“[A] woman who has not given birth… dies in the sixth month because the menses fail to appear.”
Hippocrates, Diseases of Women I
(Portrait of Hippocrates from Linden, Magni Hippocratis…1665, 2014).
Overview
Having been viewed as wives and mothers, with their ability to bear children and maintain the paternal lineage a predominant part of their lives and measure of success, women of the Classical Period from 490-323 B.C.E. who experienced infertility were forced to turn to the limited medical opportunities available to them. Women obeyed their doctors, most of whom were male, who prescribed treatments associated with teachings of the Ancient Greek physician Hippocrates. Hippocrates taught and advanced the study of clinical medicine and established medicine as a profession. His teachings and unusual treatments considered the physical characteristics of a woman as primary factors in fertility, and how particular malformations would affect her psychological health. In addition to or in place of Hippocratic treatments, women practiced the traditionally alternative method of consulting deities, such as Asclepius, in hopes of experiencing pregnancy and bearing children. Asclepius was the god of medicine and healing and the son of the god Apollo. His methods involved consulting with and finding a cure for his patients through their dreams. The majority of the Hippocratic medical and healing practices written for women were unresearched, unsafe, and demonstrated unprogressive male biases and expectations of women as their wives. The religious healing process of Asclepius, however, demonstrated safe, noninvasive therapies that were intended to serve both women and men equally.
Healing god Asclepius pictured on left (Bust of Asclepius. Hermitage Museum., 2008) and physician Hippocrates pictured on right (Bust of Hippocrates, 2014).
The Hippocratic Corpus
The Hippocratic Corpus serves a significant role in the discussion of remedies for infertility and advice for pregnant women. Written around the fifth century B.C.E., the Hippocratic Corpus was widely accepted as the foundation upon which successive medical systems would be built (Flemming, 2013, p. 570). Of the sixty anonymous medical works associated with Hippocrates’ teachings, the ten written specifically for women were considered to be gynecological works (Flemming, 2013, p. 570). Despite its dubious, problematic, and even dangerous methods, doctors relied heavily on Hippocrates’ techniques and administered his at-home remedies to their female patients (Flemming, 2013, p. 574).
Within the Corpus, Diseases of Women I includes instructional remedies for women suffering from menstrual issues, infertility, and miscarriages (DoW I). This work describes how women can combine various strange products to reproduce and use their own Hippocratic remedies (DoW I). As a man teaching on behalf of women, Hippocrates’ conclusions drawn regarding fertility, infertility, and pregnancy and potential remedies reflect gender biases of men, which are explicitly shown in this source.
Also within the Corpus is The Hippocratic Oath, which reveals Hippocrates’ ethical priorities as a physician (National Institute of Health 2002). The Oath requires new physicians to swear by gods and goddesses, including the healing god Asclepius, that they will uphold ethical standards in their practice (National Institute of Health 2002). Hippocrates develops his own remedies, despite the preexisting healing methods of gods and goddesses and despite swearing by deities in his Oath (Hipp. Oath). Further, the Oath forbids doctors from performing abortions (Hipp. Oath). Not only did the Oath keep women from having control over their own bodies, but it likely promoted childbirth and fertility no matter the woman’s health, age, and comfort with childbearing.
In light of Hippocrates’ promise to gods and goddesses in the Oath, he viewed his healing remedies as primary with those of Ascelpius as alternative. Within the Corpus, Hippocrates openly denigrates healers, and not gods, but considers gods to be healers (Wickkiser, 2008, p. 30). Hippocrates considers deities to be a critical part of his teachings as the Oath states: “I swear by Apollo the physician, and Asclepius… and all the gods and goddesses as my witnesses, that, according to my ability and judgement, I will keep this Oath and this contract” (Hipp. Oath).
Asclepius’ Healing Remedies and Testimonies from Patients
Regardless of Hippocrates’ contradictory beliefs, Greeks viewed gods and goddesses intervening with the human body as absolute, and as having the ability to decisively cure people of their ailments (Flemming, 2013, p. 569). Such views ultimately led to an increase in the popularity of Asclepius’ cult (Wickkiser, 2008, p. 30). Women traveled to his sanctuary at Epidaurus in southern Greece in hopes to be cured of their infertility, a small price to pay for a significant reward (Flemming, 2013, p. 585). The women slept in the sanctuary, awaiting a dream in which Asclepius interacts with them, demonstrating his healing practices from which results their fertility (Flemming, 2013, p. 585). Six surviving testimonial inscriptions found at the temple of Asclepius (interchangeable with Asklepios) at Epidaurus praise the healing remedies available for women experiencing infertility. The inscriptions explain his healing methods and attest to their effectiveness (Renburg, 2017, p. 604). From the testimonies, these remedies can be determined as less laborious and significantly less invasive than the methods of Hippocrates.
The testimony of Andromache describes Asclepius touching her with his hand, and giving her the ability to bear children (IG IV 1.222, lines 60-63 ( = Testimony No. 31)). A second account describes a woman who, after conversing with Asclepius about the gender of her future child, later bore a son, as she had hoped (IG IV 1.222, lines 82-86 ( = Testimony No. 34)). Two similar testimonies discuss women who interacted with serpents in their dreams, and later bore multiple children (IG IV 1.222, lines 128-131 ( = Testimony No. 42)). Two additional accounts feature women who were pregnant but unable to give birth, one woman for three years and the other for five years, until after consulting with Asclepius (IG IV 1.212, lines 3-22 ( = Testimony Nos. 1-2)). A recurring pattern that can be seen in these accounts is that those women, after visiting Asclepius’ sanctuary, subsequently bore both girls and boys, singly and multiply (Flemming, 2013, p. 585). The single-day trip to Asclepius’ sanctuary proved effective, according to the aforementioned accounts, by allowing women who had struggled with infertility to bear children. The sanctuary was open to all and Asclepius was willing to cure all women and men.
Hippocrates’ Diagnoses and Healing Remedies
On the other hand, Hippocrates viewed the woman herself as the primary reason for being unable to bear children, and declared it her own responsibility to find a cure. He claims that reproduction is an essential part of female health, with infertility and a woman’s welfare being opposing elements (Flemming, 2013, 575). Therefore, Hippocrates concludes that if a woman is incapable of bearing children, she will be unable to have a fulfilling life. Very infrequently do Hippocratic teachings mention the notion of male infertility or medical interventions of the male body (Flemming, 2013, p. 575). The responsibility for fertility is that of women, and she must be willing to speak with her doctor about remedies (Flemming, 2013, p. 575).
As a result, Hippocrates argues the immediacy of women to cure themselves of their infertility in order to start bearing children. His teachings discusses the risks to a woman’s health that result from not giving birth, whether from prolonged virginity or infertility:
[D]isease occurs, and this happens – either the mouth of the womb closes, or it doubles back upon itself, or a part of the vagina hardens… For if it should be one of these reasons, and if the woman does not have intercourse with her husband, and her belly is emptier at this time because of some pain, then the womb displaces itself. For the womb is not wet on its own, because the woman has not had sexual intercourse, and there is an open space, because the belly is emptier, so it turns on itself, and is drier and lighter than normal. And it is after the womb has turned it happens that the mouth is displaced further, so that the cervix lies farther into the vagina. For if the womb is wet from coition and is not empty, it does not easily turn. Therefore this is the reason that the uterus closes, because the woman does not have intercourse (DoW I).
Such unresearched claims were intended to frighten women into doing all that they could to become pregnant, whether seeking treatment for infertility or engaging in sexual intercourse with their husbands, or else suffer the consequences of the aforementioned disease.
In addition, Hippocrates indicates that the body will cease from functioning properly, if a woman waits too long to have intercourse. He even claims that after six months without intercourse, women will die:
And during the sixth month, she will already be incurable… [O]ccasionally she will wander restlessly and will toss herself about, and she will faint, and vomit phlegm. She will have an intense thirst, because her belly burns as a result of the excess of blood in the uterus… The patient suffers pain in the spine and the whole back, and she is tongue-tied, and becomes inarticulate… and death is imminent (DoW I).
Hippocrates tries to convince women of the outcomes that impact both the mind and body, causing her to lose control before inevitably dying.
Subsequently, infertile women must therefore seek help immediately, using remedies from Hippocratic writings. Some remedies are reasonably straightforward while others are complicated, tedious, and involve multiple treatments. A simpler treatment involves grinding into a powder lead and a stone which attracts iron, tying the compound in a rag dipped in milk, and inserting the implement into the vagina (Flemming, 2013, p. 574). However, Hippocrates explains that women with a hardened, closed, or misaligned cervix must engage themselves in a more complex process (Flemming, 2013, p. 573). Such a process involves vomiting and soon after bathing in vapour, and fumigating the vagina using one or more probes covered in ointment to correct the texture, position, and size of the uterus’ entrance (DoW I). Although women are encouraged to fast, or vomit their meals, they should drink an unsalted potion in water while fumigating themselves before switching to a diet of unsalted barley groats in water, which should be consumed twice or thrice daily for six or seven days (DoW I). During this process, wives must engage in intercourse with their husbands daily (DoW I). If, after using these techniques, pregnancy ensues, a woman must not bathe or wet their heads, unless necessary (DoW I). She is allowed to consume bread, barley-cake, flesh from doves and pigeons, seafood, and meat that is roasted, rather than boiled, while also abstaining from herbs (DoW I).
In essence, these descriptions support the argument that Hippocrates’ treatments were time-consuming and complex, were unsafe, and showed a lack of research with his conclusions being drawn from his limited prior knowledge of the female anatomy as well as male expectations of women. Only once a wife became a mother did she have freedom and authority in the household, especially if the child was male (McClure, 2020, p. 89). Hippocratic teachings serve to convince women of the significance of producing children for the family, with works written for female readers of his Corpus primarily gynecological.
Conclusion and Discussion of Medicine in the Modern World
Women struggling with infertility turned to healing remedies, some consulting with Asclepius and others relying on Hippocratic teachings. Testimonies of the women who visited Asclepius’ sanctuary provide evidence of successful child-birth upon receiving treatment. The ten gynecological works of the Hippocratic Corpus were written with the purpose of promoting pregnancy and childbirth, rather than with the intention of aiding infertile women. Between offering various complicated and tedious methods for infertility treatment, Hippocratic writings encouraged women to engage in intercourse with their husbands. Asclepius does not explicitly tell women to change their lifestyles on behalf of their husband’s familial needs, but instead requires women who wish to be cured to travel for a single day and, at the least, be in the shrine of Asclepius, and at the most, successfully produce children.
From the standpoint of modern day medicine, many of Hippocrates’ remedies are seen to be unconventional and unsafe. Very little of his work and treatments are relevant to modern-day medical systems. Perhaps the primary reason the teachings of Hippocrates are important in the medical field is his Hippocratic Oath, which is still taken by physicians today (National Institute of Health, 2002). Therefore, it seems plausible for physicians to consider the methods of Asclepius and view them in a more favorable light. Having fared well for citizens of ancient Greece, modern doctors and healers may benefit from allowing Asclepius’ practice to act as a foundation for some of their own, if they have not done so already. Such practices that are appropriate for use by modern-day doctors include privately consulting with their patients, as Asclepius privately consulted with his patients through their dreams, and offering safe, noninvasive treatments for reproductive challenges, as did Asclepius.
Female patients of Asclepius can be deemed as worshippers of the god, dedicated to making the journey to his sanctuary, entered into a new, peaceful environment, temporarily free from their husbands and seeing themselves as in the presence of a higher being. Traveling to a new environment may have allowed women to enter a relaxed psychological state free of distractions and pressure from their husbands to conceive. Temporarily entering a new environment may allow modern-day women to also find a relaxed state, and aid them in their endeavors to have children, along with other aspirations.
References
Primary Sources:
Hippocrates. The Hippocratic Oath. National Library of Medicine. (Original work published during 5th century B.C.E.).
Hippocrates (2009). Diseases Of Women I (K. Whiteley Trans.) Pretoria. (Original work published during 5th century B.C.E.)
Inscriptiones Graecae (IG) IV 1.212-1.222. Inscriptions from the Epidaurian Asklepieion, ed. G. H. Renburg.
Secondary Sources:
Flemming, R. (2013). The Invention of Infertility in the Classical Greek World: Medicine, Divinity, and Gender. Bulletin of the History of Medicine.
McClure, L. K. (2020). Women in Classical Antiquity: From Birth to Death. John Wiley & Sons Inc.
National Institute of Health (2002). Greek Medicine. National Library of Medicine.
Renburg, G. H. (2017). Sources for “Fertility Incubation” from Greece, Egypt and the Ancient Near East. Where dreams may come: Incubation Sanctuaries in the Greco-Roman World, 2.
Wickkiser, B. (2008). Asklepios, Medicine, and the Politics of Healing in Fifth-century Greece: Between Craft and Cult. JHU Press.
Media:
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Bronze probe, Roman, 199 BCE-500 CE [Photograph]. (2018). Wikimedia Commons. https://commons.wikimedia.org/wiki/File:Bronze_probe,_Roman,_199_BCE-500_CE_Wellcome_L0057277.jpg
Bust of Asclepius. Hermitage Museum. [Photograph]. (2008). Wikimedia Commons. https://commons.wikimedia.org/wiki/File:Bust_of_Asclepius._Hermitage_Museum.png
Bust of Hippocrates [Photograph]. (2018). Wikimedia Commons. https://commons.wikimedia.org/wiki/File:Bust_of_Hippocrates_Wellcome_L0005203.jpg
Henry, R. (2012). Roman medical inplement spoon probe detail [Photograph]. Wikimedia Commons. https://commons.wikimedia.org/wiki/File:Roman_medical_inplement_spoon_probe_detail_(FindID_511243)
Kings and Things. (2020). Asclepius: The Greek God of Medicine [Mp4]. Youtube. https://www.youtube.com/watch?v=A14ewB4-L5E
Koronaios, G. E. (2019). The stoa of Abaton or Enkoimeterion at the Sanctuary of Asclepius in Epidaurus [Photograph]. Wikimedia Commons. https://commons.wikimedia.org/wiki/File:The_stoa_of_Abaton_or_Enkoimeterion_at_the_Sanctuary_of_Asclepius_in_Epidaurus.jpg.
Marble stele (grave marker) of a young girl [Sculpture]. (1911). The Met Museum. https://www.metmuseum.org/art/collection/search/248499
Model of the Asklepion at Epidaurus, Greece, 1936 [Photograph]. (2014). Wikimedia Commons. https://commons.wikimedia.org/wiki/File:Model_of_the_Asklepion_at_Epidaurus,_Greece,_1936_Wellcome_L0058351.jpg
Papyrus text; fragment of Hippocratic oath. [Photograph]. (2014). Wikimedia Commons. https://commons.wikimedia.org/wiki/File:Papyrus_text;_fragment_of_Hippocratic_oath._Wellcome_L0034090.jpg
Portrait of Hippocrates from Linden, Magni Hippocratis…1665 [Photograph]. (2014). Wikimedia Commons. https://commons.wikimedia.org/wiki/File:Portrait_of_Hippocrates_from_Linden,_Magni_Hippocratis…1665_Wellcome_L0014825.jpg
Relief; anatomical votive [Sculpture]. (1867). The British Museum. https://www.britishmuseum.org/collection/object/G_1867-0508-117
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