Since we are on the topic of reproductive health, I thought I would tackle this subject, but first I must tell readers who are new to this site a story. I grew up on a small farmstead in Iowa near a very tiny town where my great-grandmother had sometimes helped other families out as a midwife. She taught my grandpa’s sister Gladys to take over when she was too old. There’s a delightful story that still gets told about how Gladys kept some local twins alive by putting them in cereal boxes in a warm oven.

My mother used a respectable number of home remedies while raising her children, even though she didn’t follow that path. So, I first learned about domestic medicine from my family and neighbors.  That’s just how life was in a lot of poor rural areas.  No one put on airs, and we all helped one another out.

 I was in my mid-twenties and had a toddler and an infant before I met a person who called themselves “an herbalist” and that was quite the experience.  I was not used to herbal remedies being marketed to me. That’s what we all did because we couldn’t afford a doctor.

I went on to learn that there were a good number of these folks who commodified herbalism in the mid-to-late twentieth century. They had started charging for “consultations” and selling products. Interventions containing difficult to obtain ingredients were branded as being “traditional” over more easily acquired historical counterparts (e.g. making slippery elm gruel rather than making it properly out of oatmeal or barley). This is what people mean when they say that capitalism is responsible for the erasure of traditional knowledge.

While I was writing my last several posts, I was reminded once more by how different the historical materia medica is from modern thinking, especially when it comes to midwifery. There are plants that have all but disappeared from use and those that popped up in the modern materia medica that were used quite differently at one point.

Red raspberry leaf is one that is frequently mentioned in modern materia medica as an herb that has a long history of use by midwives. I decided to investigate because that didn’t track with what I knew of it.

Knowing full well that just because it was not done in my region doesn’t mean that it wasn’t done at all, I started combing through the various research databases I use. It’s worth pointing out that there are over sixty thousand texts in the Early English Books Online database and another ten thousand in the databases where I transcribe handwritten documents.

I found about sixty references to raspberries in EEBO most of which were making raspberry wine or jam. John Pechey (ca 1700) wrote about including a syrup made from berries in a cordial before delivery.

I found a couple instances of wild raspberry leaves being used to alleviate rheumatism and sciatica in the Schools’ collection (ca 1930s). Sciatica often develops in the third trimester of pregnancy. So maybe that’s how it got started?

I also discovered that I wasn’t the first to tackle this as Graeme Tobyn mentions in his Western white man’s history of plant medicine that there appears to be no use of Rubus idaeus before the Renaissance, except for some authors mentioning it as a substitute for blackberry leaves used for postpartum hemorrhage because it had a similar astringency.[i]

From what I have been able to gather, Thomsonian medicine popularized raspberry leaf tea. Thomson takes credit for “discovering” it in New Guide to Health,[ii] although he certainly didn’t limit the scope of his recommendations to reproductive care. Thomson primarily recommended the tea for canker which he believed to be a coating that lined the stomach and intestines when one was ill. He taught that eventually canker became so thick that it prevented the absorption of food.

He did suggest a strong red raspberry leaf tea as a delivery mechanism for large amounts of cayenne during labor and then said to give it to the newborn with a little milk and sugar to prevent a sore mouth. I am not sure why Thomson thought infants had sore mouths?  

Mormon physicians were especially fond of the drink- most likely since they were told to avoid stimulants like caffeine and tea.  In Keith Terry’s thesis that catalogued the materia medica of the women doctors who helped settle Utah, raspberry leaf is listed for the use of canker, fever and dysentery.[iii]  Another time I will write about Mormon elders sending young Mormon women to the Women’s Medical College in Philadelphia to be educated as doctors in the late 1800s.

Thomson’s “discovery” had an international impact.  Physiomedical physicians on both sides of the pond began recommending red raspberry leaf tea.  Dr. Sarah Webb’s Diseases of Women and Children[iv]recommended raspberry leaf tea as part of dietary plan for pregnancy. Webb suggested the tea as a substitute for coffee or tea writing “the value of Raspberry leaves is that they are a mild astringent, and cleanse tissue of any morbific material adhering to them, thus allowing them to relax and contract in a natural manner.” Later she suggests it interchangeably with blackberry leaves for children with diarrhea and cholera.

Webb said the benefits were “better health, less stomach trouble and less swelling of the feet and limbs.” Like Thomson, she seems to believe this astringency has some sort of benefit on digestion and assimilation which isn’t entirely off base given tannins actions on gastrointestinal epithelial tissue. But lest we take Dr. Webb’s dietary advice too seriously, she also thought that restricting the mother’s diet could keep a fetus’ bones from hardening to make labor easier on the mother.

Recommendations like this seemed to catch the eye of the conventional medical community. In a British Medical Journal published in 1941 two physicians suggested fragarine[v] as the name for an active principle in red raspberry leaf that they had yet to isolate. [vi] They simply theorized as to its existence and a medical myth was born. 

What makes this more confusing is that an 1878 journal article had already assigned this name to a tannin found in strawberry roots[vii], but it does not appear that the authors of the 1941 article are aware of the previous use of that name. An anthocyanidin glycoside named fragarin has been identified in strawberry leaves which do hold a place in the early modern materia medica. I will leave that to another post, though.

Regardless, as you can see in the attached document, no such constituent has been identified in red raspberry leaves. Errors like this can generally be attributed to people who only read the abstracts of journal articles, or even worse only the titles.

What red raspberry leaves have is a substantial amount of potassium, magnesium, calcium, and other minerals that are vital to proper smooth muscle signalling.  This could very well account for the effect the aqueous extract has on uterine smooth muscle.  I would like to see studies on how it impacts smooth muscle tissue from other areas of the body.   I conjecture that it would be similar.   I use the leaves as a caffeine-free base for many of my nervine infusions. 

Resembles a multivitamin label, doesn’t it?

You also don’t want to overlook the tannins and pectin in the leaves. Pectin is known to increase daily diuresis which means increasing the amount of sodium and chlorine filtered from the urine in the kidneys which in turn draws excess water from the body usually resulting in increased urine output.   While I can’t find a study done on the leaves, the pectins in the berries at least seem to be potassium sparing. [viii]Tannins are known to slow intestinal peristalsis and increase the absorption of water in the small intestine and colon by reducing intestinal permeability. [ix]

It seems that, unlike some other natural diuretics, red raspberry leaves kind of balance out and more importantly don’t contain any oxalic acid, although this is true of most berry plants. You could just as easily substitute black raspberry or blackberry leaves.

The last thing I need is people getting all worked up saying I said not to drink the tea, because that is not what I am saying.  I agree with Webb that a beverage tea blend made with a base of red raspberry would certainly be far more nutritious than a cup of coffee. Being well nourished going into labor is a good call no matter how you choose to accomplish that. I just want people to stop saying that it has an affinity for the uterus because that is physiologically unsound.

I see only two concerns with frequent use in pregnancy.

  1. Ingesting pectins and tannins at the same time as supplements can interfere significantly with the absorption of nutrients. I recommend taking meals and prenatal supplements with water.
  2. Keep in mind the impact that diuretics can have on the concentration of oxytocin in the bloodstream. Red raspberry leaf might be too much diuretic for some pregnant people. If a person complains of a lot of Braxton Hicks contractions, I tell them to back off the tea. I don’t think you will run into this problem unless you are combining the leaves with other astringent diuretics like nettle and dandelion leaf.

[i] Tobyn, Graeme, Alison Denham, and Margaret Whitelegg. The Western Herbal Tradition: 2000 Years of Medicinal Plant Knowledge. Edinburgh: Elsevier, 2011.

[ii] Thomson, Samuel. New Guide to Health, or, Botanic Family Physician [Microform] : Containing a Complete System of Practice upon a Plan Entirely New, with Description of the Vegetables Made Use of, and Directions for Preparing and Administering Them to Cure Disease : To Which Is Prefixed a Narrative of the Life and Medical Discoveries of the Author. 2nd ed. Brockville, Ontario: Printed for W. Willes, by W. Buell Jr., 1831. http://archive.org/details/cihm_01684.

[iii] Terry, Keith Calvin. ‘The Contribution of Medical Women During the First Fifty Years in Utah’. MA, Brigham Young University, 1964. http://scholarsarchive.byu.edu/etd/5167/.

[iv] Webb, Sarah A. Diseases of Women and Children. Worcester, England: National Association of Medical Herbalists, 1930.

[v] Not to be confused with fragarin which is an anthocyanidin glycoside.  PubChem. ‘Pelargonidin 3-Galactoside’. Accessed 11 August 2022. https://pubchem.ncbi.nlm.nih.gov/compound/16218556.

[vi] Whitehouse, Beckwith. ‘Fragarine: An Inhibitor of Uterine Action’. British Medical Journal 2, no. 4210 (13 September 1941): 370–71.

[vii] Phipson, T.L. ‘On Some Substances Obtained from the Root of the Strawberry’. In The Chemical News and Journal of Industrial Science, 1878. 135.

[viii] Zhang, Y., Z. Zhang, Y. Yang, X. Zu, D. I. Guan, and Y. Guan. ‘Diuretic Activity of Rubus Idaeus L (Rosaceae) in Rats’. Tropical Journal of Pharmaceutical Research 10, no. 3 (2011). https://doi.org/10.4314/tjpr.v10i3.15.

I apologize for not getting back to this blog sooner, but my local activism takes precedence over blogging and my medic team has been busy supporting protests that are occurring here in our hometown.

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. If you need even further proof of this, I will offer up Lazare Rivière’s definition of the stopped terms as translated by English physician Abdiah Cole.

“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 with child and not having their menstrual cycle regularly.  

The article circulating about Ben Franklin’s abortion remedy is clearly
speaking about a formula for “stopped termes.”  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.

Please stop writing about or speaking of this term as some secret code for pregnancy. It really, really isn’t. That idea stems from a lot of second-wave feminist fantasy, and it is as much mythical nonsense as the whole midwives being prosecuted as witches thing.

I find it absolutely 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.

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 abortion in a woman with child, and I am not going to mention them here for safety concerns that I discuss below.

He defined another medical condition which 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 the use of 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.  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 smooth muscle in the intestines. Those prostaglandins can in turn get into your blood stream and may trigger contractions in your uterus.

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 acceptable practice in Culpeper’s time.  It was pope Sixtus V who first declared abortion to be homicide, with somewhat 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 woman to save her 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 botanicals medicines were prepared and administered in the past. 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 like “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 or sharp 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.”

And that’s the real reason for this post.  Herbalists need to stop spreading this myth of the safe and reliably effective herbal abortion that involves just drinking tea.  

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 propaganda of the Patriarchy; this is the reality of herbal abortion. There is no such thing as a safe and reliably effective herbal abortificient. 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 cause harm or fail far more often than we have seen successful results and anyone who is telling you different 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.  

If you want to use your herbal skills for activism, find your local street medic organization and volunteer as a support person for direct actions or providing aftercare for people who have had safe medical abortions. 

 

 

 

 

 


[1] Rivière, Lazare. The Practice of Physick in Seventeen Several Books..2011 December (TCP phase 2). London, England: Printed by Peter Cole … and are to be sold at his shop, 1655. pp 404

[2] Culpeper, Nicholas. Culpeper’s Directory for Midwives: Or, A Guide for Women. The Second Part. 2006th-02 (EEBO-TCP Phase 1). ed. London, England: Printed by Peter Cole, 1662. pp 161.

[3] Rivière, Lazare. The Practice of Physick. 311.  

[4]Coast, Ernestina, and Susan F. Murray. ‘“These Things Are Dangerous”: Understanding Induced Abortion Trajectories in Urban Zambia’. Social Science & Medicine 153 (March 2016): 201–9. https://doi.org/10.1016/j.socscimed.2016.02.025.

5. Bonet, Théophile. A Guide to the Practical Physician… 2014th-11 (EEBO-TCP Phase
2). ed. printed for Thomas Flesher, at his house over against Distaff Lane in
the Old Change, 1686.

 

 

[1] Rivière, Lazare. The Practice of Physick in Seventeen Several Books Wherein Is Plainly Set Forth the Nature, Cause, Differences, and Several Sorts of Signs…Translated
by Cole, Abdiah and Rowland, William. 2011 December (TCP phase 2). London,
England: Printed by Peter Cole … and are to be sold at his shop, 1655. pp 404

[2] Culpeper, Nicholas. Culpeper’s Directory for Midwives: Or, A Guide for Women. The Second Part. Discovering, 1. The Diseases in the Privities of Women. 2. The Diseases
of the Privie Part. 3. The Diseases of the Womb … 14. The Diseases and
Symptoms in Children. 2006th-02 (EEBO-TCP Phase 1). ed. Longon, England:
Printed by Peter Cole, 1662. pp 161.

[3] Coast, Ernestina, and Susan F. Murray. ‘“These Things Are Dangerous”: Understanding Induced Abortion Trajectories in Urban Zambia’. Social Science & Medicine 153 (March 2016): 201–9. https://doi.org/10.1016/j.socscimed.2016.02.025.

[4]Rivière, Lazare. The Practice of Physick. 311. 

5. Bonet, Théophile. A Guide to the Practical Physician… 2014th-11 (EEBO-TCP Phase
2). ed. printed for Thomas Flesher, at his house over against Distaff Lane in
the Old Change, 1686.



Since early modern medicine was largely based on the humoral theories of Hippocrates as modified by Galen and Avicenna, I feel it’s important to look at what was really going on with medicine during antiquity. I get a little tired of reading bad takes on the practices and opinions of historical figures. There’s no excuse for it when the primary source documents are so readily available these days.

In this post I am going to discuss abortion as explained by two of the physicians whose work informed early modern medicine. Hippocrates (5th Century BCE) who was the originator of humoral medicine and Soranus of Ephaseus (2ndCentury CE). Soranus was one of the more well-known physicians of the Methodic school of medicine who practiced in Alexandria and subsequently in Rome during the early Imperial era. I chose him because his work was cited frequently by Eucharius Rosslin who wrote A Garden of Roses for Pregnant Women and Midwives in 1526, and because I have a thing for the Methodics.

When I am teaching history at conferences, one of the roadblocks I hit in explaining ancient healthcare are modern misconceptions about their materia medica and their methods. Their materia medica incorporated a wide variety of minerals and animal ingredients. Hipprocates “potion” for improving scanty menses was four blister beetles, six black pomegranate seeds, eggs of cuttlefish and a little linseed oil.[1]   This potion was given part of a regimen that consisted of other therapies like dietary interventions, medicated baths, massage, fomentations, and venesection. I can’t recall one time when I read one of these physicians, take this beverage three times a day and you will be better.

One of the only contraceptives that Hippocrates mentions is misy a preparation made from a crude copper ore that would prevent pregnancy in women who must not get pregnant.[2] By the time Soranus was practicing they knew how to distill mercury from various plants and were using it medicinally. Khálkanthon (literally flowers of copper) is a water-soluble powder of oxidized copper used as one ingredient for one of his contraceptive suppositories. It is called blue vitriol in early modern medicine.

They also had an array of surprisingly modern looking medical equipment available. (What might be more surprising is that we haven’t progressed further than we have.) Hippocrates wrote regularly of using pine dilators to dilate the cervix and inserting medicines into the cervical cavity with a uterine sound – usually made of lead. The pine dilators were rounded on both ends and someone like modern Hegar dilators. Hippocrates walks you through a surgical abortion of a dead fetus. Soranus wrote of using a uterine syringe or a small clyster [enema] pipes to flush the uterus with various medicinal solutions. They were very much about topical application. While Soranus mentions using a speculum, Egyptian physician Metrodora’s On the Diseases and Cures of Women, published in the 3rd century, contain more instruction.

So, the idea that midwives didn’t have any tools at their disposal to perform a mechanical abortion is nonsense. In fact, one of Soranus’ tips for a stalled labor is not to let the midwives “dilate the uterus forcibly”[3] for too long, but we will get to that in a bit.

I suppose I should start where most people start with the Hippocratic Oath. It is sometimes incorrectly translated to “I will not give to a woman an abortive remedy to procure an abortion” when it should read “I will not give to a woman a destructive pessary to procure an abortion.” This had led to a lot of wild speculation (I believe that might be John Riddle’s middle name) as to what Hippocrates meant but if you read Soranus, he clears that up saying,

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 knobby swellings and fissures, or if some similar difficulty is involved.[4]

So yes, physicians of the era believe Hippocrates meant what he said. He was more likely to mention preventing an abortion as in Aphorisms where he says, “If a woman with child be bled, she will have an abortion, and this will be the more likely to happen, the larger the fetus.” [5] He’s mostly likely correct about that because bloodletting would concentrate the levels of oxytocin in the blood and the further along a pregnancy is the more sensitive the uterus is to oxytocin. He might also have been right about in saying that purgatives which “violently disturb her cavity (intestines)” caused the uterus to react. Soranus also mentions purgatives in the excerpt I share below.

Unfortunately he had a lot of less credible ideas about what led to abortion including the uterus being filled with air, eating foods that were sharper or more bitter than usual, exertion, fear, and my personal favorite- shouting and losing her temper.[6] That’s right …physicians used fear of losing their child as a way of policing women’s behavior.

Hippocrates warned of the danger of abortion (spontaneous or induced they didn’t specify) saying, “Abortions are more dangerous than births because it is impossible for an embryo to be aborted by medicine or by a potion or by food or by pessaries or in any way at all without applying force, and force is a painful thing. The risk here is that the womb will become lacerated or inflamed and this is dangerous.” Hippocrates might have been opposed to performing elective abortions, but he certainly shares plenty of information on how to open the cervix for cleaning or flushing the uterus as a means of promoting healthful menstruation and expelling the afterbirth, or a dead fetus.

Soranus who lived 500 years later was a little less reticent and just laid the process out saying, “For a woman who intends to have an abortion, it is necessary for two or even three days before hand 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…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 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 [laxatives] and the application of a softening clyster; [this means enema but I have seen it used for uterine flushes also so I am unsure as to the meaning here] afterwards one must apply an abortive vaginal suppository.”[7]

The softening suppositories contained a lot of the “procure the courses” herbs and that makes sense because they seemed to think that “wind” one of the things that caused the uterus to move about the body and become hardened. And to be fair carminatives may have the effect of relaxing smooth muscle when applied topically. They were combined with astringent ingredients which likely functioned as osmotic dilators, absorbing moisture from tissues around the cervix to cause it to open. This would be the functions of a lot of the resins you see in their formulas. This was more likely the effective part of the preparations. Some physicians still use laminaria which are small tubes made of dried seaweed to dilate the cervix before certain procedures today, although others use synthetic dilators made of sterile, dry sponge.

The softening suppositories were far more gentle than other techniques used to open the cervix. You can read about the way Hippocrates used pine dilators and applied medicines to the cervical canal with uterine sounds, as part of his cleaning process and to provoke obstructed menses as well. It’s quite the process and sounds a bit like torture.

Hippocrates shared formulas for abortive suppositories for the purposes of expelling a fetus that has died. One was grinding a dram of powdered alum, another of myrrh, and three obols of black hellebore with enough dark wine to form them into small suppositories to be inserted in the cervix.[8] As I said earlier, many of the herbs that you read about as herbal abortions were incorporated into preparations that were made to be inserted near or into the cervix. Some were even inserted in the cervical canal or injected into the dilated uterus.

Hippocrates suggested “sharp” suppositories for stubborn cases. These were made by wrapping a root or a feather in wool that has been soaked in some sort of medicinal substance. They would leave a bit of the hard stalk of the feather or tip of a root outside of the wool and that was meant to be inserted into the mouth of the cervix left in until bleeding occurred.

Dioscorides talked about using the root of wild carrot for this in a previous post. Hippocrates suggests using a six-inch shoot of black hellebore.[9] Soranus didn’t seem to be a fan of the sharp suppositories saying, “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.[10]

Given how much Hippocrates talks treating about ulcerations of the uterus, I am going to agree with Soranus. Ancient Greek medicine was intense. The things Hippocrates wrote about doing to women in the name of promoting normal menses and fertility still appalls me every time I read through Diseases on Women.

My point here is that at no point did these physicians just give a person a tea to abort a fetus and then expect that nature would just take its course. They weren’t idiots. They understood that incomplete abortions [spontaneous or induced] could kill a woman if they didn’t take additional measures to cause the expulsion of the fetus, and they didn’t have modern antibiotics to fall back on.

Herbal preparations played a part in the process in the same way we use medicines as part of the process now, but it was far more likely to see them applied topically than it was to make infusions. It just doesn’t work like that. I clapped my hands in joy at the scene in Bridgerton where the physician asked Marina Thompson if she really thought a tea would work to cause an abortion and then followed up with “They never do.”

The last point I want to make about Greek medicine is that male physicians were discouraged from performing gynecological exams on women, but not prohibited. Hippocrates wrote of having women perform procedures themselves or finding another woman to do it, but he also mentioned doing so himself. So they had to train these women to work with them. Soranus’ Gynecology has been argued by some to be a textbook for training midwives as his first requirement was that they be literate.

Soranus was all about midwives, which probably speaks to early Imperial Rome’s more enlightened view on the education of women. According to Soranus “the best midwife if she goes further and in addition to her management of cases is well versed in theory. And more particularly, we call a person the best midwife if she is trained in all branches of therapy (for some cases must be treated by diet, others by surgery, while still others must be cured by drugs) ; if she is moreover able to prescribe hygienic regulations for her patients, to observe the general and the individual features of the case, and from this to find out what is expedient.[11]

The most illuminating thing Soranus writes is that our midwife “must not be greedy for money, lest she give an abortion wickedly for payment.”[12] I promise you that any time someone says someone should not do something or passes a law against a practice, it is because it is being done. Midwives were being trained in how to perform these procedures in antiquity and they kept doing it right up until they were outlawed in the mid 1900’s.

The takeaway here is that medical text written in the early modern era was paraphrased and handed down from these older texts, each time leaving the chance for operant information to be left out, which has clearly happened.

I for one am concerned about the number of people who are citing them as sources for giving women toxic beverages, when that wasn’t the process used and even if it was, it was on the advice of a guy who thought the reason people with uteruses threw up blood was because their uterus moved up in their body and their menses were exiting the body through their mouth.


[1] Hippocrates. Hippocrates, Vol. X: Generation / Nature of the Child / Nature of Women / Barrenness / Diseases IV. Translated by Paul Potter. New York: Harvard University Press, 2012. pp 205.
[2] Hippocrates. Hippocrates, Volume XI Diseases of Women 1–2. Translated by Paul Potter. London: New York: Harvard University Press, 2018. pp. 179.
[3] Soranus, and Owsei Temkin. Soranus’ Gynecology. Softshell Books ed. Baltimore: Johns Hopkins University Press, 1956. pp 184.
[4] Soranus, Gynecology. pp 63.
[5] Hippocrates. ‘Aphorisms’. In Hippocrates Galen, translated by Adams, Francis, Vol. 10. Great Books of the Western World. Chicago, IL: Encyclopedia Britannica Inc., 1952. pp 138.
[6] Hippocrates. Hippocrates, Volume XI Diseases of Women 1–2. Translated by Paul Potter. London: New York: Harvard University Press, 2018. pp. 71.
[7] Soranus,  Gynecology,  pp 63.
[8]  Hippocrates. Diseases of Women 1–2. pp 201.
[9] Hippocrates. Diseases of Women 1–2. pp 237.
[10] Soranus, Gynecology, pp 68.
[11] Soranus, Gynecology, pp 6.
[12]Soranus, Gynecology, pp 7.