Female anatomy and gynaecology have been poorly understood through-out history, but there are examples of thorough gynaecological text from ancient times that are informative and to a certain, small, extent fairly accurate. One such text was written by the Greek physician Soranus of Ephesus. The text is called Gynaecology and has influenced the practice of midwifery that is being practiced today.
According to the Suda, a 10th century Byzantine encyclopaedia of the ancient medical world, Soranus of Ephesus was likely born in the second half of the 1st century CE and died towards the middle of the second century CE. Soranus studied medicine in Alexandria and practised as a physician in Rome under the reigns of Trajan and Hadrian (ca 98–138 CE).
Little else is known of Soranus' life except that he wrote some 20 books on a wide range of medical topics as well as grammar and etymology. Even though the majority of his writings are lost, or highly fragmented, his work Gynaecology survives and gives valuable information on obstetrics, midwifery and the role of the midwife, and care of the infant during the Roman empire.
The book is divided into four subsections;(1) the midwife, female anatomy and conception; (2) childbirth and the care of the newborn; (3) pathology and diet;(4) surgery and drugs.
The Soranus Gynaecological texts makes a difference between “contraceptives” and “abortive” methods stating that a contraceptive is different from abortive, as the former does not allow contraception to happen whilst the latter terminates a conception. The methods are, needless to say, not rooted in science but nevertheless shows that the choice between keeping a pregnancy or terminating it existed in the Roman Empire.
In addition to making a difference between contraceptives and abortions, Soranus also differentiates between “expulsive” and “abortive” methods stating that employing an expulsive does not mean using drugs but rather shaking and leaping. The text draws on some of Hippocrates' work, who forbade abortifacients but allowed “leaping with the heels to the buttocks for the sake of expulsion” (also called the Lacedaemonian leap). Even though the Hippocratic oath prohibits abortion, in another Hippocratic text, On the Nature of the Child, he advices a young girl who is thought to be on the sixth day of pregnancy to expel the “seed” by employing the Lacedaemonian leap.
Although these two Hippocratic texts, the Hippocratic Oath and On the Nature of the Child, have contradictive views on abortion, it has been explained throughout history as the difference between abortifacient remedies and expulsive measure. One could however interpret this as the first guideline of when in a pregnancy abortion was allowed.
Soranus does not agree with Hippocrates view on abortion and states that there are two sides to the question of aboution - just as today. One side agrees with Hippocrates and will not give an abortifacient to anyone as the purpose of medicine is to care for the patient, including the foetus, whilst the other side prescribes abortifacients albeit with limitations. For example, a person who wishes to have an abortion because they fell pregnant as a result of adultry or because of aestethic worries would not be elegible for an one. However, if there is a health risk to the mother an abortitative would be prescribed. He states as an example of this when “the uterus is small and cannot accommodate a pregnancy”.
Although wrong, Gynaecology states a few ways of avoiding contraception is for the woman to hold her breath and draw herself away when the man climaxes - as such the sperm cannot reach deep enough in the uterus. Then she has to stand up immediately and squat down, sneeze and wipe the sperm away - and perhaps have a cold drink. Another way to prevent pregnancy is to smear the orifice of the uterus with old olive oil, honey, juice from the balsam tree, or cedar resin, all together or just one of them together with white lead which is poisonous. If she fancied, she could also put some wool in her vagina. The reasoning for these methods were because styptic, logging and cooling were considered to cause the uterus to shut and as such no semen could reach deep enough to cause a pregnancy.
Even though Soranus gives methods for abortion, he states that contraceptive is safer than any abortion - and this is true for modern day medicine as well. Especially now when new laws are threatening the very fundamental right of bodily autonomy and the results and risk of “back alley abortions” are catastrophic.
Soranus gives some ludacris examples of contraceptives which could be used as abortative as well, such as to drink Cyrenaic balm once a month to the amount of a chick-pea in two cyaths (a small ladle) of water for the purpose of inducing menstruation. Another method was to use panax balm, Cyrenaic balm, and rue seed, of each two obols (a coin), grind and coat with wax and give to swallow; then follow with diluted wine. He does however warn that the harm of these concoctions are too great since they can damage and upset the stomach as well as numerous other side effects.
On abortion Soranus states that in order for the embryo to be separated from the womans body she can, amongst other methods, excersise violently, power walk, or be shaken by means of travelling in a carriage pulled by draught animals. For a woman who intends to abort an embryo it is necessary that she take protracted baths to soften the vaginal suppositories two to three days beforehand, as they soften the uterus and the embryo will more easily fall out. He continues to say that there are other ways to preform an abortion, and that other contemporary scholars have written much about it, but that it is imperative that one is on careful with powerful treatments and of detaching the embryo with sharp instruments because the surrounding tissue may be injured. Furthermore, he stated that after an abortion the woman must be treated as if she has an inflammation.
From this we can conclude that even a millenia ago the discussion of keeping a pregnancy, and the knowledge of how to preform an abortion existed. Not only that, they realised the danger of unsupervised abortions and the dangers of using sharp tools to abort. This is highly relevant today and is a sad reality for many women in countries with outdated laws, or newly instated laws, regarding women's bodies and self autonomy. Nevertheless, we do not know if it was the woman’s choice whether she could have an abortion or not, but at least there was a discussion regarding it.
Text: Anna Sunneborn Gudnadottir. MENAM Archaeology. Copyright 2022.
Images:
© The Board of Trustees of the Science Museum
Soranus of Ephesus, Gynaecology, in a Latin version of Late Antiquity: positions of the embryo in the uterus. The illustrations in this mediaeval manuscript are probably based on drawings by Soranus. Brussels, Bibliothèque Royale, Codex 3714, fol. 28r.
Further reading:
Soranus of Ephesus “Gynaecology”:(on contraception and abortion) English tr. L.Dysinger, OSB, based in part on Owsei Temkin, (tr.) Soranus. Gynaecology (Johns Hopkins Press, 1956). Greek text ed J Ilberg, Sorani Gynaeciorum libri iv, de signis fracturarum, de fasciis, vita Hippocratis secundum Soranum, ser Corpus medicorum Graecorum, vol. 4 (Teubner, Leipzig 1927). Karamanou, M., Tsoucalas, G., Creatsas, G. and Androutsos, G., 2013. The effect of Soranus of Ephesus (98–138) on the work of midwives. Women and Birth, 26(4), pp.226-228.
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