SECT. LXIX.—ON THE MOLE.
The mole, too, is a scirrhous tumour, forming sometimes at the mouth and sometimes in the body of the womb, conveying to the touch the sensation of stone, and being attended with retraction of the parts above, and emaciation, paleness, loss of appetite, retention of the menses, and swelling of the breasts, so as in certain cases to raise suspicions at first of a conception; but in process of time the true nature of the complaint is developed. Sometimes also it raises suspicions of dropsy, from which it is to be distinguished by the hardness of the swelling, and from there being no sound of water when tapped by the fingers, as is the case in dropsy. In certain cases, however, the disease actually terminates in dropsy, which for the most part proves incurable. In some cases, it also brings on a discharge of blood. In general, therefore, it is proper that the patients should lie in a small, dark, and moderately cool house, upon a firm couch, with their feet raised, and in a state of quietude; for motion provokes discharges of every kind. And the swelling and hardness are to be cured by the remedies which we have mentioned for scirrhus and scleroma of the uterus; dropsical effusions by those recommended for dropsy; and hemorrhages by those for the flux. Some call by the name of mole an unorganized mass of flesh which forms on the coats of the womb, and is delivered like the fœtus. This species is to be managed by a relaxing treatment, so as to be speedily discharged.
Commentary. By the first species of mole, fibrous tumour of the ovaria and perhaps also scirrhus of the neck of the womb are meant to be described. The other species is now well understood, and is described by many ancient authors. See an account of it at the end of Aristotle’s ‘History of Animals;’ also Pliny (H. N. vii, 15, and x, 64); Hippocrates (de Steril. xx); Plutarch (t. i, 252, ed. Xylander); Nonnus (212); Rhases (ad Mansor. ix, 88; Cont. xxii); Moschion (de Morb. Mul. 125); Actuarius (Meth. Med. i, 56.) Galen and Avicenna agree in representing the true mole as a corruption of the male semen, and consequently they believed that it never occurs in virgins. Hanneman and other modern authorities maintain the contrary. See ‘Dissertations on the Mole’ by Van Swieten (Comment. 1326), by Ambrose Paré (de Hom. Genit. xxxiii), by Martinus Akakia (ap. Gynæc. 773), by Lodovicus Mercatus (ap. Gynæc. 1013), by Leonardus Jacchinus (Comment. in Rhasis, ix, 71), and by Ruysch (Anat. Chirurg. Cent.)
Aëtius gives an account of the former species, but it is little different from our author’s. He recommends, in the first place, emollient applications of all kinds, namely, baths, pessaries, and fumigations, and afterwards dropaces, sinapisms, and the like. The same plan of treatment is pursued by Avicenna. Haly Abbas and Alsaharavius describe the two species of mole in exactly the same terms as our author. Rhases also describes the two species of mole, namely, the one which is hard and round, and the other or soft species to which the name is now generally restricted.
Hippocrates relates a curious case of a calculus which was discharged from the uterus of a woman sixty years old, who had long felt pain in that region dum venere uteretur. Aëtius also makes mention of the uterine calculus. Lodovicus Mercatus gives a curious account of this subject (Gynæc. 969.) Michaelis Angelus Morus relates a singular case of a woman who died of uterine calculi. (Mangeti Bibl. Chirurg. xviii.)
SECT. LXX.—ON INFLATION OF THE UTERUS.
The uterus becomes distended with air from cold, from abortion, or difficult parturition: its mouth being shut up, or a clot of blood being fastened in it. The air is sometimes contained in the cavity of the uterus itself, and sometimes in the pores of its body. These cases are attended with swelling about the pubes and hypogastrium, with hardness, and a pungent pain, shooting as far as the diaphragm, the stomach, and the groins. When tapped with the fingers it sounds like the swelling of tympanitis. Wherefore it is to be cured, in the first place, by venesection, if nothing prohibits its use; and then, during the exacerbations, by abstinence from food; by embrocations with oil of rue; by hip-baths of the decoction of rue, of pennyroyal, of mugwort, of cassia, and the like; by cataplasms from the seeds of parsley, of cumin, of fennel, of anise, of bishopsweed, and of the flower of iris; by dry cupping, and cupping with scarifications. But when the complaint is protracted, we must have recourse to purging with the hiera picra, dropaces, sinapisms, and the use of the natural baths. Let the midwife introduce her finger well oiled, and extract gently, if possible, the thrombus lying in the womb, by breaking it down, and then apply a cataplasm of figs, of nitre, and of wormwood. Emollient epithemes should be used, such as the Polyarchian, that from seeds, and that from bay-berries. The pessaries should consist of rue, honey, and nitre; but the following one will be particularly applicable: Of fat figs pounded, dr. j; of cumin, dr. ij; of aphronitrum, dr. j. But, owing to its acrimony, let it be previously dipped in milk. Emollient pessaries are also proper.
Commentary. This complaint is mentioned by Hippocrates (Epidem. vii), and by Galen (Meth. Med. xiv, 7, and de Causis Sympt. iii, 2.) Our author’s account of it is taken from Aëtius. Octavius Horatianus and Nonnus direct similar applications, only the former says nothing of bleeding. Haly Abbas, in like manner, omits venesection, but recommends applications consisting mostly of carminative substances, such as parsley, birthwort, dill, rue, and fennel. They are to be used in the form of baths, fomentations, and injections. Alsaharavius recommends bleeding, anointing the womb with oil of rue, baths prepared with rue, chamomile, mace, cumin, &c. cupping-instruments applied to the pubes, and so forth. Avicenna and Rhases refer to Aëtius and Paulus, and treat of the complaint in like manner.