The uterus is often ulcerated from difficult labour, extraction of the
fœtus, or forced abortion, or injury of the same occasioned by acrid
medicines, or by a defluxion, or from abscesses which have burst. If,
therefore, the ulceration be within reach, it is detected by the dioptra,
but if deep-seated, by the discharges; for the fluid which is discharged
varies in its qualities. When the ulcer is inflamed, the discharge is
small, bloody, or feculent, with great pain; but when the ulcer is foul,
the discharge is in greater quantity, and ichorous, with less pain. When
the ulcer is spreading, the discharge is fetid, black, attended with
great pains, and other symptoms of inflammation; irritation is produced
by relaxing medicines, and relief by the opposite class. When the ulcer
is clean, the fluid is small in quantity, consistent, without smell,
thick, white, with an agreeable sensation. When the ulcer is inflamed,
we must use those things recommended for inflammations. When it is foul,
we must inject the juice of ptisan with honey, or basilicon ointment
with the oil called Susinum; or honied water, having fenugreek, mallows,
bran, or lentil without its husk, boiled in it; and in order to clean it
the more, horehound or vetches may be added; or mixing with honey the
flour of vetches, or iris, or round alum, or the like, we may inject
them; and externally we may apply cataplasms of the same things mixed
with honied water. And this medicine is particularly applicable: The
finest saffron is triturated with a woman’s milk, and being added to
rose-cerate with the grease of a goose, is rubbed upon flocks of wool.
But the following is a more effectual application, and one proper for
violent pains: Poppy-heads are mixed in diluted must for three days, and
then boiled until they become soft; then rose-leaves, dr. v, and saffron,
dr. iij, are pounded together, and the decoction of the poppy-heads
mixed with them; then wax, dr. ij, melted with rose-oil, are poured on
them, and applied on a pessary, anointing with rose-oil. The same good
effects may be derived from the preparation of eggs, saffron, rose-oil,
the grease of a goose, and stag’s marrow. And the Egyptian ointment
without the verdigris answers admirably for the cure of ulceration.
When the ulcer is spreading and attended with inflammation, we must
apply a cataplasm of warm bread mixed with hydromel, oil, marshmallows,
fenugreek, and fatty dates. We must inject also the juice of plantain,
of nightshade, of knotgrass, and of endive, first by themselves, but
afterwards with austere wine or vinegar. When the ulcer spreads and is
without inflammation, we may inject more tonic remedies, such as the
decoction of pomegranate-rind, of roses, of olive shoots, of cypresses,
of quinces, of bramble, of myrtles, of lentisk, of buckthorn, of sumach,
in astringent wine, and afterwards with alum, acacia, lycium, and
hypocistis. A hip-bath is also to be prepared from these decoctions. When
these things do not succeed, we must use an injection, at first of paper
with oxycrate, and then of vinegar, or of the powder called anthera, or
of chalcitis, or of copperas, in the same liquids; or of the remedies for
dysentery. We must allow wholesome food in small quantities. When the
ulcer has become clean, we must bathe more frequently, administer food
freely, and give wine, so that the body may soon recover its flesh. In
place of a pessary, we may inject the preparation from mulberries, mixed
with calamine, Cretan cistus, or plumbago. Externally we may apply the
epulotic plaster to the abdomen and loins; for the powers of cataplasms,
as well as those of plasters, may be thus communicated by the insensible
pores of the skin.
* * * * *
COMMENTARY. Our author has described the treatment of ulcers in the womb
so fully and judiciously, that little of importance can be added to it.
It is mostly compiled from Aëtius, who, in his turn, professes to have
copied from Archigenes, Aspasia, and Asclepiades.
Aretæus says that of ulcers in the womb some are broad, attended with
pruritus and a discharge of thick matter without fetor. These are not
dangerous. But when the discharge is thin, ichorous, and fetid, when
the lips of the sore are callous, and when it spreads like a phagedenic
ulcer, it is of a malignant kind. His chapter on the treatment is lost.
Unfortunately there is also a hiatus in the text of Celsus, which
detracts from the value of his account.
Octavius Horatianus recommends a potent remedy for putrid ulcers of the
uterus which supervene upon wounds. It is a trochisk formed of arsenic,
quicklime, sandarach, burnt paper, and the like. Although the case
recently reported of the man who killed his wife, by introducing into her
vagina the oxyd of arsenic, ought to teach us caution, we can certainly
conceive that such an application, if properly managed, might prove safe
and effectual. It ought also to be kept in mind that the orpiment of the
ancients was less virulent than the arsenic of the moderns.
Scarcely any additional information is to be learned from the Arabians.
The following application recommended by Avicenna seems to be a
judicious one: Take equal parts of litharge, ceruse, and sarcocolla;
make a cerate with wax and rose-oil. When the ulcers are attended
with a bloody discharge, Haly Abbas directs us to use pessaries and
injections of an astringent nature, consisting of galls, hypocistis,
plantain, rose-oil, and the like. When the discharge is whitish and
purulent, he recommends the tepid bath and injections of barley-gruel,
honey, &c. For relieving the pain he recommends an ointment containing
litharge, frankincense, axunge, fresh butter, strained wax, and rose-oil.
Alsaharavius recommends similar remedies.