Catholic Bioethics
A
NCIENT
MEDICAL ETHICS
 

  Hippocrates


1. HIPPOCRATIC TEXTS: 1.1. Precepts (Philanthropia/Philotechnia); 1.2. Epidemics (no harm)

2. ANCIENT MEDICAL PRACTICE: 2.1. Medical Instruments; 2.2 Observations

3. ARISTOTLE'S EMBRYOLOGY

4. ROMAN INFANTICIDE and ABORTION: 4.1. Letter on Exposure; 4.2. Soranus on Contraception and Abortion; 4.3. Obstetrical Infanticide

5. JEWISH RESPECT for LIFE: 5.1. Josephus; 5.2. Exodus 21; 5.3. Talmud on Obstetrical Emergencies


 1. Hippocratic Texts

 

 

1. HIPPOCRATIC TEXTS
 

 

 


 

1.1.  from THE PRECEPTS of HIPPOCRATES, 6

 

 Praeceptiones, ed. by É. Littré Oeuvres Completes d’Hippocrate, vol. 9
(Paris: Baillie 1861 repr. Amsterdam: Hakkert 1962), pp. 250-272. TLG canon 627.51. tr. L. Dysinger,
OSB

Ἢν δὲ καιρὸς εἴη χορηγίης ξένῳ τε ἐόντι καὶ ἀπορέοντι, μάλιστα ἐπαρκέειν τοῖσι τοιουτέοισιν· AND should an opportunity arise to serve someone who is a stranger and poor, render assistance to such [persons].

ἢν γὰρ παρῇ φιλανθρωπίη,

 πάρεστι καὶ φιλοτεχνίη.

For where there is love of humankind
           
(philanthropia),

        there is also love of  The Art
              (
philotechnia)

FOR some patients, although aware that their condition is dangerous, return to health through their contentment with the physician's kindness.

Ενιοι γὰρ νοσέοντες ᾐσθημένοι τὸ περὶ ἑωυτοὺς πάθος μὴ ἐὸν ἐν ἀσφαλείῃ, καὶ τῇ τοῦ ἰητροῦ ἐπιεικείῃ εὐδοκέοντες, μεταλλάσσονται ἐς ὑγιείην.̈

Articella, Oxford, 13th c. DeRicci NLM [78].) fol 32r


 

 

1.2from THE EPIDEMICS of HIPPOCRATES, 1.2.5

 

 De morbis popularibus († Epidemiae), ed. by É. Littré Oeuvres Completes d’Hippocrate, vol. 2
(Paris: Baillie 1840 repr. Amsterdam: Hakkert 1961). TLG canon 627.6.
tr. L. Dysinger, OSB

Λέγειν τὰ προγενόμενα·

  γιγνώσκειν τὰ παρεόντα·

     προλέγειν τὰ ἐσόμενα·

μελετᾷν ταῦτα·

DECLARE [the patient's] past

DIAGNOSE [know] the [patient's] present

PROGNOSE [foretell] the future

Meditate on [practice] these things.

ἀσκέειν, περὶ τὰ νουσήματα, δύο,

In regard to disease strive for two things:

ὠφελέειν,

μὴ βλάπτειν.

(1) To HELP;

(2) or at least to DO NO HARM.

Η τέχνη διὰ τριῶν,

τὸ νούσημα, ὁ νοσέων, καὶ ὁ ἰητρός·

The Art is threefold:

The patient, the disease, and the physician

 ὁ ἰητρὸς, ὑπηρέτης τῆς τέχνης·

ὑπεναντιοῦσθαι τῷ νουσήματι τὸν νοσεῦντα μετὰ τοῦ ἰητροῦ χρή.

The physician is the servant of the art,

and the patient must cooperate with the physician in battling the disease.

 


 

 

2. Ancient Surgery and Medicine

 

 

2. ANCIENT SURGERY and MEDICINE
 

 

 


ANCIENT MEDICINE

Hippocrates examines a youth
 as the god Asclepius looks on

2.1

IN 79 A.D. the eruption of Vesuvius buried the Roman cities  of Pompei and Herculaeneum.  Among the treasures excavated in Herculaneum were a small chest of ancient medical and surgical instruments that provide insight into the practice of ancient surgery and medicine. 

BEAR in mind that there was generally NO antisepsis and very little analgesia when these instruments were employed.

Instrument Case Scalpels Tenacula - artery hooks

Bone Drills Bone or obstetrical  forceps Urethral catheters and sounds

Speculum Papaver somniferum Poppy juice

 

 

THE pharmacopeia (medicine chest of drugs) in antiquity was restricted largely to:

1. opium-derivatives that dulled consciousness and induced sleep;

2. cathartics (drugs that induced diarrhea) and;

3. emetics (drugs that induce vomiting).

There were NO SPECIFIC MEDICINES that actually CURED ANY DISEASES, with the possible exception of bathing in sulphur-springs, that may sometimes have improved scabies (an insect skin-parasite).  As will be described, certain poisons taken internally or used as suppositories may have had the effect of decreasing fertility or inducing abortions - sometimes with fatal results.


 

 


2.2 OBSERVATIONS


[1] PATIENT AUTONOMY:

There existed no obligation to visit or obey physician; in fact, medical care in antiquity was expensive and beyond the reach of the majority.  It was the patient - not the physician - who determined whether treatment would be undertaken.

 

[2] TRUST and HOPE, DESPITE LACK of SPECIFIC MEDICAL REMEDIES and DANGERS of SURGICAL REMEDIES:

Despite the lack of real efficacy, patients were willing to submit to painful, sometimes brutal procedures, and to take bizarre, sometimes repulsive, medication.

 

[3] MOST PRIMARY-CARE CONDITIONS IMPROVE WITHOUT TREATMENT

Today around 70% of conditions that cause patients to consult primary-care physicians (internists and family physicians) will improve without treatment.  In antiquity the percentage was probably significantly lower, but the fact remains that unless the physician actually harms the patient, they will very often be credited with a cure for which they are not responsible.

 

[4] MEDICAL MYTHOLOGY - e.g. HERBAL PHARMACOLOGY:

Medications based on plant or mineral preparations that actually treat specific diseases are a phenomenon of the modern world, increasingly common only since the end of the eighteenth century.  However the conviction (in antiquity a myth) that plant-products or other preparations can cure has existed since the dawn of time.  Patients very often imagine there exists a cure for their treatment, and that whatever the physician offers holds the potential for restoring their health.  This makes informed consent for controlled drug studies very difficult, if not impossible, to obtain.

 


 

 

 3. Aristotle's Embryology

 

 

3. ARISTOTLE’S EMBRYOLOGY
 

 

 

Arisotle, The History of Animals, Bk 7, pt. 3
Historia animalium,  Aristote. Histoire des animaux, vol. 1 (Les Belles Lettres, Paris, 1964)

IN the case of male children the first movement usually occurs on the right-hand side of the womb and about the fortieth day, but if the child be a female then on the left-hand side and about the ninetieth day.

Ἐπὶ μὲν οὖν τῶν ἀρρένων ὡς ἐπὶ τὸ πολὺ ἐν τῷ δεξιῷ μᾶλλον  περὶ τὰς τετταράκοντα γίνεται ἡ κίνησις, τῶν δὲ θηλειῶν ἐν τῷ  ἀριστερῷ περὶ ἐνενήκονθ’ ἡμέρας.

 

 

However, we must by no means assume this to be an accurate statement of fact, for there are many exceptions, in which the movement is manifested on the right-hand side though a female child be coming, and on the left-hand side though the infant be a male. And in short, these and all suchlike phenomena are usually subject to differences that may be summed up as differences of degree.

Οὐ μὴν ἀλλ’ ἀκρίβειάν γε (5) τούτων οὐδεμίαν ὑποληπτέον· πολλαῖς γὰρ θηλυτοκούσαις ἡ κίνησις ἐν τῷ δεξιῷ γίνεται, καὶ ταῖς ἐν τῷ ἀριστερῷ ἄρρεν· ἀλλὰ καὶ ταῦτα καὶ τὰ τοιαῦτα πάντα διαφέρει ὡς ἐπὶ τὸ πολὺ τῷ μᾶλλον καὶ ἧττον.  

About this period the embryo begins to resolve into distinct parts, it having hitherto consisted of a fleshlike substance without distinction of parts.

Περὶ δὲ τοῦτον τὸν χρόνον καὶ σχίζεται  (9) τὸ κύημα· τὸν δ’ ἔμπροσθεν ἄναρθρον συνέστηκε κρεῶ δες. (10)

What is called effluxion is a destruction of the embryo within the first week, while abortion occurs up to the fortieth day; and the greater number of such embryos as perish do so within the space of these forty days.

Καλοῦνται δ’ ἐκρύσεις μὲν αἱ μέχρι τῶν ἑπτὰ ἡμερῶν δια- φθοραί, ἐκτρωσμοὶ δ’ αἱ μέχρι τῶν τετταράκοντα· καὶ  πλεῖστα διαφθείρεται τῶν κυημάτων ἐν ταύταις ταῖς ἡμέραις.  

In the case of a male embryo aborted at the fortieth day, if it be placed in cold water it holds together in a sort of membrane, but if it be placed in any other fluid it dissolves and disappears. If the membrane be pulled to bits the embryo is revealed, as big as one of the large kind of ants; and all the limbs are plain to see, including the penis, and the eyes also, which as in other animals are of great size.

Τὸ μὲν οὖν ἄρρεν ὅταν ἐξέλθῃ τετταρακοσταῖον, ἐὰν μὲν (14) εἰς ἄλλο τι ἀφῇ τις, διαχεῖταί τε καὶ ἀφανίζεται, ἐὰν (15) δ’ εἰς ψυχρὸν ὕδωρ, συνίσταται οἷον ἐν ὑμένι· τούτου δὲ δια- κνισθέντος φαίνεται τὸ ἔμβρυον τὸ μέγεθος ἡλίκον μύρμηξ  τῶν μεγάλων, τά τε μέλη δῆλα, τά τε ἄλλα πάντα καὶ τὸ αἰδοῖον, καὶ οἱ ὀφθαλμοὶ καθάπερ ἐπὶ τῶν ἄλλων ζῴων  μέγιστοι. (20)

But the female embryo, if it suffer abortion during the first three months, is as a rule found to be undifferentiated; if however it reach the fourth month it comes to be subdivided and quickly attains further differentiation.

Τὸ δὲ θῆλυ, ὅ τι μὲν ἂν διαφθαρῇ ἐντὸς τῶν τριῶν  (20) μηνῶν, ἀδιάρθρωτον ὡς ἐπὶ τὸ πολὺ φαίνεται· ὅ τι δ’ ἂν  ἐπιλάβῃ τοῦ τετάρτου μηνός, γίνεται ἐσχισμένον καὶ διὰ  ταχέων λαμβάνει τὴν ἄλλην διάρθρωσιν.

In short, while within the womb, the female infant accomplishes the whole development of its parts more slowly than the male, and more frequently than the man-child takes ten months to come to perfection. But after birth, the females pass more quickly than the males through youth and maturity and age; and this is especially true of those that bear many children, as indeed I have already said.

Τέως μὲν οὖν πᾶσαν τὴν τελείωσιν τῶν μορίων βραδύτερον ἀπολαμβάνει τὸ θῆλυ τοῦ ἄρρενος, καὶ δεκάμηνα γίνεται μᾶλλον τῶν ἀρρέ νων  (25) · ὅταν δὲ γένηται, θᾶττον τὰ θήλεα τῶν ἀρρένων καὶ νεότητα καὶ ἀκμὴν λαμβάνει καὶ γῆρας, καὶ μᾶλλον αἱ  πλείοσι χρώμεναι τόκοις, ὥσπερ εἴρηται πρότερον

 

 

 

 

ARISTOTLE on EUGENICS

Politics 7.14.10.1335b

 

 

 

 

   

AS to exposing or [20] rearing the children born, 

περὶ δὲ ἀποθέσεως καὶ [20] τροφῆς τῶν γιγνομένων

let there be a law that no deformed child shall be reared; ἔστω νόμος μηδὲν πεπηρωμένον τρέφειν,
but on the ground of number of children, if the regular customs hinder any of those born being exposed, διὰ δὲ πλῆθος τέκνων ἡ τάξις τῶν ἐθῶν κωλύῃ μηθὲν ἀποτίθεσθαι τῶν γιγνομένων:

there must be a limit fixed to the procreation of offspring,

ὁρισθῆναι δὲ δεῖ τῆς τεκνοποιίας τὸ πλῆθος,

and if any people have a child as a result of intercourse in contravention of these regulations,

ἐὰν δέ τισι γίγνηται παρὰ ταῦτα συνδυασθέντων,

abortion (amblosis) must be practised on it before it has developed sensation (aisthesis) and life (zoe);

πρὶν αἴσθησιν ἐγγενέσθαι καὶ ζωὴν [25] ἐμποιεῖσθαι δεῖ τὴν ἄμβλωσιν:

for the line between lawful and unlawful abortion will be marked by the fact of having sensation and being alive.

τὸ γὰρ ὅσιον καὶ τὸ μὴ διωρισμένον τῇ αἰσθήσει καὶ τῷ ζῆν ἔσται.

 

 

 

 


 

 

 4. Roman Infanticide and Abortion

 

 

4. INFANTICIDE, CONTRACEPTION,
and ABORTION in the ROMAN EMPIRE
 

 

 

 

 

  4.1. INFANTICIDE PERMITTED and WIDELY-PRACTICED

 

IT should be borne in mind that during the early Roman Empire free-born parents had the right to kill their newborn children for any reason. Exposure” meant abandonment of the infant, sometimes in a public place in the hope the child would be found and raised by someone else (although often as a slave or prostitute), but sometimes in a deserted location with the clear intention that the child should die.  Just how casually such infanticide was regarded is revealed in letter written by a soldier named Hilarion stationed in Alexandria. He congratulates his wife (whom he calls sister) on being pregnant and instructs her to raise the newborn if it is a boy, but to expose the child (literally throw it away) if it is a girl .

papyrus 744  on Exposure of Female Infant

 Ἱλαρίωνα Ἄλιτι τῆι ἀδελφῇ πλεῖστα χαί-

  ρειν καὶ Βεροῦτι τῇ κυρίᾳ μου καὶ Ἀπολλω -

  ναριν. γίνωσκε ὡς ἔτι καὶ νῦν ἐν Ἀλεξαν-

  δρέᾳ σμεν· μὴ ἀγωνιᾷς ἐὰν ὅλως εἰσ-

 5 πορεύονται, ἐγὼ ἐν Ἀλεξανδρέᾳ μενῶ.

  ἐρωτῶ σε καὶ παρακαλῶ σε ἐπιμελη-

  θι τῷ παιδίῳ καὶ ἐὰν εὐθὺς ὀψώνι-

  ον λάβωμεν ἀποστελῶ σε ἄνω. ἐὰν

  πολλὰ πολλῶν τέκῃς ἐὰν ἦν ἄρσε-

 10 νον ἄφες, ἐὰν ἦν θήλεα ἔκβαλε.

  εἴρηκας \δὲ/ Ἀφροδισιάτι ὅτι μή με

  ἐπιλάθῃς· πῶς δύναμαί σε ἐπι-

  λαθεῖν; ἐρωτῶ σε οὖν ἵνα μὴ ἀγω-

  νιάσῃς.

 15 (ἔτους) κθ Καίσαρος Παῦνι κγ.

Original text of Oxyrhynchus papyrus 744 G, with transcription.  Selections from the Greek papyri, ed. with tr. by G. Milligan  edited by George Milligan (Cambridge Univ. Pr. 1910), pp. 32-33.

HILARION to his wife [sister] Alis, hearty greetings, also to my lady Berous and Apollonarion. Know that I am still in Alexandria; and do not worry if I stay in Alexandria when all the others return. I ask and beg you to take [good] care of the child; and if I receive my pay soon I will send it on to you.

Above all, if you bear a child and it is male, let it be; but if it is female, expose it [ekbale lit.“throw it away”]. You have told Aphrodisias, “Do not forget me.” But how could I forget you? Thus I ask you not to worry.

The 29th year of Cæsar [Augustus], Pauni 23. [= 1 BC]

 

 

  4.2. MEDICAL CONTRACEPTION and ABORTION

 

 

THE famous and widely-respected medical author Soranus reflects the ambiguous Greco-Roman attitude in antiquity towards contraception and abortion.  While noting that there are some physicians who refuse to recommend either, he distinguishes between these two actions and states that he prefers contraception to abortion.  It is not clear whether this is primarily because of moral considerations, or because of the potential danger to the woman

 

 

 

 

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

Εἰ φθορίοις καὶ ἀτοκίοις χρηστέον καὶ πῶς

 

 

 

 

60. A contraceptive is different from an abortifacient,

Ἀτόκιον δὲ φθορίου διαφέρει͵

for while the former does not allow conception to occur,

τὸ μὲν γὰρ οὐκ ἐᾷ γενέσθαι σύλληψιν͵

the latter destroys (phtheirei) 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 abortive 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 abortive remedies and expulsive measures.]

 

But a controversy has arisen.

γεγένηται δὲ στάσις.

For one side rejects abortifacients, citing the testimony of Hippocrates who says: “I will not give an abortive 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. 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.

And they say the same about contraceptives as well; and we agree with them.

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

61. For if it is much more advantageous not to conceive than to destroy the embryo, πολὺ μᾶλλον συμφέρει τὸ μὴ συλλαβεῖν͵

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͵]

Soranus then describes a variety of physical activities, contraceptive devices, and medications that are believed to inhibit conception, noting that some have dangerous side-effects.  He then moves on to abortifacient methods and agents

 

 

 

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 engage in more vigorous 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 . . . 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͵

Various abortifacient activities and drugs are described

 

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.

Further abortifacient methods and drugs are listed

 

[. . .] 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.

4.3_Obstetrical_Infanticide

 

 

 

 

_4.3. OBSTETRICAL INFANTICIDE (craniotomy and embryotomy)

  Infant at Asklepian shrine

 

 

 

 

ONE of the most feared complications of pregnancy in antiquity was malpresentation, the situation in which the baby is not normally positioned with the head ready to emerge first.  Sometimes the buttocks, shoulder, side, or feet obstruct the birth canal, and normal delivery is difficult or impossible.  In classical antiquity if the infant could not be physically pushed (manual version) into the normal head-first or more dangerous buttocks-first (breech) position, the infant would not survive delivery. In the ancient world there existed no technology that would allow the mother to survive surgical (cæsarian) delivery of her infant, or for the child to survive forcible extraction with instruments. Until the advent of safe, antiseptic surgery in the nineteenth century, cæsarian section invariably killed the mother through bleeding or infection.  Obstetrical forceps that could (sometimes) deliver a child without seriously injuring either child or mother would not be invented or widely-used until the early eighteenth century.

THUS in the ancient world, in situations where normal delivery was impossible, parents and midwives faced the agonizing choice of either waiting for the death of mother or child (or both), or of surgically intervening in a way that would certainly destroy the life of one or the other.

 


4.3.1 ROMAN OBSTETRICAL INSTRUMENTS



 

 

4.3.2. OBSTETRICAL CRANIOTOMY
in the
HIPPOCRATIC CORPUS
On the Diseases of Women, Bk. 1, 70.5

ΓΥΝΑΙΚΕΙΩΝ ΠΡΩΤΟΝ

 

 

The terrible procedure for extracting a dead infant piecemeal during delivery is described in the Hippocratic treatise On the Diseases of Women, of uncertain date, (? ca 400 BC.)  It contains the first reference to a cranioclast, an instrument used to crush the head of the infant.

De mulierum affectibus  i-iii
Oeuvres complètes d'Hippocrate,
v. 8 pub Baillière, Paris,1853

70.5 Opening the head with a scalpel, break it up with the cranioclast in such a way as not to splinter it into fragments, and remove the bones with a bone forceps. Σχίσαντα τὴν κεφαλὴν μαχαιρίῳ ξυμπλάσαι ἵνα μὴ θραύσῃ τῷ πιέστρῳ καὶ τὰ ὀστέα ἕλκειν τῷ ὀστεουλκῷ.
   
   
   

 

 

4.3.3. SORANUS on EMBRYOTOMY

 

 

 

In his book on Gynecology Soranus describes embryotomy of an infant who is not dead, but cannot be delivered

 
III.[XIX] On Extraction by Hooks and Embryotomy Περὶ ἐμβρυουλκίας καὶ ἐμβρυοτομίας.
9.[61].  If the fetus does not respond to manual traction, because of its size, or death, or impaction in any manner whatsoever, Εἰ δὲ μὴ ἐπακούοι πρὸς τὴν διὰ τῶν χειρῶν ἐφολκὴν διὰ μέγεθος ἢ νέκρωσιν ἢ καθ΄ οἱονδηποτοῦν τρόπον σφήνωσιν͵
one must proceed to the most forceful methods, those of extraction by hooks and embryotomy.  ἐπὶ τοὺς εὐτονωτέρους τρόπους δεῖ μετελθεῖν͵ τὸν τῆς ἐμβρυουλκίας καὶ τῆς ἐμβρυοτομίας·
For even if one loses the infant, it is still necessary to take care of the mother. καὶ γὰρ εἰ τὸ κυηθὲν διαφθείρει͵ τὴν κυοφοροῦσαν τηρεῖν ἀναγκαῖον.

Soranus, Gynaeciorum, libri iv, 4.9.t.1 

 

 


 

 

5. Jewish Respect for Life

 

 

5. JEWISH RESPECT for LIFE
 

 

 

 

 

5.1. DIRECT, INTENTIONAL ABORTION FORBIDDEN
[JOSEPHUS (37-c.100)]

 

 

The Works of Flavius Josephus, "Against Apion". Translated by. William Whiston, A.M. Auburn and Buffalo. John E. Beardsley. 1895.Cambridge:  Harvard University Press. pp. II.25, p. 597.  Greek: . Flavii Iosephi opera. B. Niese. Berlin. Weidmann. 1892.


[202] [The law requires] us to bring up all our offspring,

[202] τέκνα τρέφειν ἅπαντα προσέταξεν,

and forbids women to cause abortion of what is begotten, or to destroy it afterward; καὶ γυναιξὶν ἀπεῖπεν μήτ᾽ ἀμβλοῦν τὸ σπαρὲν μήτε διαφθείρειν
and if any woman appears to have so done, she will be a murderer of her child, ἀλλὰ ἢν φανείη τεκνοκτόνος ἂν εἴη
by destroying a living creature, and diminishing the [human] race. ψυχὴν ἀφανίζουσα καὶ τὸ γένος ἐλαττοῦσα.

 


 

 

5.2. BUT EARLY ABORTION NOT CONSIDERED HOMICIDE in JUDAISM

 

 

 

 

EXODUS 21:

SEPTUAGINT VERSION

22 And if two men fight and strike a woman who is with child,

ἐὰν δὲ μάχωνται δύο ἄνδρες καὶ πατάξωσιν γυναῖκα ἐν γαστρὶ ἔχουσαν͵

and her child be born imperfectly formed,
      [Heb: she miscarries but suffers no further injury]

καὶ ἐξέλθῃ τὸ παιδίον αὐτῆς μὴ ἐξεικονισμένον͵

he shall be forced to pay a penalty: whatever the woman's husband may impose upon him, he shall pay with a valuation.

ἐπιζήμιον ζημιωθήσεται· καθότι ἂν ἐπιβάλῃ ὁ ἀνὴρ τῆς γυ ναικός͵ δώσει μετὰ ἀξιώματος·

23 But if it be perfectly formed,

23 ἐὰν δὲ ἐξεικονισμένον ἦν͵

     [Heb: But where injury ensues [i.e. to the woman],  
     he shall give life for life, δώσει ψυχὴν ἀντὶ ψυχῆς͵

24 eye for eye, tooth for tooth, hand for hand, foot for foot,

24 ὀφθαλμὸν ἀντὶ ὀφθαλμοῦ͵ ὀδόντα ἀντὶ ὀδόν τος͵ χεῖρα ἀντὶ χειρός͵ πόδα ἀντὶ ποδός͵

25 burning for burning, wound for wound, stripe for stripe.

25 κατάκαυμα ἀντὶ κατα καύματος͵ τραῦμα ἀντὶ τραύματος͵ μώλωπα ἀντὶ μώλωπος.

 

 

The following discussion of this passage is offered by Prof. D. DeMarco
 
The Roman Catholic Church and Abortion: An Historical Perspective - Part I [http://www.catholicculture.org/docs/doc_view.cfm?recnum=3361 ];

[...] an incorrect translation (intended or unintended) in the Septuagint version gives a totally different meaning to this Mosaic Law. The word zurah or surah, which means form, is erroneously used for the word ason, which means harm. Thus, the Septuagint version conveys the meaning of the fetus “not being further formed” [mē exeikonismenon] rather than the woman “not being further harmed.”  The penalty, therefore, was now understood to be a fine if the fetus was not formed, but death if the fetus was formed [exeikonismenon] . Thus, through a mistranslation by Hebrew scholars who were conversant with Greek thought, the distinction between the “formed” and “unformed” or “pre-formed” fetus was given moral significance and Biblical authority.


 

5.3. OBSTETRICAL INFANTICIDE PERMITTED in JUDAISM

 

 

 In the Jewish Talmud the life of the mother takes precedence over the life of the infant, unless the newborn's head has been delivered.


IF a woman suffers hard labor in childbirth, the child must be cut up in her womb and brought out piecemeal, for her life takes precedence over its life. If its greater part has already come forth [i.e. if the infant's head has already been delivered], it must not be touched, for the [claim of one] life cannot supersede [that of another] life.

Mishna, Ohalot 7:6.

 


This Webpage was created for a workshop held at Saint Andrew's Abbey, Valyermo, California in 2002....x....  ’ “.