This will be my final post discussing the history of herbal abortion. We have already established that provoking the terms or courses was a term used for addressing amenorrhea caused by poor diet, infirmity, or weakness in a previous post. I will remind you here of Lazare Rivière’s definition of the stopped terms as translated by English physician Abdiah Cole in 1655.

“THe Terms are said to be stopped, when in a Woman ripe of Age, which gives not suck, and is not with Child, there is a seldom, smal, or no evacuation of blood by the Womb, which used to be everyz
month. The cause of this stoppage is either in the Womb, or in its Vessels, or in the blood whichz comes, or ought to come that way.”[1]

Edited to clarify because people asked, this means someone who is not breastfeeding or pregnant is not having their menstrual cycle regularly.  

There is an article circulating the Interwebz about Ben Franklin’s abortion remedy that is clearly speaking about a formula for amenorrhea.  I noticed that I was not the only person to bring that up in the comments and I am thankful that other scholars are speaking up about this.  We need to stop writing about or speaking of this phrase “stopped terms” as some secret code for pregnancy.

It really isn’t.  I find it infuriating that a man who seems utterly ignorant of the anatomy of people who menstruate, and the many reasons menstrual flow might stop, has shaped this narrative for so many decades. 

What this post will focus on is the reality of abortion during the early modern era. I chose to start with Culpeper’s thoughts since the first medical texts widely published in the colonies were Culpeper’s works.

Culpeper defined abortion as “the exclusion of a child, not perfect nor living, before legitimate time. This time is defined by Hippocrates.”  He went on to say that the primary cause of abortion was the “the expulsive faculty stirred up.” He named a handful of herbs that would cause abortions. I am not going to mention them here for the safety concerns that I discuss below.

He defined another medical condition that can be roughly compared to dysmenorrhea saying “diaeresis is from much blood, when there is great motion, as when there is long copulation with a strong man that hath a great tool, or a hard travel, or abortion, a fall or stroke; also when sharp humors corrode, or sharp pessaries.”

So here we see that  sharp pessaries as defined by Hippocrates were still in use during Culpeper’s time – most likely by midwives brokering abortions but that’s some conjecture on my part based on a comment he makes in the London Dispensatory in which he stated that the long birthwort (Aristolochia longa) “being drunk in wine, brings away both birth and afterbirth, and whatsoever a careless Midwife have left behind.”

Like the ancients, Culpeper felt herbs that were strong purgatives were likely to cause an abortion writing, 

“You must not give strong Purges, least their force which moveth the humors, should reach to the womb, and cast out the child. Therefore you must not purge women with child in all diseases, nor at all times, but only in the fourth month til the seventh, and that sparingly.

He urged caution in bloodletting but said that it could be used sparingly because early modern physicians did not let blood in the volume that Greek physicians did.

This goes back to what I spoke about in the physiology post. Purgatives, emetics, and other measures that reduce blood volume increase oxytocin concentration in the blood. They also cause spasmodic peristalsis in the GI tract triggered by prostaglandins that contract the smooth muscle in the intestines. Those prostaglandins can in turn get into your bloodstream and may trigger contractions in your uterus. How sensitive a uterus is to these prostaglandins depends on how far along the pregnancy is.

It is very important to mention that they cause these spasms because they are somewhat toxic, especially when given in large doses, and this is the body’s natural mechanism of protecting the body from toxicity.  They were given in amounts that often resulted in the death of the mother as you will read about below.

French physician Lazare Rivière explained the physiology behind using purgatives and it wasn’t entirely wrong, even if they didn’t understand the mechanism.

The continual straining at stool doth much disturb the Womb, which is so neer to the straight Gut. Besides, the same Muscles which serve to throw out the Excrements, are imployed for delivery; therefore when they daily compress the lower Belly, they cause Abortion.[2]

I want to briefly touch on whether causing an abortion was an acceptable practice in Culpeper’s time.  It was Pope Sixtus V who first declared abortion to be a homicide, with dubious results.  This was a debate that was still raging during Culpeper’s time but at least for his part he made his feelings quite clear:

Question 5. Whether is it lawful to cause an Abortion to preserve the Mother?

A Christian may not cause an abortion for any cause, for it
is wicked and the Gentiles in Hippocrates his time never allowed it, they would
not hinder Conception, much less would they destroy it when made. Nor must the
mother be preserved by the loss of the child, For we must not do evil, that
good may come thereby.

But if to preserve the mother, the Physitian purge or bleed,
and the abortion follow, the fault is not the Physitian that intended it not,
but in the weakness of Nature and of the child, and is better to preserve the
mother, then by neglecting the lawful means, let both die.[3]

Here’s a contradiction in which Culpeper says that abortion should not be performed to protect the life of the mother, but if a physician chooses to purge or bleed a person to save their life then they should not be held responsible for the subsequent abortion.  This speaks to the fact that the conflict of beliefs Soranus mentioned centuries earlier was still playing out in Early Modern Europe.

Reading through other early modern works, we even see little glimpses of the same kind of controversies we do today.  Italian physician Gabriele Falloppio famous for the discovery of the fallopian tubes dubiously assured readers,

“If Quick-silver [Mercury preparation] be drunk down, it doth not so much as when it is used with an Oyntment; I have seen Women to cause Abortion take a pound thereof without hurt. I give it to Children for the Worms, and it doth bring no symptome, but only kill the Worms.”

This speaks to the idea that people were unsuccessfully mucking around with trying to provoke abortions for centuries as well as the idea that the delivery mechanism is important.   

This is the crux of the problem, I believe.  Some modern herbal clinicians have an extremely poor understanding of how botanical medicines were prepared and administered in the past. Early modern physicians were still recommending that the cervix be dilated, and the uterus be flushed with medicinal preparations.  Ointments and suppositories were applied directly into the cervical canal.  In other words, their delivery of herbs was very much mechanical and much less “drink this tea” than you are being told in some of these silly memes floating around.

This is not to say abortions were not being performed by midwives. As you saw
in my previous post, this practice was something that physicians were speaking
out against centuries before Culpeper practiced. Herbal preparations were
undoubtedly part of their process, but the process also involved mechanical
methods such as manual dilation and pessaries, as it had for centuries. 

This continues to be a modern practice in some places where traditional practitioners are still performing abortions.  It is not unusual to read accounts such as the following in modern medical literature from women who eventually needed to seek hospital care.

R: I went to the clinic and the doctor told me that I need to pay K150 and I failed to find the money … after I went to the clinic and they told me the price, the money was too much for me so I went to a certain lady and she told me that I have to pay K70 and she gave me some herbal medicine which I took and then she also inserted a stick in my cervix … [4]

In another atypical case study, the person who died was given “some generic herbal
products to be taken orally; in addition, some herbal twigs to be inserted
into vagina and to be kept in-situ throughout the night during sleeping.”

This passage written in 1686 lays it out better than I can.  Bonet, who was a bit more of a rationalist, wasn’t concerned with the morality of performing an abortion like Culpeper. He was concerned with the safety risks.

But some rash men, if they see their Patient in great danger, advise the procuring of Abortion. Now Abortion is more painfull and dangerous than a natural birth, from the violent divulsion of the unripe Foetus, whence very many die, some escape, but not without grievous symptoms…Wherefore their advice is pernicious that counsel the procuring of Abortion in acute Diseases,

1. Because in many it is not easily done; 2. It cannot be done but by dangerous Remedies, and those often repeated, which aggravate and heighten acute Diseases; 3. Nor is it safe, seeing Abortion it self is a dangerous and deadly affection, as experience shews: for by the aphorism above cited, it is deadly to a Woman with Child to be taken with an acute Disease, from the Fever, the thin diet, and the danger of Abortion: now ’tis bad to add affliction to the afflicted: the Mother often perishes by destroying the Foetus with such Remedies.”[5]

This is not the propaganda of the Patriarchy; this is the reality of herbal abortion. There is no such thing as a safe and reliably effective herbal abortifacient. That would become evident to you if you read historical medical texts and case studies on the Internet of people harmed when attempting herbal abortion. 

I speak with great confidence when I tell you that I know many very excellent herbal practitioners who have seen these methods fail or cause harm far more often than we have seen successful results and anyone who is telling you differently is most likely trying to capitalize on this issue and sell you something. 

We are lucky to live in an era when abortion procedures have become safe and reliable. It is unconscionable that this access is being taken away in many places.  The responsible action for an herbal practitioner to do is to quietly make connections with groups working to continue to provide access to medicalized abortion services and to refer people who need reproductive care to those groups.  

I understand that some of you feel drawn to service. If you want to use your herbal skills for activism, volunteer as a support person providing aftercare for people who have had safe medical abortions.