Probably the most interesting passage in her book for the modern time is
that with regard to a torn perineum and its repair, even when prolapse of
the uterus is a complication. The passage, which may be found readily in
De Renzi or in Gurlt, runs:
"Certain patients, from the severity of the labour, run into a rupture
of the genitalia. In some even the vulva and anus become one foramen,
having the same course. As a consequence, prolapse of the uterus
occurs, and it becomes indurated. In order to relieve this condition,
we apply to the uterus warm wine in which butter has been boiled, and
these fomentations are continued until the uterus becomes soft, and
then it is gently replaced. After this we sew the tear between the
anus and vulva in three or four places with silk thread. The woman
should then be placed in bed, with the feet elevated, and must retain
that position, even for eating and drinking, and all the necessities
of life, for eight or nine days. During this time, also, there must be
no bathing, and care must be taken to avoid everything that might
cause coughing, and all indigestible materials."
There is a passage almost more interesting with regard to prophylaxis of
rupture of the perineum. Trotula says: "In order to avoid the aforesaid
danger, careful provision should be made, and precautions should be taken
during labour after the following fashion: A cloth folded in somewhat
oblong shape should be placed on the anus, and during every effort for the
expulsion of the child, that should be pressed firmly, in order that there
may not be any solution of the continuity of tissue."
There are records of other women professors of Salerno, though none of
them as famous as Trotula. A lady of the name of Mercuriade is said to
have written "On Crises in Pestilent Fever," and as she occupied herself
with surgery as well as medicine, there is also a work on "The Cure of
Wounds." Rebecca Guarna, who belonged to the old Salernitan family of that
name, a member of which in the twelfth century was Romuald, priest,
physician, and historian, wrote "On Fevers," "On the Urine," and "On the
Embryo." Abella acquired a great reputation with her work "On Black Bile,"
and curiously enough on "The Nature of Seminal Fluid." From these books
it is clear that, while as professors they had charge of the department of
women's diseases, they studied all branches of medicine. There are a
number of licences preserved in the Archives of Naples in which women are
accorded the privilege of practising medicine, and apparently these
licences were without limitation as to the scope of practice. The preamble
of the licence, however, suggests the eminent suitability of women
treating women's diseases. It ran as follows:
Public-domain text, read in full here on John Shaqi.
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