On Superfetation — First Draft Translation

CONCERNING SUPERFETATION. Whenever a woman conceives upon a prior conception: if the first child lies in the middle of the womb, the additional conception falls away, thrust out by the original; but if she has the embryo in the other horn, she delivers the later one afterwards — not viable — when the womb has relaxed and become moist, having been released from the viable one. 1. If the additional conception does not pass off at once, it causes pains, a foul-smelling flux, and fever; and the face, the shins, the feet, and the belly swell; and she refuses food until it is expelled. Women who conceive additionally are those in whom the os of the womb has not closed very firmly after the first conception, or has closed without the signs appearing. As for the additional conceptions that are delivered later: if they do not yet have differentiation but are simply flesh, they do not swell but putrefy until they exit the womb. In the case of a woman from whom the child slips out of the afterbirth inside the womb before the child begins to move outward, the birth is more difficult and dangerous unless the head leads. 2. But in the case of a woman where the child moves outward together with the afterbirth, and having advanced to the os slips free of the afterbirth when it ruptures, the birth goes more easily; the child passes out through the opening, while the afterbirth is held back, draws itself up, and stays where it is. When the child is not viable, its flesh projects beyond the nails, and the nails fall short on the hands and feet. 4. When, a viable child having been born, a hand protrudes, first push it back until you have forced it away; and if both hands protrude, push both back; and if a leg protrudes, push that back too. Whenever both legs have appeared and stay there and advance neither way, it is necessary to use a vapor-fomentation, by which the womb will become most moist; let the fomentation have an odor. And whenever the head appears but the rest of the body is still inside, foment in the same way; and whenever part of the body is in the womb, part in the birth-canal, and the part outside the birth-canal swells and stays put, foment in the same way here too. And if after the fomentation it moves off — but if not, smear the os of the womb with squirting-cucumber juice thickened, diluted with water, so as to induce labor-pains; and induce labor-pains also from drinks and foods; and anoint the birth-canal itself with cerate, if it seems to you drier than the proper measure. Whenever, the child's head having appeared from the os, the rest of the body refuses to advance and the child has died, wet the fingers with water, insert the finger between the os and the head, lead it round in a circle; then slide the finger under the chin, insert it into the mouth, and draw outward. 6. But whenever the rest of the body is outside the birth-canal and the head is inside — the embryo being carried feet-first — when you have led the finger round in a circle, insert both hands between the os and the head, having wetted them with water, and draw it out. If it is outside the os but inside the birth-canal, insert the hands, take hold of the head, and draw it out. If the embryo remains inside dead and is able to be expelled neither spontaneously nor through medicines in the natural way, anoint the hand with a cerate that is as slippery as possible, then insert it into the womb, divide the shoulders from the neck pressing with the great finger; one should have a nail on the great finger for such tasks; and having divided it, bring out the arms, then insert again into the belly and cut it open, and having cut it open quietly remove the inward parts, then having removed them crush the ribs, so that the small body, collapsing, becomes more compact and passes out more easily, not being bulky. 8. If the afterbirth does not fall out readily, it is best to let it hang attached to the embryo and have the woman after birth sit as on a chamber-pot; let something elevated be constructed, so that the embryo hanging down draws the afterbirth outward by its weight; but do this gently, not by force, so that nothing torn away contrary to nature causes inflammation. Under the embryo there must be placed freshly-carded wool of the greatest possible bulk, so that it may give way little by little — two water-filled bladders joined together; wool on top of the bladders; on top of this the embryo; then pierce each of the bladders with a needle, so that the water flows out little by little; as the water flows out the bladders give way; as they give way the embryo draws the umbilical cord, and the cord draws the afterbirth. If she cannot sit on the chamber-pot, let her sit on a perforated reclining chair. If she is too weak to sit at all, raise the bed as steeply as possible from the side toward the head, so that the weight inclines downward as much as possible and the downward weight draws together with it; bind the woman after birth under the armpits outside her garments to the bed with either a band or a broad soft strap, so that when the bed is upright the body is not carried downward. In the same manner, whether the cord has broken off or someone has cut it before the proper time, suspend proportionate weights and effect the extraction of the afterbirth; for this is the best treatment for such cases and causes the least harm. If in someone the child dies in the womb and does not come out: when the womb is moist and no longer has what it contains, but the womb becomes dry — first the child itself swells, then it melts and the flesh putrefies and flows out through the opening; last the bones pass out; and sometimes a flux takes hold, if she has not died before. 10. Whenever a child has died in the womb, judge by the other signs too, and direct her to lie sometimes on the right side, sometimes to turn to the left; for the child falls in the womb to whichever side the woman does, like a stone or something else, if it is dead, and she has the lower belly cold; but if it is alive, she has the lower belly warm, and the whole belly shifts taut as a whole along with the rest of the body, while within it nothing shifts independently of the rest of the body. In the case of a woman in labor in whom before the child there occurs a large bloodstained painless flux, there is danger that the child will be released dead, or will be born unable to survive. 12. In pregnant women the os of the womb happens to be close before birth in most cases. A pregnant woman, if she does not have intercourse, will be delivered of the birth more easily. 14. A woman who is carrying twins gives birth in the same manner as she conceived; she carries both children in a single afterbirth. For a woman with difficult labor, if the child is held fast in the passages and does not come out easily but with struggle and by the physician's contrivances, these children are barely alive. 15. Of these one must not cut the umbilical cord before the child has urinated, or sneezed, or cried out; but let it be, and bring the woman as close as possible to the child; and if it is thirsty, let it drink honey-water. And if the umbilical cord is inflated like an os, the child will stir, or it will sneeze and break forth in cry, and then cut the cord while the child is breathing. But if the cord is not inflated and does not stir, when time has passed, it will not survive. A pregnant woman — if you cannot recognize it otherwise — the eyes are drawn back and become more hollow, and the whites of the eyes do not have the natural whiteness but are more livid. 17. If a woman while pregnant has hollow eyes, and her face and her whole body swell up slightly, and her feet swell, and she appears as though held by white phlegm, and her ears are white and the tip of her nose is white and her lips are livid — they give birth to dead children, or to living ones that are sickly and unable to survive and bloodless as if diseased, or they have previously delivered non-viable children. In these women the blood has become watery; after birth, therefore, one must apply fragrant things to them and have them drink fragrant things, and restore them with foods. And the first part of the face to show signs is the tip of the nose, which takes on color. If a woman while conceiving craves to eat earth or charcoal and eats it, on the head of the child when it is born there appears a mark from such things. 19. One should know, for a woman, which of the breasts is larger for her; for there lies the embryo; and likewise with the eye: it will be larger and altogether brighter on the inner side of the eyelid on whichever side the breast is larger. In the case of a woman in whom, from pessaries that are not very strong, pains reach the joints and gnashing comes upon her, and she stretches and yawns, there is more hope that this woman will conceive than one who suffers none of these things. 21. A woman who has become unnaturally fat and fleshy and filled with phlegm does not conceive during that time; but one who is naturally such does conceive on that account, unless something else prevents her. In most women, when the monthly discharge is about to appear, the os of the womb has drawn itself up more than at other times. 23. A woman who is fruitful but has stopped conceiving, let her be bled twice a year from the arms and the legs. In the case of a woman who has pains in the hip or in the head or in the hands or somewhere else in the body when she is not pregnant, and these cease when she is with child, but when she is released from the womb they come back — aromatic things are beneficial both for drinking and for applying to the os of the womb. 25. Whenever you are treating a woman with a view to conception: when it seems that she has been purged and the os of the womb is in good condition, let her bathe and wash her head; but let her not anoint herself with anything; then, having placed around her hair itself a linen cloth with no smell that has been washed, let her bind it up having first placed it under a hair-net that has been washed or smells of nothing; then let her rest having applied galbanum to the os, having boiled and softened it over fire and not in the sun; then in the morning, having removed the hair-net together with the linen, let her offer the top of her head to someone to smell; and if it smells, the purging is going well; if not, badly; let her do these things while fasting. And if she is not one who has given birth, it will never smell, whether she is being purged or otherwise; nor if she applies it while pregnant will it smell in that case either; but one who conceives readily and is fruitful and in good health, if you apply it without even purging her, the top of her head will smell, and nothing else. When it seems good and she needs to go to her husband: let the woman be fasting, and the man unstuffed with food, having bathed in cold water and eaten what is beneficial; and if she perceives that she has taken in the seed, let her not go to the man the first time but stay quiet; she will know: if the man says he has discharged but the woman is unaware of it on account of dryness; but if the womb gives back the seed into the birth-canal and it becomes moist, let her come together again until she conceives. 27. A woman who conceives but miscarries children at precisely two months, always at the same time, neither before nor after, and this happens to her two or three times in the same way, and who miscarries some at three or four months or longer, in this same manner — in these women the womb does not expand further as the child grows and exceeds the measure of the two months or three months or however long it may be; but the child grows while the womb is no longer adequate, and on this account the miscarriage occurs at the same time. This woman's womb must be irrigated and inflated as much as possible with pessary-medicines as follows: having pounded the inner part of the gourd, sieve it; then mix a small amount of it with boiled honey in a larger quantity, and a little silphion; let the honey be well-boiled; smear this around a probe, making the thickness such as the os will receive; apply it to the os of the womb and push it so that it passes into the interior of the womb; when the medicine has melted, remove the probe. And apply the squirting-cucumber juice prepared in this way, and wild gourd likewise. And during this time let her eat as much garlic as possible and the stalk of silphion and whatever produces wind in the belly. Let the pessary be applied every other day, as long as it seems to be going well, and in whatever quantity she can tolerate; on the days between, use emollient applications. When the os of the womb has settled with the emollients, after the appearance of the discharge has persisted and she is already dry, let her have intercourse. In the case of a woman whose womb becomes filled with pus, whether after childbirth or from a miscarriage or in some other way, and the pus is not contained in a separate vessel and membrane as in the case of an abscess — it is beneficial for this woman to introduce a cleansing probe into the os of the womb; for she will have less need of irrigation if it moves toward the probe; then, collecting the caterpillars from the spurge-plant — those that have prickles — cut them off gently, so that the nourishment does not run out; then dry them in the sun and grind them; and likewise dry the dung-worms in the sun, then grind them; and two Aeginetan obol weights of the caterpillar, double that of the worms, and mix in a little anise or something of that kind; for it has an unpleasant smell; grind these smooth, dissolve in fragrant white wine; and when she has drunk it, heaviness comes on and numbness falls in the belly; if this comes on, let her drink a little honey-water. 29. As for the woman who has need of conception and child-bearing — whether she is childless and has not yet conceived, or has conceived but is a woman who does bear children — whenever the os is hard, either at the tip or throughout, or has closed, and is not straight but has one part deviated toward the hip, or has bent toward the rectum or drawn itself up, or the lip of the os folds over on itself, or from whatever source it is rough and callous, and it becomes hard both from closing and from callusing — in these women the monthly discharge does not appear, or appears less than is proper, and appears at longer intervals. There are some in whom the monthly discharge finds its exit in accordance with the health of the body and the womb; and in keeping with what is natural and right, and through the warmth and moisture of the monthly discharge when the os is not greatly damaged; but the seed is not received on account of the damage, whatever that is, which prevents reception because the os is not in good condition. This woman must first have the whole body vapor-fomented, then be given a medicine to drink, and be purged of the body first — whether she needs purging both upward and downward, or upward only; and if you give the medicine upward, do not foment before the purging; but having fomented, give it to drink downward; if she does not seem to need an upper purgative, having fomented beforehand, give it to drink for downward purging. When the body seems to be in good condition from the purging, after this vapor-foment the womb, having her sit frequently in whatever seems beneficial; throw into the fomentation shavings of cypress and crushed laurel leaves; and bathe her with much hot water. When she has just bathed and just been vapor-fomented, widen the os of the womb with the tin probe and straighten wherever needed, or with a lead one, beginning from a thin one and then a thicker one if she receives it, until it seems to be going well; dip the probes in one of the emollient preparations diluted as seems beneficial, making it liquid; make the probes hollow at the back, then fit them onto longer wooden handles and use them thus. During this time let her drink, having boiled in fragrant white wine as sweet and pleasant as possible, very fat split pine-wood cut into thin strips, and crushed celery seed and Ethiopian cumin seed and the finest frankincense; let her drink this fasting in whatever quantity seems moderate, for as many days as seems sufficient; and let her eat boiled puppies and octopus boiled in wine or in sweet wine; let her drink the broth and boiled cabbage; let her drink white wine over it and not be thirsty; let her bathe in hot water twice a day; let her abstain from solid foods during this time. After this, if discharge passes through the os and something of the purging appears outside, let her drink the potion still for one or two days, cease using the probes, and try to purge the womb with pessary-medicines. In the case of a woman in whom the monthly discharge does not appear at all, or appears in smaller amount and at longer intervals and not healthily, even though the os is straight and soft and sound and in good condition and in the right position — having found what disease the womb has, and whether the body contributes something too, having found the cause from which she is not conceiving; and when it is thus, make the treatment by applying whatever therapy it receives, beginning from stronger measures as the occasion seems to demand, ending with gentler ones, until it seems that the womb has been sufficiently purged and the os has come to be in a rightly sound and proper position. If it does not advance from the drink and the medicine, and she has been drinking for a reasonable time, do not cease this drink; but when the work of the probes seems to be going well, soften the os and make it open up as a pathway for the pessary, by means of fumigant medicines and emollients. 29 (50). When it seems that it is going well with the softening and the fumigation, apply a medicine as a pessary and carry out purging of the womb as seems good, beginning from gentle measures toward stronger ones, ending again with gentle fragrant ones; for most of the strong medicines ulcerate the os and bite; then settle the os into a straight, sound, and well-disposed condition for receiving the seed, and make the womb dry and produce wind in it. If a woman seems to have suffered harm to the womb for conception from fatness, thin and slim her as much as possible in addition to the other measures. The spring season is best for conception; let the man not get drunk, nor drink white wine, but the strongest and most unmixed; and the strongest foods; let him not take hot baths; let him be strong and in good health; and let him abstain from foods not beneficial to the matter. 31. Whenever one wants to engender a male, have intercourse when the monthly discharges are waning or have ceased; and thrust as much as possible until emission occurs; when one wants a female to come about, when the monthly discharge is most plentiful in the woman and while it is still flowing, bind the right testicle as tightly as one can and endure; when one wants to engender a male, bind the left one. The os of the womb, having been closed by fumigations, opens up; by emollients it is softened. 32. One should fumigate with: bark of lotus, seeds of laurel and fresh crushed leaves, frankincense, myrrh, fruit or leaves of artemisia; and crushed anise, or fat and wax and sulfur and cypress seed, root of peucedanum, fresh crushed myrtle leaves, castor's testicle, male-donkey genital, garlic, styrax, swine's fat; and if the os is turned, one should fumigate with these; for it opens and turns by this means. To soften the os of the womb from these: sandarach, goat's fat, fig-tree sap, silphion sap, cyclamen juice, thapsia, spurge sap, cress seed, the plant called peplos, castor's testicle, flax seed, natron, aron root, wild raisin, fresh crushed calamintha leaves, strouthion fruit, the inner part of squill. Emollient medicines, and to produce a strong purging and agitate: root of thapsia, ox marrow, goose fat, rose-oil; grind these and boil and let her apply as pessaries for four days; and let her drink leek juice and sweet white wine; and resin, and warm olive oil and cumin, natron, honey — let her use these in greasy wool for four days, drinking celery seed, five grains of frankincense, and Ethiopian cumin in sweet unmixed white wine; and let her bathe twice a day. 33 [5] Myrrh, frankincense, ox bile, turpentine resin, or nētopon: mix equal parts of each and apply in clean wool or a thin cloth; after dipping the cloth in fragrant white Egyptian perfumed oil and tying it with a thread, let her bathe first and then insert it. And let her also eat crushed polypus, and drink the seed of celery and of asparagus, and white wine three times a day while fasting. Myrrh, cassia, frankincense, cinnamon, nētopon: equal parts of each, formed into suppositories in wool, or made as pessaries, and applied. Another: the inner part of wild gourd, roasted cumin, seed of dill, root of cypress — grind these smooth, knead with boiled honey, form into pessaries, and give to insert; and let her drink the root of glykyside, seed of celery, juice of silphium, and wine. The bolbion bulb also purges by itself when applied as a suppository. And myrrh first — a small amount of the flower in fragrant white wine — apply as a suppository. Suppositories most suited to purging the womb: take flower of copper and one-third part of natron, knead with boiled honey, form into pessaries of a size and thickness that seem appropriate, and apply thus to the mouth of the womb; and if you wish it to be stronger, mix in elaterion and the flower alone, and made in this way give to insert; and mix in bark of fig-branch, scraped and ground smooth, when the mouth of the womb seems drier — half the amount likewise. Another: grind elaterion and flower of copper smooth — two parts of the flower, one part of elaterion — pass these through a strainer; then grind cyclamen and mix it into the strained mixture, using as much as seems timely; and having formed suppositories, let them be applied in wool. A suppository that cleanses white discharge: artemisia herb, natron, half-dry cyclamen, cumin. Another that accomplishes the same cleansing: grind fresh green artemisia herb and one-third part of myrrh, mix in fragrant wine, wrap in white wool, soak in wine, and give to apply. When the wombs are relaxed: natron, the inner part of cucumber, half-dry cyclamen — apply in wool. Suppositories of all kinds capable of purging: grind fresh green wild stavesacre, plaster it around; grind the leaves of artemisia herb, shape in boiled honey, dry in the shade — from this make suppositories and give the woman to apply. Another: mix flower of copper or Egyptian alum, dissolve in cyclamen, as with the previous preparations, shape in boiled honey, or formed in a dried fig, and a little myrrh. Another: grind the cyclamen, mix in fragrant white wine, bind in as thin and clean a cloth as possible, and give to apply. Another: half-dry cyclamen, natron, cantharides, fat, sandarach. On the maiden: when for a maiden the seasonal flowings do not come, and the wombs are moving — she becomes bilious and feverish and in pain, thirsty and hungry, and vomits, and raves and then is again in her right mind; and whenever the wombs turn toward the viscera, vomiting and fever and confusion come upon her; when they withdraw, she is hungry and thirsty, and a shivering fever holds her. 34 [10] For these women, warm fleeces must be applied to the belly, and fumigation given into the genitals themselves as much as possible, with the woman seated over the neck of a large jar; myrrh in the amount of a bean, frankincense twice that amount — mix these together with hulled spelt, and throw the whole on the fire to fumigate, while she is as much as possible fasting; and bathe her in much hot water. A suppository: Egyptian alum wrapped in soft wool, let her insert. 35 Another: grind artemisia, soak in white wine, and give to apply as a suppository. For a woman who has just given birth: mix rose-oil, myrrh, and wax in wool and give to apply as a suppository; but when the wombs fall upon her, you should bring dry and astringent things for her both to drink and to apply. 37 Black fig, garlic, natron, cumin — grind all these smooth, give to apply in wool. Another: pound the bone of a cuttlefish smooth, soak in wine, apply in hare's hair and wool. If after delivery she has pain in the uterus, let her boil barley-gruel, leeks, and goat fat together and sip as little of this as possible. 39 A suppository: natron, cumin, an equal amount of fig. A purging and softening suppository: nētopon, rose perfumed oil, goose fat — in thin linen cloth. If the monthly flowings become excessive, let her drink fourteen black seeds of glykyside in two kyathoi of wine. 41 If the wombs protrude frequently: rinse the wombs with lukewarm water, lay her on her back, mix pomegranate rind, gall-nut, and red sumach, grind together in white wine, smear this over the wombs and replace them; then give her to drink bay leaves in astringent wine. When a pregnant woman has flux, grind dry wild onion, red ochre, and the bone of a cuttlefish smooth, bind in a cloth, and apply as a suppository. 43 If she is not purged: grind elaterion — an Attic obol's weight — in white wine, about a kyathos of it, give to drink, and she will be purged.