to those now in vogue among nurses and other old women of both sexes. Fomentations, cataplasms, fumigations, &c., all connected with the female and her uterine affections, follow in rapid succession,—some of a character of great violence, and requiring much courage or hardihood in their prescription; thus, thirty grains of the cucumis agrestis, with other active ingredients, made up and applied to the os uteri five times daily, as a pessary; that formed with cantharides, is repeatedly mentioned as an emmenagogue pessary;—some are singular enough, such as fumigations with two pounds of bull’s urine, with other articles. It would seem that almost every substance employed as a medicine, internally, is also here to be found in some or other form of pessary.

[a ]“Et si quidem sic intro redierint, satis est, sin minus, summis uteris derasis et calefactis, ablutis et illitis, alligataque ad scalam muliere, scalam ad caput concutito, et manu uteros intro trudito, postea ejus cruribus alternatim simul colligatis, sic per diem et noctem sinito, et paucum ptisanæ succum frigidum, nihilque aliud exhibeto.” See, also, treatises “De Articulis,” “De Morbis Mulierum,” and “De l’Extrait du Fœtus Mort.”