Immoderate discharges in women take place, sometimes from retention of
the menses which break out more copious than usual, and sometimes after
parturition at the full time, when they cease spontaneously for the most
part; and frequently after miscarriages, when a violent hemorrhage often
takes place, and proves dangerous. In the first place, then, we must
apply ligatures round the members, at the armpits and groins; give to
drink oxycrate not cold; sprinkle with oxycrate; and apply to the parts
a large quantity of wool squeezed out of wine and oil, or rose-oil, or
oil of apples, or myrtle-oil. For food, we may give chondrus soaked in
oxycrate, or rice, or alica; but prohibiting wine, we may give austere
hydromel, omphacomel, or the like. The patient may take propomata of
pomegranate flowers in oxycrate, or the juice of hypocistis, or of
acacia, or lycium, or Samian earth, or unripe grapes dried, or rhubarb,
or the ashes of cork burnt in an Italian earthen vessel; or she may eat
sesame soaked in oxycrate until it become soft. The following substances
introduced into the vagina stop hemorrhage: The juice of hypocistis,
or of acacia, with manna, being triturated with vinegar. An admirable
application is a sponge soaked in wine or liquid pitch, and applied;
or the ashes of it burnt when applied with vinegar or oxycrate; and in
like manner the ashes of cork burnt in an Italian earthen vessel. But
astringent epithemes applied externally are beneficial; and cataplasms
from dates and quinces, containing also pomegranate rind, or the tops
of bramble, or acorns of the holm oak, or the leaves of lentisk, wild
pomegranate flowers, acacia, hypocistis, galls, or alum; but more
particularly the following: Taurocolla is macerated in oxycrate until
it is dissolved, and is then spread upon a strong rag, and glued to
the loins. The agglutinative plasters are also powerful remedies, such
as the Harmonium, Icesium, Athena, Melinum, Indicum, and the like.
Pessaries are to be used for the hemorrhage; mixing the inner part of
galls powdered and rosemary with water, apply; or the flowers of the
cultivated pomegranate, or the sweet pomegranate in like manner, or
powdered knotgrass. The following is a compound one: Of fissile alum,
of the inner part of galls, of the juice of acacia, of manna, of each,
dr. iv; the yelks of four roasted eggs; these powders are rubbed with
the juice of plantain, and mixed. In using it a pessary of wool is
impregnated with it, dipped into rose-oil, and applied. And dry-cupping
by large instruments applied frequently under the nipples acts powerfully
by revulsion. The following is a composition for a hip-bath, in which a
person having hemorrhage may sit: Of the heads of sharp rush, of myrtle,
of roses, of the leaves of rhamnus, of bramble tops, equal parts; boil
in water, which let the patient use for a hip-bath.—_Another_: Of the
bark of sweet pomegranate-root, of myrtle, of the rind of cypress, of
each, p. iij; of galls, p. j; boil in a sufficient quantity of water.
Inject with an uterine syringe the decoction of plantain, or of endive,
or of knotgrass, or of nightshade, or of perdicium, or of fleawort, or
of hypocistis, or of acacia; and let these things also be applied with
wool, or by the finger, or a speculum, or a long-shaped feather, to the
mouth of the uterus. And the trochisk of Andron, when injected by an
uterine syringe, with some of the decoctions formerly mentioned, or with
astringent wine, is an active remedy.
* * * * *
COMMENTARY. Aëtius gives a very full account of these complaints, but
nearly in the same terms as our author. He condemns the practice of
applying sponges soaked in cold posca, because, he says, they prove
injurious to the uterus by producing too much coldness. Galen remarks
that pregnant women have sometimes discharges of blood from the veins of
the os uteri. We can attest the correctness of this statement.
Oribasius and Actuarius treat these complaints like our author.
Octavius Horatianus directs us to subject the parts to the vapours of
such astringent articles as pomegranate-rind, roses, and galls; or to
apply to the parts a sponge soaked in posca, or wool squeezed out of some
of the styptic juices. He also recommends us to produce revulsion by
means of cupping-instruments applied to the breasts. He further directs
us to apply to the parts epithemes of astringents, especially Theban
dates boiled in wine or vinegar.
Moschion gives a very sensible account of uterine hemorrhages, for which
he recommends perfect quietude and sponging with cold water and vinegar,
or if that fail, with astringent decoctions, &c.
Soranus, in like manner, gives a very accurate detail of the symptoms and
treatment of uterine hemorrhage.
Rhases recommends venesection (but does not point out the cases in which
it is applicable); astringent trochisks containing the recrementum ferri;
cupping-instruments applied to the breasts; stuffing the vagina with
wool smeared in the mixture of frankincense, wild pomegranate-flowers,
galls, antimony, acacia, and alum. He also recommends epithemes, and when
these things do not succeed, pessaries made with escharotics. In uterine
hemorrhage after delivery, he recommends cold astringent applications,
and bandages to the extremities. Haly Abbas correctly remarks that
uterine hemorrhage sometimes proceeds from plethora of the system, in
which case he properly recommends bleeding. When connected with thinness
of the blood, he recommends incrassant food. He also makes mention of the
usual astringent applications consisting of galls, vinegar, and the like.
Serapion and Alsaharavius lay down similar rules of practice. Avicenna,
however, is the fullest of the Arabian authorities upon menorrhagia.
Like Haly, he states that it sometimes proceeds from plethora, when he
recommends us to produce revulsion by bleeding at the arm. When connected
with debility, he prescribes astringents. When it proceeds from ulcers,
he approves of a combination of agglutinative, astringent, and narcotic
medicines. His general treatment during an attack is almost the same
as that recommended by Paulus. He mentions acidulated water, vinegar,
camphor, alum, galls, &c. Some of his prescriptions contain opium, which
is an anticipation of the modern practice in such cases.