HEALTH---GREEK APPROACH TO WOMEN'S ILLNESS,
PREGNANCY AND CHILDBIRTH
It is tempting to credit the medicine we are taking when an illness is cleared up, forgetting that the condition might have gone away by itself regardless of what we did. This is undoubtedly the key to the popularity even today of so many “folk medicines” that researchers insist do nothing at all except make money for the manufacturers, and there were certainly many medical procedures in the ancient world that did very little good and some that did considerable harm.
We can put ancient world remedies on our ladder of scientific achievement, giggle at the silly things they tried, and take pride in the miracles we work today. Nevertheless, some very exciting things were happening in ancient Greece. We can track the movement away from the supernatural toward a desire to understand anatomy and the workings of the human body. Athenians took justifiable pride in their desire to draw conclusions based on empirical evidence rather than chance or supernatural intervention, but when it came to the medical condition of women their political and social philosophy often got in the way of anatomy.
The remainder of this web page expresses ideas about the health of women that can be found in the writings of the ancient Greeks. In most cases I have made no comment on whether the ideas are right or wrong. Consider the following four questions as you go through each section:
1. Does it appeal to an external, supernatural force?
2. Is it based on an attempt, however faulty, to understand anatomy.
3. Could it work?
4. How much is it influenced by women’s political and social position in society?
The time in a young woman’s life between puberty and loss of virginity was thought to be particularly dangerous. Early marriage was the only cure as sexual intercourse would open the entrance to the womb, allowing blood to flow out so it could not back up into the lungs and heart where it would cause licentiousness and dangerous hallucinations. The womb, as if it had a life of its own, was so anxious to become pregnant that it could wander around inside a woman’s body causing her all manner of ill health. Since sexual intercourse was the only cure, early marriage was thought to be essential to a girl’s health.
Hippocrates believed that a woman’s flesh was warmer and softer than that of a man, and that its sponge like character allowed it to absorb excess blood to the point of pain. Menstruation permits the surplus to dissipate. Giving birth stretches the blood vessels and allows it to flow more freely relieving the menstrual pain felt by some women who have never been pregnant. Since men have firmer flesh and work harder they do not need menstruation to allay pain.
Those women with a heavy menstrual flow lasting more than four days were thought to be delicate and to produce delicate embryos, while women with a light flow lasting fewer than three days were believed to be healthy and robust but masculine in appearance and uninterested in having children.
One test of a woman’s fertility involved burning incense under her cloak. If the scent passed through her mouth it meant her body was sufficiently hollow, receptive to sperm, and ready to conceive.
Almost everyone believed that the only proper behavior for the daughter of a citizen was to marry as soon after puberty as possible, get pregnant and raise children. Failure to conceive was thus a serious problem. Many sought help by appealing to a god or goddess: a particularly popular treatment involved sleeping in a dormitory in Epidaurus where the god Asclepius would induce dreams to heal the inner body. Others sought to find and repair some condition in the body that was preventing pregnancy. Having no knowledge of ovaries they assumed the problem must lie in the inability of the semen to reach the inside of the womb. Cures sought to soften and thus open the entrance to the uterus. While they may have come up with the wrong answer they were the first to attempt to solve the problem by looking at the inner workings of the body.
Although Aristotle believed that pregnancy resulted when semen and menstrual blood mixed in the womb, he downplayed the woman’s role to little but a secure environment in which the fetus could grow. Most other Greek writers believed in a more equal contribution by the father and mother, but they were unaware of the ovaries and therefore could speak only in philosophic terms.
Women who are too fat will have difficulty conceiving because the fat will block the entrance to the womb. Their only hope for pregnancy is to lose weight.
A pregnant woman with good color will deliver a male baby; if the mother's color is bad the child will be a girl.
There is very little direct evidence of contraception in Ancient Greece, but families did tend to be small. Daughters needed dowries and sons divided their father’s estate equally so there was an incentive to limit the number of children, but we do not know how this was accomplished. Abortion plus the exposure of unwanted babies may have been enough. The Hippocratic Oath included a vow not to give a pessary to cause an abortion, but Hippocratic writings include other prescriptions to accomplish the same end. A number of herbs were known at this time to prevent conception or abort an early stage fetus. The Pythagoreans were the only ones to openly oppose abortion on moral grounds.
When a woman is pregnant some of her blood enters the womb to surround and nourish the fetus. If her womb gapes open there will be some bleeding. This is a sign the woman needs special care to prevent a miscarriage. Aristotle wrote about women suffering from sickness in the early stages of pregnancy, which he said would be worse if the baby was a girl.
There were danger signs to watch for: diarrhea signaled potential trouble in a pregnant woman; if her breasts suddenly lose their fullness she will miscarry; if she is carrying twins and the right breast loses its fullness she will lose the male child, or if the left then the female. A woman's physical condition will affect her chances of delivering a healthy baby. If she is too thin or in poor physical shape she will have a good chance of miscarrying.
Heavy lifting, improper diet, a beating and jumping up and down can also cause a miscarriage. Doctors should not bleed a pregnant woman as this can produce a miscarriage, especially if the fetus is large. If the inside of the womb is too smooth a miscarriage may result simply because there is nothing to keep the baby from sliding out.
Unless there were serious complications babies were delivered by midwives, not physicians. Delivery was usually in a sitting position on a birthing stool. If the baby was overdue there were herbs available to induce delivery, although one doctor described how he had four women assistants violently shake his patient in order to speed up the delivery.
A FINAL NOTE
On the positive side, Hippocrates did urge physicians to ask more questions of their women patients. Women do not know very much about the kinds of disease they might have, he said, and they are often embarrassed to talk about it. The physician must recognize this and inquire diligently for he cannot treat an illness without a proper diagnosis.