‘Finally there are cases of children that are dead when they are born, how so unless they have also lived? For who are dead unless they have previously been alive? And yet, an infant is sometimes by an act of necessary cruelty destroyed when yet in the womb, when owing to an oblique presentation at birth delivery is made impossible and the child would cause the death of the mother unless it were doomed itself to die. And accordingly there is among the appliances of medical men an instrument by which the private parts are dilated with a priapiscus worked by a screw, and also a ring-knife whereby the limbs are cut off in the womb with judicious care, and a blunt hook by which the whole mass is extracted and a violent form of delivery in this way effected. There is also a bronze stylet with which a secret death is inflicted; they call it the ἐμβρυοσφάκτης (foeticide) from its use in infanticide, as being fatal to a living infant. Hippocrates had this (instrument), Asclepiades and Erasistratus, and of the ancients also Herophilus the anatomist, and Soranus, a man of gentler character. Who, being assured that a living thing had been conceived, mercifully judged that an unfortunate infant of this sort should be destroyed before birth to save it from being mangled alive.’
We have here apparently a different instrument from the embryotome, which we saw was a form of knife. This is a pointed spike-shaped instrument. It must have had much the shape of one of the huge bodkins in the Naples Museum ([Pl. LI, fig. 1]).
Apparatus for fumigating the Uterus and Vagina.
Fumigation formed an important part of the treatment of all varieties of disease of the uterus and vagina. The notion that the uterus was an animal within the body which could wander about on its own initiative and which was attracted by pleasant smells and repelled by disagreeable smells, was responsible for much of the treatment of gynaecological diseases by the ancients. To make a fumigation, Hippocrates directs us to take a vessel which holds about four gallons (δύο ἑκτέας), and fit a lid to it so that no vapour can escape from it. Pierce a hole in the lid, and into this aperture force a reed about a cubit in length so that the vapour cannot escape along the outside of the reed. The cover is then fixed on the vessel with clay. Dig a hole about two feet deep and sufficiently large to receive the vessel, and burn wood until the sides of the hole become very hot. After this remove the wood and larger pieces of charcoal which have most flame, but leave the ashes and cinders. When the vessel is placed in position, and the vapour begins to issue out, if it is too hot wait for some time; if, however, it be of the proper temperature the reed should be introduced into the uterine orifice and the fumigation made. Oribasius, quoting Antyllus (Coll. X. xix) varies the treatment somewhat by placing a vessel similarly prepared underneath an obstetrical chair, which had an opening in the seat, allowing a leaden pipe connected with the tube of the fumigating vessel to be passed into the vagina.
A fumigating apparatus of a more portable nature is mentioned by Soranus (xxiii) who tells us that Strato, a pupil of Erasistratus, used to place in a small vessel of silver or bronze, closed by a cover of tin, herbs of various kinds, and, having adjusted a small tube to the vessel, the mouth of the tube was placed in the vagina, and the vessel was then gently heated. Soranus admits that severe burning might follow this practice if unskilfully used.
Pessaries.
Greek, βάλανος, πεσσόν, πεσσός; Latin, pessum, pessus, pessulum.
Pessaries are frequently mentioned. They are usually bags filled with medicaments and not mechanical supports. However, in ii. 824, Hippocrates says that prolapse of the womb is to be reduced and the half of a pomegranate is to be introduced into the vagina. Soranus says that in prolapse Diocles was accustomed to introduce into the vagina a pomegranate soaked in vinegar. He also says that a large ball of wool may be introduced after reduction, and Aetius, Oribasius, and Paul copy him.
Hippocrates (iii. 331) says that in cases of fistula in ano, after the introduction of a medicated plug of lint, a pessary of horn is to be inserted (βάλανον ἐνθεὶς κερατίνην). This would appear to be partly to distend the rectum, but partly also most likely to carry medicament, like the leaden tubes full of medicaments which were inserted into the uterus.
A pessary of bronze was found in Pompeii ([Pl. LI, fig. 2]), and is described by Ceci. It is hollow and has a plate perforated with holes (evidently for stitching it on a band, to fix it round the body). Heister figures a similar instrument. It is impossible to say whether this specimen was intended for rectal or vaginal use.