Whether Abortifacients and Contraceptives may be used - and how [to use them].

Εἰ φθορίοις καὶ ἀτοκίοις χρηστέον καὶ πῶς

60. A contraceptive is different from an abortive,

Ἀτόκιον δὲ φθορίου διαφέρει͵

for while the former does not allow conception to happen,

τὸ μὲν γὰρ οὐκ ἐᾷ γενέσθαι σύλληψιν͵

the latter destroys (phtherei) what has been conceived.

τὸ δὲ φθείρει τὸ συλληφθέν·

We shall thus call the one “abortifacient” (phthorion) and the other “contraceptive” (atokion).

εἴπωμεν οὖν ἄλλο φθόριον καὶ ἄλλο ἀτόκιον.

And while some say an “expulsive” (ekbolion) is synonymous with an abortifacient, others [claim] there is a difference; since [employing] an expulsive does not mean drugs but rather shaking and leaping, . . .

τὸ δὲ ἐκβόλιον οἱ μὲν συνωνυμεῖν τῷ φθορίῳ λέγουσιν͵ οἱ δὲ διαφέρειν τῷ μὴ ἐν φαρμάκοις νοεῖσθαι͵ κατασεισμοῖς δὲ καὶ πηδήμασιν͵

And for this reason they say Hippocrates, while forbidding abortifacients, nevertheless in his book On the Nature of the Child permits [the practice of] leaping with the heels to the buttocks for the sake of expulsion.

εἰ τύχοι·διὸ καὶ τὸν Ἱπποκράτην παραιτησάμενον τὰ φθόρια παραλαβεῖν ἐν τῷ Περὶ παιδίου φύσεως ἐκβολῆς ² χάριν τὸ πρὸς πυγὰς πηδᾶν.

[In the Hippocratic Oath the physician swears not to give a woman “an abortifacient suppository.” However, the Hippocratic text On the Nature of the Child, advises a girl, thought to be in the sixth day of pregnancy, to expel the “seed” by leaping so that the heels touch the buttocks (the so-called Lacedaemonian leap). “After the seventh leap the seed fell down with a noise” (ed. Littrē, vol. 7, p. 490). Some commentators attempted to reconcile the contradictory views of these two Hippocratic texts by distinguishing between abortifacient remedies and expulsive measures.]

But a controversy has arisen.

γεγένηται δὲ στάσις.

For one side banishes abortifacients, citing the testimony of Hippocrates who says: “I will not give an abortifacient to anyone”;

οἱ μὲν γὰρ ἐκβάλλουσιν τὰ φθόρια τὴν Ἱπποκράτους προσκαλούμενοι μαρτυρίαν λέγοντος· οὐ δώσω δὲ οὐδενὶ φθόριον͵

For the purpose of medicine is to care for [terein] and preserve [sozo] what has been engendered by nature.

καὶ ὅτι τῆς ἰατρικῆς ἐστιν ³ ἴδιον τὸ τηρεῖν καὶ σῴζειν τὰ γεννώμενα ὑπὸ τῆς φύσεως.

While the other side prescribes abortifacients, but with limitations,

οἱ δὲ μετὰ διορισμοῦ συντάσσουσιν αὐτά͵

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 knobby swellings and fissures, or if some similar difficulty is involved. And they say the same about contraceptives as well, and we too agree with them.

τοῦτ΄ ἔστιν οὐχ ὅτε διὰ μοιχείαν τις βούλεται φθεῖραι τὸ συλληφθὲν οὔτε δι΄ ἐπιτήδευσιν ὡραιότητος͵ ἀλλ΄ ὅτε διὰ τὸ κίνδυνον κωλῦσαι γενησόμενον ἐν ταῖς ἀποτέξεσιν͵ μικρᾶς τῆς μήτρας ὑπαρχούσης καὶ μὴ δυναμένης χωρῆσαι τὴν τελεί ωσιν͵ ἢ κατὰ τοῦ στομίου κονδυλώματα καὶ ῥαγάδας ἐχούσης͵ ἤ τινος ⁴ ἐμφεροῦς περιστάσεως ἐγκειμένης. τὰ δὲ αὐτὰ λέγουσιν καὶ περὶ ἀτοκίων͵ οἷς καὶ ἡμεῖς συναινοῦμεν.

ON CONTRACEPTION

And since it is safer to prevent conception from taking place than to destroy the fetus, we shall now first discourse upon such prevention.

 ὅθεν ἐπεὶ τοῦ φθεῖραι τὸ κωλῦσαι εἰ γὰρ τοῦ [μὴ] φθείρειν τὸ συλληφθὲν πολὺ μᾶλλον συμφέρει τὸ μὴ συλλαβεῖν͵

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.

[ἀναγκαῖον] δεῖ τοίνυν οὓς εἰρήκαμεν ἐπιτηδείους εἶναι καιροὺς πρὸς σύλληψιν φυλάττεσθαι [χρὴ] πρὸς συνουσιασμόν͵ [οἷον ἀρχομένων ἢ ληγόντων τῶν καταμηνίων͵]

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.

καὶ ἐν τοῖς πλησια σμοῖς ἐν τῷ καιρῷ τῆς συνουσίας͵ ὅταν ὁ ἀνὴρ ἀποκρίνειν τὸ σπέρμα μέλλῃ͵ κατέχειν χρὴ τὸ πνεῦμα καὶ μικρὸν ὑφέλκειν ἑαυτήν͵ ὡς μὴ πορρωτέρω ἐν τῷ κύτει τῆς μήτρας τὸ σπέρμα ἀκοντισθῆναι͵ καὶ διαναστᾶσαν εὐθέως καὶ ὀκλὰξ καθίσασαν πταρμὸν κινεῖν καὶ περιμά ² ξασθαι τὸν κόλπον ἐπιμελῶς ἢ καὶ ψυχρὸν πίνειν.

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.

συνεργεῖ δὲ τῇ ἀσυλληψίᾳ καὶ τὸ διαχρίειν τὸ στόμα τῆς ὑστέρας ἐλαίῳ παλαιῷ ἢ μέλιτι ἢ κεδρίᾳ ἢ ὀποβαλσάμῳ κατ΄ ἰδίαν ἢ καὶ μετὰ ψιμυθίου ἢ κηρωτῇ ὑγρᾷ διὰ μυρσίνου καὶ ψιμυθίου ἢ στυπτηρίᾳ ὑγρᾷ πρὸ τοῦ πλησιάζειν ἢ χαλβάνῃ μετ΄ οἴνου͵ ἢ ἐρίου τρυφεροῦ μαλλὸν ἐντιθέναι εἰς τὸ στόμα τῆς μήτρας͵ ἢ πρὸ τῶν συνουσιῶν πεσσοῖς χρῆσθαι στέλλειν ³ τε καὶ πυκνοῦν δυναμένοις. τὰ γὰρ τοιαῦτα͵

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.

εἰ μὲν στυπτικὰ εἴη καὶ ἐμπλαστικὰ καὶ ψυκτικά͵ μύειν παρασκευάζει τὸ στόμα τῆς μήτρας πρὸ τοῦ καιροῦ τῆς συνουσίας καὶ οὐκ ἐᾷ παρελθεῖν εἰς τὸν πυθμένα αὐτῆς τὸ σπέρμα· τὰ δὲ θερμὰ καὶ ἐρεθίζοντα οὐ μόνον τὸ τοῦ ἀνδρὸς σπέρμα ἐναπομεῖναι [καὶ] ἐν τῷ κύτει τῆς μήτρας οὐ συγχω ροῦσιν [ἐλθεῖν]͵ ἀλλὰ καὶ ἑτέραν ὑγρότητα ἐξ αὐτῆς ἕλκουσιν.

62. And we shall make specific mention of some.

μνημονεύσομεν δὲ ἐνίων καὶ κατ΄ εἶδος.

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.

πίτυος φλοιόν͵ ῥοῦν βυρσοδεψικόν͵ ἑκάστου ἴσον͵ τρῖβε μετὰ οἴνου καὶ προστίθει μετρίως πρὸ τῆς συνουσίας περιειληθέντος ἐρίου͵ καὶ μετὰ ὥρας δύο ἢ τρεῖς ἀφαιροῦσα συνουσιαζέτω.

Another : Of Cimolian  earth, root of panax, equal quantities, rub with water separately and together, and when sticky apply in like manner.

 ἄλλο· γῆς Κιμωλίας͵ πάνακος ῥίζης ἀνὰ ἴσον͵ κατ΄ ἰδίαν καὶ ὁμοῦ μεθ΄ ὕδατος τρῖβε καὶ γλοιῶδες γενόμενον ὡσαύ ² τως προστίθει.

Or : Grind the inside of fresh pomegranate peel with water, and apply.

 ἢ σιδίων νεαρῶν τὸ ἐντὸς λεάνας μεθ΄ ὕδατος προστί θει.

Or: Grind two parts of pomegranate peel and one part of oak galls, form small suppositories and insert after the cessation of menstruation.

 ἢ σιδίων μέρη δύο͵ κηκίδων μέρος ἓν λειώσας ἀνάπλασσε βαλάνια μικρὰ καὶ ὑποτίθει μετὰ τὴν λῆξιν τῶν καταμηνίων.

Or: Moist alum, the inside of pomegranate rind, mix with water, and apply with wool.

 ἢ στυπτηρίαν ὑγράν͵ ῥόας κελύφους τὸ ἐντὸς διιέναι μεθ΄ ὕδατος͵ καὶ δι΄ ἐρίου προσ ³ τίθει.

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.

 ἢ κηκίδος ὀμφακίνης͵ σιδίων τοῦ ἐντός͵ ζιγγιβέρεως ἀνὰ ¹⁰¹ β ἀνάπλασσε μετ΄ οἴνου ὀρόβων μεγέθει καὶ ξήραινε ἐν σκιᾷ καὶ πρὸ τῆς συνουσίας δίδου προστίθεσθαι ἐν πεσσῷ.

Or: Grind the flesh of dried figs and apply together with natron.

 ἢ ἰσχάδων σάρκας λειώσας μετὰ νίτρου προστίθει.

Or: Apply pomegranate peel with an equal amount of gum and an equal amount of oil of roses.

 ἢ σίδια μετὰ κόμμεως ἴσου καὶ ῥοδίνου ἴσου ⁴ προστίθει.

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.

 εἶτα μελίκρατον ἐπιρροφεῖν ὁμοίως͵ φυλάττεσθαι δὲ τὰ ἐπὶ  πολὺ δριμέα διὰ τὰς ἀπ΄ αὐτῶν ἑλκώσεις.

And we use all these things after the end of menstruation.

ἅπασιν δὲ χρώμεθα μετὰ τὴν ἀπόληξιν τῶν καταμηνίων.

63. Moreover to some people it seems advisable:

ἐνίοις δὲ ἔτι δοκεῖ

However, these things not only prevent conception, but also destroy any already existing. In our opinion, moreover, the evil from these things is too great, since they damage and upset the stomach, and besides cause congestion of the head and induce sympathetic reactions.

ταῦτα δὲ οὐ μόνον κωλυτικὰ συλλήψεως ὑπάρχει͵ ἀλλὰ καὶ φθαρτικὰ τῆς ἤδη συνεστώσης. καθ΄ ἡμᾶς δὲ πλείων ἐστὶν ἡ ἀπὸ τούτων κάκωσις φθειρόντων μὲν καὶ ἀνατρεπόντων τὸν στόμα ³ χον͵ πληρούντων δὲ τὴν κεφαλὴν καὶ συμπάθειαν ἐπιφερόντων.

Others, however, have even made use of amulets which on grounds of antipathy they believe to have great effect; such are uteri of mules and the dirt in their ears and more things of this kind which according to the outcome reveal themselves as falsehoods.

οἱ δὲ καὶ περιάπτοις ἐχρήσαντο πολλὰ τῷ τῆς ἀντιπαθείας λόγῳ ποιεῖν νομίζοντες͵ ἐν οἷς μήτρας ἡμιόνων καὶ τὸν ἐν τοῖς ὠσὶ ῥύπον αὐτῶν καὶ ἄλλα πλείονα τούτων͵ ἅπερ ἐπὶ τῶν ἀποτελεσμάτων φαίνονται ψευδῆ.

ON ABORTION

64. Yet if conception has taken place, one must first, for 30 days, do the opposite of what we said earlier. But in order that the embryo be separated, the woman should have <more violent exercise, walking about energetically and being shaken by means of [traveling in a carriage pulled by] 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 clusters; 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.

γενομένης δὲ τῆς συλλήψεως τὸ μὲν πρῶτον ἕως τριάκοντα ἡμερῶν τὰ ἐναντία ποιεῖν οἷς ἔμπροσθεν εἰρήκαμεν͵ εἰς δὲ τὸ διαλυ θῆναι τὸ συλληφθὲν σφοδρότερον κινεῖσθαι περιπατοῦσαν εὐτόνως καὶ διὰ ζευκτῶν κατασειομένην͵ εὐτόνως  καὶ πηδᾶν καὶ βαστάζειν τὰ ὑπὲρ δύναμιν βάρη͵ ἀφεψήμασι δὲ διουρητικοῖς χρῆσθαι τοῖς δυναμέ νοις καὶ καταμήνια κινεῖν͵ καὶ τὴν γαστέρα λαπάττειν καὶ κλύζειν δριμυτέροις κλύσμασι͵ θερμῷ τε ἐλαίῳ καὶ γλυκεῖ ποτὲ μὲν ἐγχυματι ζομένην͵ ποτὲ δὲ συναλειφομένην ὅλην καὶ τριβομένην εὐτόνως καὶ μάλιστα περὶ τὸ ἐφήβαιον καὶ τὸ ἐπιγάστριον καὶ τὴν ὀσφὺν καὶ λουομένην καθ΄ ἡμέραν ἐν τῷ μὴ λίαν ζεστῷ ὕδατι γλυκεῖ καὶ τοῖς λουτροῖς ἐγχρονίζουσαν καὶ προπίνουσαν οἰνάριον καὶ δριμυφαγοῦσαν. ² εἰ δὲ μή͵ καὶ τοπικῶς ἐγκαθίζουσαν εἰς ἀφέψημα λινοσπέρμου͵ τήλεως͵ μαλάχης͵ ἀλθαίας͵ ἀρτεμισίας καὶ καταπλασσομένην τοῖς αὐτοῖς͵ ἐγχυμα τιζομένην δὲ τῷ παλαιῷ ἐλαίῳ κατ΄ ἰδίαν ἢ καὶ μετὰ πηγάνου χυλοῦ͵ ποτὲ δὲ καὶ μέλιτος͵ ἢ ἰρίνῳ ἢ ἀψινθίῳ σὺν μέλιτι ἢ ὀποπάνακι ἢ ³ ἄλλως χόνδρῳ μετὰ πηγάνου καὶ μέλιτος ἢ μύρῳ Συριακῷ. κἂν ἐπι μένῃ͵ καταπλασσομένην μηκέτι τοῖς κοινοῖς καταπλάσμασιν͵ ἀλλὰ τοῖς διὰ θερμίνου ἀλεύρου μετὰ χολῆς ταυρείας καὶ ἀψινθίου͵ καὶ τοῖς ὁμοιογενέσιν τῶν ἐπιθεμάτων χρωμένην.

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 removed.

τὴν δὲ μέλλουσαν φθείρειν χρὴ πρὸ δύο ἢ καὶ τριῶν ἡμερῶν λουτροῖς συνεχέσι χρῆσθαι καὶ ὀλιγοτροφίᾳ καὶ πεσσοῖς μαλακτικοῖς͵ ² καὶ οἴνου ἀπέχεσθαι͵ εἶτα φλεβοτομεῖν καὶ πλεῖον ἀφαιρεῖν.

For the dictum of Hippocrates in the Aphorisms, even if not true in a case of constriction, is not true of a healthy woman: “A pregnant woman if bled, miscarries.”

τὸ γὰρ ὑπὸ Ἱπποκράτους εἰρημένον ἐν τοῖς Ἀφορισμοῖς εἰ καὶ μὴ ἐπὶ στεγνοπαθούσης͵ ἀλλὰ [καὶ] ἐπὶ ὑγιαινούσης ἀληθές· γυνὴ ἐν γαστρὶ ἔχουσα φλεβοτομηθεῖσα ἐκτιτρώσκει.

[Hippocrates, “Aphorisms” V, 31: “A pregnant woman, if bled, miscarries; the larger the embryo the greater the risk.”]

 For just as sweat, urine or faeces are excreted if the parts containing these substances slacken very much, so the fetus falls out after the uterus dilates. Following the venesect ion 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 unfavorably to venesection and is languid, one must first relax the parts by means of sitz 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 abortifacient 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 sitz baths; and if after some time she brings forth nothing, she should again be relaxed by sitz baths and for the second time a suppository should be applied.

ὡς γὰρ ἱδρὼς κινεῖται καὶ οὖρον ἢ σκύβαλον ὑπερχαλωμένων τῶν περιεχόντων τὴν οὐσίαν  αὐτῶν͵ οὕτως ³ καὶ τὸ συλληφθὲν ἐκπίπτει προδιισταμένης τῆς μήτρας. μετὰ δὲ τὴν φλεβοτομίαν καὶ ζευκτῷ κατασειστέον (ἐνεργέστερος γὰρ νῦν ὁ βρασμὸς ἐπὶ προητονηκόσιν τοῖς τόποις) καὶ πεσσοῖς δὲ μαλακτικοῖς χρηστέον. ⁴ εἰ δὲ πρὸς τὴν φλεβοτομίαν ἀλλοτρίως ἔχοι τις καὶ ἄτονος εἴη͵ προανιέναι μὲν τοὺς τόπους ἐγκαθίσμασι καὶ λουτροῖς καὶ πεσσοῖς μαλακτικοῖς καὶ ὑδροποσίᾳ καὶ ὀλιγοσιτίᾳ καὶ κοιλιολυσίᾳ καὶ κλύσμα τι ⁵ προστίθεσθαι μαλακτικόν͵ μετὰ ταῦτα πεσσὸν φθόριον. αἱρεῖσθαι δὲ τούτων τοὺς μὴ ἄγαν δριμεῖς͵ ἵνα μὴ πλείονα συμπάθειαν καὶ θερμα σίαν ἐπάγωσιν. ἐκ δὲ τῶν πραϋτέρων οἱ τοιοῦτοι καθεστᾶσιν οἷον· μυρσίνης͵ λευκοΐου σπέρματος͵ θέρμων πικρῶν ἐξ ἴσου μετὰ ὕδατος ἀναπλάττειν τροχοὺς ὡς κυάμου μέγεθος. ἢ φύλλων πηγάνου γ͵ μυρσίνης β͵ δάφνης ἴσας ὁμοίως διιέναι μετ΄ οἴνου͵ καὶ πότιζε. ⁶ ἄλλος πεσσὸς ἀκινδυνότερον ἐκβάλλων· λευκοΐου͵ καρδαμώμου͵ θείου͵ ἀψινθίου͵ σμύρνης͵ ἑκάστου ἴσον͵ δι΄ ὕδατος ἀνάπλασσε. προλελούσθω δὲ ἡ μέλλουσα προστίθεσθαι ἢ ἐγκαθίσμασιν προανιέσθω͵ κἂν μέχρι πλείονος μηδὲν ποιῇ͵ πάλιν ἐγκαθίσμασι προανεθεῖσα δεύτερον προστι ⁷ θέσθω.

And much has been said [on this subject] by others;

πολλὰ δὲ καὶ ἄλλα παρ΄ ἄλλοις εἴρηται͵

however one must, be on guard concerning

φυλάσσεσθαι δὲ δεῖ

[treatments] that are too powerful

τὰ λίαν πληκτικὰ

and of detaching the embryo with some sharp instrument,

καὶ τὸ καταλύειν τὸ ἔμβρυον διά τινος ἐπάκμου͵

for there is danger that the surrounding tissues may be injured.

⁸ κίνδυνος γὰρ τρωθῆναί τι τῶν παρακειμένων.

After the abortion one must treat as for inflammation.

μετὰ δὲ τὴν φθορὰν ὡς φλεγμονὴν θεραπευτέον.