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(ERRONEOUSLY ASCRIBED TO ARISTOTLE.)
If men and women, after they have reached a certain age, do not have children after , the fault sometimes rests with both, and sometimes in only one of them. And first, it is requisite to examine the uterus of the female, that if the fault lies there it may be relieved by proper treatment. If the fault is not there, attention must be paid to some other cause of sterility. We may conclude that this organ is in a healthy state, when, like the other parts of the body, it performs its functions without pain, and is free from fatigue after the function is performed. Just as the eye is in a healthy state if it suffers no pain in seeing, and is not disordered with the exercise of its function, or unable to perform it again, so the uterus is healthy which suffers no pain, and is well able to perform its functions, whatever they may be, and after they are performed is not impotent, but is free from fatigue.
2. The uterus is said to be disordered, when, even if it performs its functions properly and without pain, it does not hinder its function by any part of itself. As there is nothing to prevent an eye from seeing accurately, although all its parts are not perfect, or if there happens to be a tumour in it; so the uterus may have received no injury in this respect, if it is properly situated in the right place. In the first place, then, the healthy uterus will not be situated in this place or in that, but will always be in a similar position; but it is not difficult to decide whether it is not placed at too great a distance without suffering and pain, or whether it is devoid of sensation when touched. That these parts ought to be properly placed is evident from the following considerations, for if the uterus is not near, it will not be able to imbibe the semen, for the place from which it [Pg 281] ought to receive it will be at too great a distance. If the uterus is near, and not able to retire further, it will be useless, for it will be always touched so as to refuse to open; but it ought to do this, and to be obedient to its function. These things ought to be thus ordered, and if they are not, the case requires attention.
3. The catamenia also should proceed correctly, that is, if the general health is good, they should last for their proper time, and not come irregularly, for when the catamenia are right, the uterus will open properly, and receive the fluids of the body whenever they are secreted; but when they make their appearance too often, or not often enough, or irregularly, while the rest of the body does not sympathise with them, and the general health is good, we must look to the uterus for the cause of their irregularity. The dullness of the uterus prevents its being opened at the proper time, so that it receives but a small portion, or rather the uterus imbibes the fluid from some inflammation of the parts. So that it shows that it requires attention, like the eyes, the bladder, the stomach, and other parts. For all the parts, when inflamed, imbibe the fluid which is secreted into each place, but not such a fluid, or in so great quantities.
4. In like manner, if the uterus secretes more than it ought to do, it exhibits an inflammatory tendency, if the secretion is regular but too abundant; but if the secretion is irregular, or more putrid than it should be in healthy subjects, the disease is then quite manifest, for it is necessary that some pain should show that all is not well. In a healthy subject, at the commencement, and the cessation of menstruation, the secretion appears white and putrid. All those subjects in whom the secretion is more putrid than in healthy persons, or is irregular, or too abundant, or deficient, should receive attention, for this it is that prevents child-bearing. But in those subjects who are only irregular, and unequal in the periods of the secretion, the disease is not the preventive of child-bearing, though it shows that the habit of the uterus is changeable, and does not always remain the same. And this affection is sufficient to prevent those persons from conception who are otherwise well disposed towards it. It is, however, hardly a disease, but an affection which may be restored without medical treatment, unless it is affected by some previous fault.[Pg 282]
5. If the regularity and quantity of the discharge is subject to alteration, without any corresponding change in the rest of the body, which is sometimes in a more fluid, at other times in a more dry state, the uterus is not in fault, though it ought to follow the habit of the rest of the body, and receive and secrete in proportion. If the body is in a good state of health, but undergoing a change, when this takes place, and there is no need of medical treatment; but if the secretion is too small from disease, and the secretion is taken through some other source, the body suffers: and if the discharge is too great, from all the secretions of the body being turned in one direction, this does not point to disease of the uterus, but of the whole body. Whenever the catamenia coincide with the general habit of the body, it is evident that the fault does not lie with the uterus, which would perform its functions properly if the general health were correct.
6. Sometimes the uterus is weak, and sometimes strong; sometimes too fluid, and sometimes too dry; and the discharge coincides with the state of the body, it is abundant when that is full, deficient when it is less full. If the body is full of fluid, the discharge is watery; if the body is dry, it is more sanguineous; it begins with being white, like milk, and is without smell. Some are dark-coloured, and when about to cease they become white, at the last secretion. The white discharge has not the smell of putrid matter, but is more harsh and disagreeable, nor has it the smell of pus; and when this is the condition of the symptoms, there is no wearing away, but the body becomes heated. In all that are in this state, the uterus is in a healthy condition for child-bearing.
We must, then, first of all inquire whether all these particulars are well ordered; and, next, we must learn the position of the body of the uterus; for it ought to be straight; and if it is not so, the seminal fluid can never reach it. And it is evident that women project their semen forwards, from what happens when they have lascivious dreams; for this part of them then requires attention, being moistened as though they had sexual intercourse, for they also project into the place where the semen of the male is emitted, and not into the uterus; and when projected to this place, the semen is [Pg 283] drawn into the uterus by inhalation, as the mucus is drawn into the nose. For this reason they become pregnant in every position; for the seminal fluid both in men and women is always projected forwards; but if it were projected into the female she would not always conceive after copulation.
2. But if the uterus is not straight, but inclined to the hips, the loins, or the hypogastric region, it is impossible to conceive, for the before-mentioned reason, that the uterus cannot take up the seminal fluid. If this deformity is great, either naturally or from disease, the disorder is incurable. If there is a rupture, either by nature or arising from the disease, which contracts the parts with inflammation, the disorder will take a different turn from this. But in order that women may become pregnant, it is necessary, as it was said, that the mouth of the uterus should be straight and, moreover, should be well opened. By this I mean that when the menstrual discharge commences, the os uteri should, on contact, appear softer than before, though not distinctly expanded. But if this is the case, let the first appearance be white.
3. But when the appearances are more the colour of flesh, the uterus will be evidently relaxed without pain when it is touched, and the os uteri is neither dull nor different from itself; and when the discharge ceases, let the aperture be very open and dry, but not hard, for a day and a half or two days; for this shows that the uterus is in a healthy state, and fit to perform its functions. If the os uteri is not immediately relaxed, but appears soft, it shows that both the uterus and the rest of the body are relaxed, and the uterus does not prevent, but first discharges the secretion from the os uteri. And when the rest of the body has discharged a great deal, and the os uteri becomes relaxed, it is a sign of a healthy condition.
4. And when the appearances cease to take place directly, the uterus shows that, if there is any difficulty, it will become empty and dry, and wanting in moisture, and there will be no remains in the passage. When the uterus, therefore, is capable of contraction, it shows that it is in a proper state for receiving whatever is brought to it, when it is in this state without pain, and indeed is insensate; and it is good that the os uteri should not be in any other condition. This shows that there is no reason why it should not close [Pg 284] at the proper time. This is the manner of considering the os uteri, whether it is in a healthy condition or not.
These ought to be the symptoms of the uterus itself after purification. First of all, that the woman should dream of sexual intercourse, and project her seminal fluid readily, as if a man were lying with her; and if this symptom occur frequently, it is better. And when she has arisen, sometimes she should require the same treatment as if she had been with a man, sometimes she should be dry; but this dryness should not be immediate; but after awaking she should be fluid, sooner or later, about as much as half a short day. The humidity should be of the same kind as if she had been with a man. For all this shows that the uterus is in a fit state to receive what is given it, and that the cotyledons are drawn up and will retain what they have received, and be unwilling to part with it.
2. A flatulent state of the uterus is also a good sign, when it enlarges and discharges the wind as the bowels do without pain, and when it becomes larger and smaller without any symptom of disease; for these symptoms show that the uterus is not in want of what is necessary nor sluggish, either naturally or from disease, but that it will be able to find room by growth for anything that it may receive, for it has the power of dilation. When this is not the case, the uterus is too thick, or some natural defect or disease has rendered it insensible. For this cause it cannot nourish, but it will destroy the embryo, if the symptoms are violent, while the embryo is small; if they are less so, when it is larger; if the uterus is slightly affected, the offspring will be inferior, as if it had been fed in an inferior vessel.
3. Upon contact, the right and left side will be found to be alike, and all the other parts in the same way; and in the act of copulation moisture will be produced, not frequently nor in great abundance. This affection is, as it were, a perspiration of the place, like the saliva, which is frequently produced both in the use of food and in speaking. Tears also are shed from the eyes, when we look upon brilliant objects, and under cold or greater heat, of which these [Pg 285] parts also partake, when they happen to be moist. So the uterus becomes moist when employed, when it is of a more moist disposition. Those that are in the best health suffer from this affection, for which reason women always require more or less attention, as also the mouth requires saliva. In some this moisture is so abundant that they cannot imbibe the seminal fluid of the man in a state of purity, on account of its admixture with this uterine moisture.
4. Besides these affections, the following also is to be considered, whether, when they dream of sexual intercourse, their general health is good or not, as whether they are weak, and whether they are so always, or only sometimes, and whether they are not sometimes strong, and whether they are dry at first and moist afterwards; for this ought to be the condition of a woman capable of child-bearing; for relaxation shows that the body has been profuse of the seminal fluid, and that it can perform its functions; but when the uterus is hard, it is a sign of debility. If a woman has this affection without any disease, it shows that the emission takes place naturally and as it ought to do. For if it were not so, there would be disease and prostration of strength. Sometimes, when the uterus is dry and afterwards becomes moist, it is a sign that the whole body receives and makes away with the seminal fluid, and that both the uterus and the body are strong; for it has been already observed that the uterus absorbs the semen which is placed upon it by the process of inhalation, for it is not emitted into it but upon the same place as that of the man. All that takes by inhalation is accompanied with force, so that it is plain that the body of such a person must have the power of retraction.
5. It sometimes happens that women who have lascivious dreams, or men of strong passions, are robust not from strength but from health. This takes place when a large quantity of seminal fluid has been collected near the place from whence they emit it. If this makes its escape, they are in no ways debilitated; for they are not relaxed by the loss of a portion, if sufficient remains behind, or if that which was emitted was useless, nor if it was emitted easily, as if they parted with superfluous matter. For which reason such persons are not robust from strength but from dullness. But [Pg 286] when any part is emitted which is necessary for the body, they become debilitated.
6. If a person is in good health, and of a proper age, the seminal fluid is rapidly formed. This takes place in those that have not done growing and in those that are grown. Women rarely know when they are first pregnant; for they do not think that they have conceived unless they perceive that the semen has been emitted, suspecting that it ought to be emitted at the same time both by the female and the male; and it escapes their notice, more especially when they think that they are unable to conceive, unless they have become dry, and that which they have received has disappeared entirely; but it sometimes happens that both the male and the female emit more than could possibly disappear, and more than enough for conception. When sufficient has been drawn in and much left out, they become pregnant without knowing it.
7. That it is possible that this should take place, and that the affection does not arise from the whole of the seminal fluid, we may learn from those animals which produce many young ones from a single act of intercourse, or from the case of twins produced by a single act. It is evident that they are not produced from the whole semen, but each place receives some portion of it, but the larger portion is left behind; and if many young are produced from a single act of intercourse, which appears to be the case with swine and with twins, it is evident that the semen cannot come from every part of the body, but it is divided out to each form. It is possible, therefore, that it may be separated from every part of the body, and that the whole may be divided among many, so that it is not possible that all should have every part. The female also projects her semen into the os uteri, where the man also emits his, when he approaches her. From thence she imbibes with inhalation as if it were with the mouth or nostrils; for whatever is not joined to the members is either hollow above and united by a symphysis, or is sucked in from this place by the act of inhalation. For which reason they take care that it should be dry, as if this had happened before.
8. The path along which it passes is thus formed in women. There is a tube enclosed in the body like the penis of the male. The inhalation takes place through this by a [Pg 287] small passage above the passage for the urine. When, therefore, they desire sexual intercourse, this part is not in the same condition as it was before. A falling down takes place from this passage, and the fore part of the uterus becomes much larger than the part where it falls into this passage. This resembles the nostrils; for, as the nostrils have a passage into the pharynx and into the external air, so this tube has a very small and narrow passage, like a passage out for the wind. That to the fore part of the uterus is wide and broad, as the nostrils are to the external air between the mouth and the pharynx. So women have a larger passage to the fore part of the uterus, and wider than the external passage.
9. Whatever conjecture is formed concerning these affections, it makes to the same conclusion, that the woman also emits a seminal fluid. The same things arise from the same cause, for to some it seems to be the cause of disease or of death; and these consider the end at the beginning as it ought to be considered; for to some women these are important causes, to some of no importance; and of these causes some are and some are not of consequence. They divide also in proportion the consequences which may result from them. To some it happens to pass through all these affections; to those who have many, through many of them: others through few; and others, again, who have none, through none of them.
10. There are some persons who suffer from the affection called inflation. This ought not to be. The affection is of this kind. In copulation they neither evidently emit semen, nor do they become pregnant. Wherefore they are said to be inflated. The excessive dryness of the uterus is the cause of this complaint; and when it has drawn the fluid into itself, it ejects it again. This becomes dried up, and having become small falls out, without any notice being taken of the circumstance on account of its size. When the uterus is violently affected in this way, and becomes very dry, and ejects it very soon, it is plain that pregnancy cannot take place. If this does not take place very soon, impregnation appears for a time to have taken place until it is ejected. The same thing also takes place at times in those who have conceived properly; if a long time has elapsed, the uterus becomes elevated, so that it plainly appears as if impregnation had [Pg 288] taken place until it falls out. Then all becomes as it was at first. They refer this affliction to a divine origin. It is curable, unless it is natural, or the disease has gone a great way. It is a sign that this disease is not present, when women appear neither to have emitted semen, nor to have conceived after sexual intercourse.
1. Pregnancy is prevented also by spasm in the uterus. This complaint attacks the uterus when it is either distended with inflammation, or in the act of parturition. When any large quantity of matter suddenly enters it, and the os uteri is not open, spasm then arises from distension. It is a sign of the absence of spasm, if the uterus does not appear to reach inflammation in its functions: whereas, if spasm were present, there would be some signs of inflammation. Again, a swelling at the mouth of the uterus, if it is much drawn out, will prevent conception. It is a sign that this is not the case, when the uterus appears to open and close properly after the discharge of the catamenia, or the use of the male.
2. In some, also, the os uteri is closed, either from the period of birth, or in consequence of disease. Sometimes this is curable, and sometimes not so. It is not, however, difficult to ascertain the state of the case, for it is not possible either to receive or to emit anything in a proper manner. If it appears to have received and rejected the seminal fluid of the male, it is an evidence of the presence of the disease. But those who have no impediment in the way of conception, but are, as it has been said, as they ought to be, unless the man is impotent, or they are not able to have children together, being unable to emit their semen at the same time, and differ very much, such persons will have no children.
In order to understand of sterility in the male, we must take other symptoms. These will appear very easy, if he copulates with other women, and impregnates them. When the sexes do not appear to concur with each other, although all the before-mentioned circumstances are present, they do not have children together. For it is evident that this is the [Pg 289] only reason of sterility: for if the woman contributes to the semen and generation, it is evident that both the sexes should be concurrent: for if the man is quick, and the woman slow, in the emission of the semen (and many women are comparatively slow), this will prevent conception; for which cause they do not produce children by sexual union with each other. They do so, however, when they happen to be concurrent with each other; for if the woman is desirous, and prepared for the intercourse, and is inclined for it, but the man is suffering previous pain, and of a cold disposition, it is then also necessary that they should be concurrent.
It is quite plain when animals desire sexual intercourse; for the female pursues the male, as hens pursue the cock and place themselves beneath him, if the male is not desirous. Other animals also do the same. But if all animals appear to have these affections with respect to sexual intercourse, it is plain that the causes must be the same throughout. This bird, however, has not only the desire of receiving, but also of emitting semen. This is a proof of it. If the male is not present, she will emit the semen into herself, and become pregnant, and produce barren eggs, as if she desired both to emit semen, and when she had done so, soon ceased, just as when the male was present. Others also do the same, for a person has attempted to rear some singing locusts, which he had taken in a young state. When grown, they became pregnant spontaneously.
2. From these considerations it is plain that every female contributes to the semen, if this appears to take place in any one class of animals, for the barren animal differs in no respect from the other, except that it does not produce an animal, and this because it was formed by the union of both sexes. For this reason all the seminal fluid of the male does not appear to be productive, but some parts are barren, when not properly compounded from both sexes. And when women have lascivious dreams, the same affections of weakness and debility often occur, as if they had been lying with a male. It is plain, therefore, that if they appear to have emitted a seminal fluid in their dream, they will then conjecture that after their dream the same place [Pg 290] will become moist, and they will be obliged to bestow the same attention upon themselves as if they had had sexual intercourse. So that it is evident that there must be an emission of semen from both if it is to be productive.
3. But the uterus does not emit its semen into itself, but on the outside, into the place where that of the male also is received, and then draws it into itself. For some females produce spontaneously, as the bird produces barren eggs, and other females do not so, as the horses and sheep; either because the bird projects her semen into the uterus, and the place upon which that of the male is emitted is not external; for which reason, if he does not copulate properly with the female, it is poured out upon the ground. But in quadrupeds there is another place for the reception of the semen, both of the male and female, which in other animals it is combined with other fluids of the body, and is not collected in the uterus, because it does not enter it. But in birds, the uterus receives and matures the seminal fluid, and forms a body similar in other respects though not a living creature. It is necessary, therefore, the living creature should be derived from both sexes.
We must enquire whether women speak the truth, when they say that after a lascivious dream they find themselves dry; for it is plain that the uterus draws upwards. And if so, why do not females become pregnant spontaneously, since the male seminal fluid is drawn in, mixed with their own? And why do not she goats draw that part of it which extends outwards? for this affection takes place in some that have been pregnant many years; for they produce what is called myle (an amorphous mass of flesh), a circumstance which has also happened to a certain woman; for having had sexual intercourse, and to all appearance conceived, the size of the uterus increased, and everything at first went on regularly: but when the time of parturition arrived, she produced nothing, nor did the enlargement become any smaller: but after three or four years, a dysentery occurred, which placed her life in danger, when she produced a large mass of flesh, which they call myle. The affection continues in some to old age, even to the day of their death.[Pg 291]
2. Does this affection arise from a warm habit of body, when the uterus is warm and dry, and for this reason capable of drawing into itself in such a manner that it is taken up and kept in it? For, in persons so affected, if the seminal fluid of both sexes is not united, but, like the barren egg, is taken up by one sex, then the myle is produced, which is not living creature, for it does not originate in both sexes, nor is it lifeless, for it is taken to have life like the barren egg. It remains, however, a long while, on account of the disposition of the uterus, and because the bird, which has produced many eggs in herself, when the uterus is stimulated by these, goes and lays them: and when the first is produced, the last will also come forth in proper time: for there is nothing to prevent it, but the body being productive as soon as it is full, causes the uterus to be no longer retentive. But in viviparous animals, on account of the change of force, as the ftus increases, and the diversity of food is required, the uterus causes parturition from a kind of inflammation.
3. But the flesh, because it is not alive, always requires the same kind of food, for it does not cause any weight in the uterus, nor any inflammation. So that the affection would continue, in some cases, throughout life, unless some fortunate debility should take place, as in the woman who was attacked with dysentery. But does this affection arise from warmth, as it was said, or rather from a fluid state, because there is a fulness as it closes, either because the uterus is neither cold enough to reject it, nor warm enough to bring it to maturity? Wherefore, the disease lasts a long while, like those things which remain a long while before they are matured; but those that are about to come to maturity have an end, and that quickly. Such uteri, being very high up, cause a long delay. And, again, not being alive, it does not cause any pain by its movements, for the movement of the ligament which the living ftus produces, causes pain. And the hardness of the substance is the effect of imperfect production, for it is so hard that it cannot be cut by the stroke of an axe. All ripe and mature things become soft, but imperfectly digested things are immature and hard.
4. Wherefore, many physicians, deceived by the resemblance, [Pg 292] say that women are suffering from myle, if they only see the abdomen elevated without dropsy, and a cessation of the catamenia, when the disease has lasted for a long while. But this is not the case, for the myle is a rare disease. Sometimes there will be collections of cold and moist excrements and fluids, and sometimes of thick ones in this part of the abdomen, if either the nature or the habit is of this kind. For these things afford neither pain nor heat, on account of their cold nature; but if they increase, more or less, they bring no other disease after them, but remain quiet, like some maimed thing.
5. The cessation of the catamenia takes place on account of the excrementitious matter of the body being directed to this point, as when women are nursing; for they occur either not at all, or only in small quantities. A collection of matter from the flesh sometimes takes place between the uterus and the stomach, which has the character of the myle, but is not it. But it is not difficult to know the difference, by touching the uterus; for if it is correctly placed, and not enlarged, it is evident that the disease is not there; but if it is the same as when with child, it will be warm, and cold, and dry, because all the fluids are turned inwards; and the os uteri will be in the same condition as when they are pregnant; but if the enlargement is of any other kind, it will be cold, and not dry when touched, and the os uteri will always be the same.