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CHAPTER XI. ON HYSTERICAL SUFFOCATION

IN the middle of the flanks of women lies the womb, a female viscus, closely resembling an animal; for it is moved of itself hither and thither in the flanks, also upwards in a direct line to below the cartilage of the thorax, and also obliquely to the right or to the left, either to the liver or spleen; and it likewise is subject to prolapsus downwards, and, in a word, it is

altogether erratic. It delights, also, in fragrant smells, and advances towards them; and it has an aversion to fetid smells, and flees from them; and, on the whole, the womb is like an animal within an animal.

When, therefore, it is suddenly carried upwards, and remains above for a considerable time, and violently compresses the intestines, the woman experiences a choking, after the form of epilepsy, but without convulsions. For the liver, diaphragm, lungs and heart, are quickly squeezed within a narrow space; and therefore loss of breathing and of speech seems to be present. And, moreover, the carotids are compressed from sympathy with the heart, and hence there is heaviness of head, loss of sensibility, and deep sleep.

And in women there also arises another affection resembling this form, with sense of choking and loss of speech, but not proceeding from the womb; for it also happens to men, in the manner of catochus. But those from the uterus are remedied by fetid smells, and the application of fragrant things to the female parts; but in the others these things do no good; and the limbs are moved about in the affection from the womb, but in the other affection not at all. Moreover, voluntary and involuntary tremblings . . . . . . . . . . . but from the application of a pessary to induce abortion, powerful congelation of the womb, the stoppage of a copious hemorrhage, and such like.

If, therefore, upon the womb's being moved upwards, she begin to suffer, there is sluggishness in the performance of her offices, prostration of strength, atony, loss of the faculties of her knees, vertigo, and the limbs sink under her; headache, heaviness of the head, and the woman is pained in the veins on each side of the nose.

But if they fall down they have heartburn . . . . . in the hypochondriac regions; flanks empty, where is the seat of the womb; pulse intermittent, irregular, and failing; strong sense

of choking; loss of speech and of sensibility; respiration imperceptible and indistinct; a very sudden and incredible death, for they have nothing deadly in their appearance; in colour like that of life, and for a considerable time after death they are more ruddy than usual; eyes somewhat prominent, bright, not entirely fixed, but yet not very much turned aside.

But if the uterus be removed back to its seat before the affection come to a conclusion, they escape the suffocation. When the belly rumbles there is moisture about the female parts, respiration thicker and more distinct, a very speedy rousing up from the affection, in like manner as death is very sudden; for as it readily ascends to the higher regions, so it readily recedes. For the uterus is buoyant, but the membranes, its supporters, are humid, and the place is humid in which the uterus lies; and, moreover, it flees from fetid things, and seeks after sweet: wherefore it readily inclines to this side and to that, like a log of wood, and floats upwards and downwards. For this reason the affection occurs in young women, but not in old. For in those in whom the age, mode of life, and understanding is more mobile, the uterus also is of a wandering nature; but in those more advanced in life, the age, mode of living, understanding, and the uterus are of a steady character. Wherefore this suffocation from the womb accompanies females alone.

But the affections common to men happen also to the uterus, such as inflammation and hemorrhage, and they have the common symptoms; namely, fever, asphexy, coldness, loss of speech. But in hemorrhage the death is even more sudden, being like that of a slaughtered animal.

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