SECT. LXV.—ON ABSCESS OF THE UTERUS.
When the inflammation is converted into abscess, all the symptoms formerly mentioned become more intense; and, besides, there are irregular attacks accompanied with rigor, which at first are attended with intense pain; but when suppuration has fairly taken place, there is some remission of it. About the time of the abscess’ bursting, the pains, however, become more keen and seem to attack in a pungent manner; the fevers formerly slight become more oppressive; sometimes there is obstruction of the urine, and sometimes of the fæces, occasioned by the pressure of the affected part of the uterus. Sometimes there is swelling in the region of the pubes, and a sense as it were of fluctuation, when the abscess is large. Abscess in the more exposed parts is discovered by means of the surgical instrument called dioptra, or the touch of the finger, and from the pains being more violent, owing to the nervous nature of the mouth; as when the collection is in the fundus and vagina it is attended with less pain, and no swelling is felt heavy upon the finger, and the mouth of the womb appears less tumid. Wherefore we must promote suppuration by cataplasms of fenugreek, linseed, barley, or wheaten flour intermixed with boiled figs, and sometimes with pigeons’ dung. Let the patient often use the hip-baths recommended for inflammation, and pessaries of turpentine, myrrh, grease of wool and butter. When the abscess bursts, if the matter pass to the bladder, we must give milk to drink, and draughts from the seeds of cucumber; but if it is discharged into the rectum we must throw up injections of lentils and pomegranate-rind. But if it burst into the womb, provided the pus be pure, we may inject rose-oil, or whitened oil, or the ointment composed of four ingredients, which is called basilicon, or fresh butter; but if a thin fetid ichor is discharged, as from a spreading ulcer, we must use an astringent injection of myrtles, dates, and dried lentils; and after the discharge of the humours, if there he inflammation, we must persevere with the cataplasms and hip-baths. When the aposteme is seated about the mouth of the uterus, and does not burst, after the parts which cover the pus have become thin, we must endeavour to procure the evacuation of the pus by a surgical operation, as will be explained in the Surgical part of the Work.
Commentary. Our author abridges the account given by Aëtius, but has omitted some things of importance. Aëtius directs us, when the abscess is forming, to apply fomentations by introducing a piece of sponge into the vagina, and to steam the uterus by means of a tube calculated to convey the fumes to it. When the pain is violent, poppy-heads are to be added to the cataplasms. The poppy is an ingredient in several of the cataplasms mentioned by Serapion. Avicenna’s treatment is perfectly similar. Oribasius remarks that an abscess may burst by the os uteri, the bladder, or into the rectum. When it makes its way into the rectum, Haly Abbas prescribes clysters composed of such articles as lentils, pomegranate-flowers, Armenian earth, rose-oil, ceruse, dragon’s blood, gum arabic, the yelk of an egg, and vinegar. His general treatment consists of pessaries, plasters, injections into the vagina, and clysters of various cooling and emollient articles.