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Soranus
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Soranus came from Ephesus (Asia Minor). He studied in Ephesus and Alexandria at the Methodist school
of Medicine. He rejected Hippocrates theory of the humours and was influenced by Epicurean atomism.
He practiced at Rome under Trajan (98-117) and Hadrian (117-38). He wrote about twenty works on
medicine and biology. His famous work Gynaecology covers midwifery, female anatomy, conception and
childbirth, diet, surgery and drugs. He disagreed with the Platonic-Aristotelian theory of ‘the
wandering uterus’.
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His greatest works, On Acute Diseases and On Chronic Diseases, are lost, but
Caelius Aurelianus (C5-6) paraphrases much of them in a Latin translation. He also wrote books
on fevers (lost), surgery (small fragment surviving), bandages (surviving, with Medieval
illustrations), hygiene (lost), ophthalmology (lost), history of medicine (lost except for
a few excerpts), Commentaries on Hippocrates (lost).
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The writings of Soranus give many details about abortion in the ancient world. Abortion was a
fairly common practice in ancient Rome. Soranus describes several methods for abortion in his
Gynaecology. To cause an abortion, he prescribes violent exercise such as walking about and
leaping energetically and "being shaken by means of draught animals and carrying things that
are heavy beyond her strength." The woman should also use diuretics that cause menstruation
and empty the abdomen. Abortions usually took place before the middle of the second trimester,
after which dangerous surgical procedures may be required. Before the abortion, Soranus
prescribes "protracted baths, little food and softening vaginal suppositories." Soranus follows
Hippocrates by advising bleeding as a method of abortion. In the case of healthy women, "a pregnant
woman, who is bled, miscarries." (Gynaecology 64-5)
Several methods of abortion which rely upon herbs are evident in the texts provided by Soranus and
Dioscorides. In order to abort the foetus during the early months of pregnancies, Soranus and
Dioscorides suggest dietary diuretics, laxatives with pungent clyster, and lupine beans, which
are poisonous unless properly prepared. (Also, several recipes including the plant silphium are
prescribed). Unfortunately, this plant is now extinct and its effectiveness can only be estimated
through a distant relative of the species (Riddle). This relative seems to provide evidence for
an effective abortifacient.) Abortifacients can cause abortion before the middle of the second
trimester of pregnancy. Any form of abortion after the second trimester was highly dangerous for
the mother. Other drugs such as the squirting cucumber, through a distant relative of the species
(Riddle). This relative seems to provide evidence for an effective abortifacient.) Abortifacients
can cause abortion before the middle of the second trimester of pregnancy. Any form of abortion
after the second trimester was highly dangerous for the mother. Other drugs such as the squirting
cucumber, black hellebore, pellitory, and panax balm are recommended for oral intake in order to
abort the foetus.
Soranus (Bk.I, Ch. XIX) suggests two methods to induce abortion:
'...use diuretic decoctions which
also have the power to bring on menstruation, and empty and purge the abdomen with relatively pungent
clysters; sometimes using warm and sweet olive oil as injections, sometimes anointing the whole
body thoroughly therewith and rubbing it vigorously, especially around the pubes, the abdomen,
and the loins, bathing daily in sweet water which is not too hot, lingering in the baths and drinking
first a little wine and living on pungent food.'
The second method describes specific steps to be taken to remove the foetus from the uterus.
'First the womb must be separated from the uterus. In order to create the separation, empty the
abdomen and purge it with warm and sweet olive oil as injections. Then bathe the whole body in
sweet water, lingering in the tub, drinking a little wine first and eating pungent food. If at
this point, it is not effective, then sit in a bath of linseed, fenugreek, mallow, marsh mallow,
and wormwood. Have injections of old oil, alone or with rue juice or with honey, iris oil, or
absinthian with honey, or panax balm spelt together with rue and honey or Syrian unguent. If it
is still not effective, then take a meal of lupines with ox bile and absinthian.'
'Before abortion, take protracted baths, little or no food, use softening vaginal suppositories, abstain from wine,
and be bled in large amounts. Then follow the procedures by then mould to the size of a bean with
water. (See appendix for other vaginal suppositories used as abortifacients. A major danger of this
type of abortion is that it can lead to air in the uterus, which leads to major complications and
infections.)'
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Surgical Abortions:
Although archaeological finds have provided evidence for the surgical removal of a foetus, it is
believed (since such methods hardly ever appear in medical texts) that this method of abortion was
neither common nor frequently recommended. Soranus warns his readers of the danger of separation of
the womb and uterus that may occur if sharp-edged objects are used (Soranus Bk.I, Ch. XIX).
The following quotations taken from Soranus’ 'Gynaecology' detail his writings about abortion:
'60. A contraceptive differs from an abortive, for the first does not let conception
take place, while the latter destroys what has been conceived ... And an expulsive some people say
is synonymous with an abortive; others, however, say that there is a difference because an expulsive
does not mean drugs but shaking and leaping ... For this reason they say that Hippocrates, although
prohibiting abortives, yet in his book 'On the Nature of the Child' employs leaping with the heels
to the buttocks for the sake of expulsion. But a controversy has arisen. For one party banishes
abortives, citing the testimony of Hippocrates who says: 'I will give to no one an abortive';
moreover, because it is the specific task of medicine to guard and preserve what has been engendered
by nature. The other party prescribes abortives, but with discrimination, that is, they do not
prescribe them when a person wishes to destroy the embryo because of adultery or out of consideration
for youthful beauty; but only to prevent subsequent danger in parturition if the uterus is small
and not capable of accommodating the complete development, or if the uterus at its orifice has
knobbly swelling and fissures, or if some similar difficulty is involved. And they say the same
about contraceptives as well, and we too agree with them. And since it is safer to prevent conception
from taking place than to destroy the foetus, we shall now first discourse upon such prevention.'
'61. for if it is much more advantageous not to conceive than to destroy the embryo,
one must consequently beware of having sexual intercourse at those periods which we said were
suitable for conception. And during the sexual act, at the critical moment of coitus when the man
is about to discharge the seed, the woman must hold her breath and draw herself away a little, so
that the seed may not be hurled too deep into the cavity of the uterus. And getting up immediately
and squatting down, she should induce sneezing and carefully wipe the vagina all round; she might
even drink something cold. It also aids in preventing conception to smear the orifice of the uterus
all over before with old olive oil or honey or cedar resin or juice of the balsam tree, alone or
together with white lead; or with a moist cerate containing myrtle oil and white lead; or before
the act with moist alum, or with galbanum together with wine; or to put a lock of fine wool into
the orifice of the uterus; or, before sexual relations to use vaginal suppositories which have
the power to contract and to condense. For such of these things as are styptic, clogging and
cooling cause the orifice of the uterus to shut before the time of coitus and do not let the
seed pass into its fundus. [Such, however, as are hot] and irritating not only do not allow the
seed of the man to remain in the cavity of the uterus, but draw forth as well another fluid from it.'
'62. And we shall make specific mention of some. Pine bark, tanning sumach, equal
quantities of each, rub with wine and apply in due measure before coitus after wool has been wrapped
around; and after two or three hours she may remove it and have intercourse. Another: Of Cimolian
earth, root of panax, equal quantities, rub with water separately and together, and when sticky
apply in like manner. Or: Grind the inside of fresh pomegranate peel with water, and apply.
Or: Grind two parts of pomegranate peel and one part of oak galls, form small suppositories and
insert after the cessation of menstruation. Or: Moist alum, the inside of pomegranate rind, mix
with water, and apply with wool. Or: Of unripe oak galls, of the inside of pomegranate peel, of
ginger, of each 2 drachms, mould it with wine to the size of vetch peas and dry indoors and give
before coitus, to be applied as a vaginal suppository. Or: Grind the flesh of dried figs and apply
together with natron. Or: Apply pomegranate peel with an equal amount of gum and an equal amount
of oil of roses. Then one should always follow with a drink of honey water. But one should beware
of things which are very pungent, because of the ulcerations arising from them. And we use all
these things after the end of menstruation...'
Abortion
'64. In order that the embryo be separated, the woman should have [more violent
exercise], walking about energetically and being shaken by means of draught animals; she should
also leap energetically and carry things which are heavy beyond her strength. She should use
diuretic decoctions which also have the power to bring on menstruation, and empty and purge the
abdomen with relatively pungent clysters; sometimes using warm and sweet olive oil as injections,
sometimes anointing the whole body thoroughly therewith and rubbing it vigorously, especially
around the pubes, the abdomen, and the loins, bathing daily in sweet water which is not too hot,
lingering in the baths and drinking first a little wine and living on pungent food. If this is
without effect, one must also treat locally by having her sit in a bath of a decoction of linseed,
fenugreek, mallow, marsh mallow, and wormwood. She must also use poultices of the same substances
and have injections of old oil, alone or together with rue juice or maybe with honey, or of iris
oil, or of absinthium together with honey, or of panax balm or else of spelt together with rue
and honey, or of Syrian unguent. And if the situation remains the same she must no longer apply
the common poultices, but those made of meal of lupines together with ox bile and absinthium,
[and she must use] plasters of a similar kind. '
'65. For a woman who intends to have an abortion, it is necessary for two or
even three days beforehand to take protracted baths, little food and to use softening vaginal
suppositories; also to abstain from wine; then to be bled and a relatively great quantity taken
away. For the dictum of Hippocrates in the Aphorisms, even if not true in a case of constriction,
is yet true of a healthy woman: 'A pregnant woman if bled miscarries.' For just as sweat, urine
or faeces are excreted if the parts containing these substances slacken very much, so the foetus
falls out after the uterus dilates. Following the venesection one must shake her by means of
draught animals (for now the shaking is more effective on the parts which previously have been
relaxed) and one must use softening vaginal suppositories. But if a woman reacts unfavourably
to venesection and is languid, one must first relax the parts by means of hip-baths, full baths,
softening vaginal suppositories, by keeping her on water and limited food, and by means of
aperients and the application of a softening clyster; afterwards one must apply an abortive
vaginal suppository. Of the latter one should choose those which are not too pungent, that
they may not cause too great a sympathetic reaction and heat. And of the more gentle ones there
exist for instance: Of myrtle, wallflower seed, bitter lupines equal quantities, by means of
water, mould troches the size of a bean. Or: Of rue leaves 3 drachms, of myrtle 2 drachms and
the same of sweet bay, mix with wine in the same way, and give her a drink. Another vaginal
suppository which produces abortion with relatively little danger: Of wallflower, cardamom,
brimstone, absinthium, myrrh, equal quantities, mould with water. And she who intends to apply
these things should be bathed beforehand or made to relax by hip-baths; and if after some time
she brings forth nothing, she should again be relaxed by hip-baths and for the second time a
suppository should be applied. In addition, many different things have been mentioned by others;
one must, however, beware of things that are too powerful and of separating the embryo by means
of something sharp-edged, for danger arises that some of the adjacent parts be wounded. After
the abortion one must treat as for inflammation.'
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Bibliography
Contraception and Abortion from the Ancient World to the Renaissance John M. Riddle Harvard University Press Hardcover - 3 July, 1992
Eve's Herbs: A History of Contraception and Abortion in the West John M. Riddle
Related Links
Abortion
Ancient Gynaecology
Soranus and Galen
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