Contraception

John T. Noonan Jr.

• Publisher: Belknap Press
• Year: 2012
• ISBN:
  9780674070271
• Topic: Theology & Religion
• Subtopic: Christian Denominations

Originally published in 1965, Contraception received unanimous acclaim from all quarters as the first thorough, scholarly, objective analysis of Catholic doctrine on birth control. More than ever this subject is of acute concern to a world facing serious population problems, and the author has written an important new appendix examining the development of and debates over the doctrine in the past twenty years. John T. Noonan, Jr., traces the Church's position from its earliest foundations to the present, and analyzes the conflicts and personal decisions that have affected the theologians' teachings on the subject.

PART ONE

SHAPING OF THE DOCTRINE 50–450

CHAPTER I

CONTRACEPTION IN THE ROMAN EMPIRE

Unlike many acts on which moral judgment has been passed, contraception requires a knowledge of technique. Even the most elementary contraceptive behavior calls for the possession of some biological information; mechanical methods rest on some awareness of physiology; chemical preparations demand a further mastery of pharmacology. If these kinds of technical knowledge were nonexistent, there would be no acts of contraception for moralists to judge. The effectiveness of existing technique, and the distinction between it and means used to control birth by producing abortions, are also germane to the moral evaluation, as are the extent of the diffusion of the practice, and the motives of those who employ it. The judgments made by Christians on contraception in the first four centuries can be understood only if the existence, effect, and use of contraceptive technique in the Roman Empire are appraised.

The existence of contraceptive technique in the pre-Christian Mediterranean world is well established. The oldest surviving documents are from Egypt. Five different papyri, all dating from between 1900 and 1100 B.C., provide recipes for contraceptive preparations to be used in the vulva. The Kahun Papyrus has three different formulas: pulverized crocodile dung in fermented mucilage; honey and sodium carbonate to be sprinkled in the vulva; and a substance, whose name is now undecipherable, to be mixed with mucilage and sprinkled in the vulva. In the Ebers Papyrus it is said that pregnancy may be prevented for “one, two, or three years” by a recipe of acacia tips, coloquintida, and dates, mixed with honey, to be placed in the uterus. The Ramasseum Papyrus IV reports that to prevent pregnancy crocodile dung should be placed on moistened fibers in the opening of the uterus. A recipe to prevent pregnancy given in the Berlin Papyrus is fumigation of the uterus with the seed of a particular grain. In the Carlsberg Papyrus the contents of the recipe are lacking, but the contraceptive purport of a formula is evident.¹

These prescriptions, aimed at blocking or killing the male semen, were rational ways of attempting contraception. Some of the substances mentioned, like coloquintida and sodium carbonate, appear in contraceptive prescriptions in much later European literature. It is not unreasonable to suppose that some form of this ancient lore was in existence in early Christian times. But the Greek and Roman writers do not use the unsystematized Egyptian material directly.² The papyri are relevant here only in revealing a culture where contraception was already a matter of medical technique. The desire to prevent pregnancy by artificial means will be found even more characteristic of the society the Christians knew.

THE KNOWLEDGE AVAILABLE

JEWISH INFORMATION

The practice of coitus interruptus, intercourse followed by withdrawal and semination outside the vagina, is close to being a self-evident method of contraception. Its early practice among the Hebrews is testified to by Genesis 38:8–10, the story of Onan. The prevalence of this simple method in the world the early Christians were familiar with is suggested by several references in the Babylonian version of the Talmud that go back to at least the first century of the Christian era.³ In Yebamoth (“Sisters-in-Law”) 34b the Gemara refers to the practice during the first twenty-four months of lactation; the act is described euphemistically as “threshing inside and winnowing outside.” The text is third century or later; the statement is attributed to the first-century Rabbi Eliezer. In Niddah (“The Menstruant”) 13a there is a quotation of Rabbi Johanan ben Nappaha, the founder of a school at Tiberias in the third century, on the deadly sin of Onan, and the sin here is clearly his contraceptive act.

Pessaries are spoken of several times. In Yebamoth 35a, Rabbi Jose is said by the third-century Babylonian, Rabbah, to believe that a harlot will use an absorbent to prevent conception. Rabbi Abaye suggests that a proselyte to Israel will also take contraceptive steps, so that she can be sure that her child is born after she has been received. Similarly, he indicates, a slave about to be freed will not want to conceive before her freedom. A parallel passage in Kethuboth (“Marriage Contracts”) 37a implies that a captured woman will use a contraceptive to prevent conception before she is sure of her future status. It is not definitely said that the proselyte, the slave, and the captive will, like the harlot, use “absorbents,” though this may be implied. Abaye himself comments simply that “a woman playing the harlot turns over to prevent conception,” that is, attempts to expel the semen by postcoital exercise. An absorbent of flax or hackled wool is also mentioned in the fourth-century Gemara on Niddah 45a, and its use as a pessary is indicated. Niddah 3a, in passing, refers to a discussion by Shammai, a rabbi of the second century B.C., of the problem of determining the time when menstruation begins for a woman using a contraceptive absorbent which soaks up the menstrual flow. Sterilization of some sort was also known: the Talmud mentions women who have been “split,” in a context which does not explain the operation but indicates a sterilizing effect (Yebamoth 17a).

Another type of contraceptive measure referred to by the Talmud is “root potions.” This is mentioned in Shabbath (“Sabbaths”) 110a–110b, not as a contraceptive but as a cure for jaundice; it is incidentally noted that two thirds of a cup of this mixed with beer will sterilize, apparently permanently. The cup of roots is described by Rabbi Johanan ben Nappaha as a mixture of Alexandrian gum, liquid alum, and garden crocus. A smaller dosage of the same potion mixed with wine is said to have a fertilizing effect on a menstruant. Yebamoth 65b, in an express discussion of the moral duty of procreation, tells the story of Judith, the wife of Rabbi Hiyya (circa A.D. 330), who, troubled by difficulty in bearing twins, took a potion that made her sterile permanently. The Tosefta, a fifth-century compilation independent of the Talmud, refers to a “cup of roots” which, drunk, will make a man or woman sterile (Yebamoth 8:4).⁴

In short, the means of contraception known to the Jewish communities included not only coitus interruptus, but postcoital ejection, occlusive pessaries, sterilizing potions, and sterilizing surgery. The pessaries and potions seem to be of later date than coitus interruptus, and may reflect Hellenistic influence and the diaspora’s encounter with the pagan world. Probably the effectiveness of these methods varied widely. Coitus interruptus was a sure means of contraception if the withdrawal was duly effected; the pessaries and the surgery could have worked; postcoital ejection had a chance of success.

The potions are the most difficult to evaluate. As they are a type of contraceptive which constantly recurs in this history, I will summarize here what can be guessed today as to their effectiveness. In the course of history over a hundred different plants have been reported to contain substances affecting human fertility. Reports of such plants come from every continent in the world. Some sixty of them have been identified, and tentative estimates made of their contraceptive properties. Some of the plants appear to have properties effecting temporary sterility, and would be true contraceptives. Others are abortifacients, disturbing implantation or gestation, although in some cases, taken in smaller amounts, these abortifacients might only affect conception.⁵ The most successful instance of experimental tests of a “root potion” have been performed on a desert plant, Lithospermum ruderale, used by the Shoshone Indians of Nevada as a contraceptive. “Most investigations support the view that some orally active material is present in Lithospermum which causes a reduction of reproductive capacity.”⁶ Other tests in 1955 of the seed of the legume Psoralea corylifolia have shown it to have antifertility effects when used in the diet of adult female mice. Polygonum hydropiper, when administered as a dry powdered whole plant, temporarily impaired the fertility of male and female mice and produced sterility in female guinea pigs, apparently through effect on the gonadotropic functions of the pituitary.⁷

These experiments, of course, tell us nothing about the contraceptives so often described in the literature here investigated as “root potions,” “herb potions,” or merely “potions.” But the experiments do show that contraception is possible by means of distilled or crushed plants. Without being able to determine accurately whether the potions used by a given society were effective, we can say that the use of plant potions to affect fertility was a rational method of trying to achieve temporary sterility.

GRECO-ROMAN INFORMATION

Turning from papyri preserved by chance and references interspersed in the moral argumentation of the rabbis, we may now consider certain works of a professedly technical character, which deal with contraception as a matter of scientific interest. These works are of two general kinds: books on the phenomena of nature, and books explicitly concentrating on medical topics. In the first group are two rather different books: Aristotle’s History of Animals, and Pliny’s Natural History. The first established Aristotle’s reputation as an observer of biological phenomena, and from the fourth century B.C. until the seventeenth century was a highly regarded scientific work. The other, by Pliny the Elder (A.D. 23–79), contained a great garnering from other works, popular superstition, and the writer’s own experience. It was the Roman world’s best approximation to an encyclopedia of science.

In the second group, composed of books intended to impart medical information, the earliest are The Nature of Women and Diseases of Women. Both are anonymous products of what is conventionally designated as the school of Hippocrates, in the fifth century B.C.⁸ A much later Greek authority is the Materia medica of Dioscorides of Cilicia, a collection of pharmaceutical information from earlier Greek sources, made about A.D. 75. Much of it is paralleled by Pliny.⁹ Of far greater importance is the Gynecology of Soranos of Ephesus. Soranos, who practiced medicine in Rome between A.D. 98 and 138, was a physician with an excellent knowledge of past medical theories, and the most judicious authority on childbearing in the Roman epoch.¹⁰ Gynecology is the principal fount of contraceptive information for the Empire, for the Arabs, and, through the Arabs, for medieval Europe. Later works are substantially dependent on Soranos and Dioscorides. Among them are the Books for Eunapius of Oribasios, and Medicine, by Aëtios of Amida.¹¹ These books exhibit the persistence of contraceptive information in the later Empire. Oribasios was a well-known doctor in mid-fourth-century Constantinople. Aëtios was the court physician of the Emperor Justinian (527–565) and a count of the Empire.

Potions are the first form of contraceptive mentioned by any of the classical writers, and the type most often mentioned. In the Hippocratic writings a potion is the only contraceptive described. It is a drink of misy, which could mean either a plant called a truffle or copper from Cyprus; the plant would seem more likely to have been effective, but later writers appear to understand the word as “copper.” It is clearly distinguished from an abortifacient. It is also clearly intended to achieve only temporary sterility: it is said to be effective for one year (The Nature of Women 93; cf. Diseases of Women 1.102).

The first-century writers on pharmacology are familiar with a variety of contraceptive potions. Dioscorides lists the following: willow leaves in water (Materia medica 1.135);¹² the leaves of barrenwort (Epimedium alpinum), finely ground and taken in wine after menstruation (4.19); the roots of the brake, a fern (4.184); ostracite, a kind of clay, to be drunk for four days after menstruation (5.164). Besides these varieties, there are two whose use seems to have been suggested by an association of ideas between a sterile metal and sterility: iron rust and iron slag (5.93, 94). All of these potions are apparently intended as temporary sterilizers. Of the mixture based on leaves of barrenwort, Dioscorides says explicitly that it will work only for five days. There are potions which apparently will sterilize completely: barrenwort taken plain (4.19); asparagus (2.151); the bark of white poplar taken with the kidney of a mule (1.109); rennet of hare drunk for three days after menstruation (2.21). Pliny, interested though he is in pharmacopoeia, gives only one prescription for a contraceptive potion, and that cautiously: a drink of rue, which is also an abortifacient, is “said to impede generation” if boiled with rose oil and an ounce of aloes (Natural History 20.51.142–143).

Soranos deals with potions under the heading, “Ought One to Make Use of Abortifacients and Contraceptives, and How?” (Gynecology 1.19.60–63). He is far more selective than Dioscorides, admitting only three types: a mixture of panax sap, rue seed, and Cyrenaic sap coated with wax and drunk in wine; a mixture in wine of wallflower seed, myrtle, myrrh, and white pepper, to be drunk for three days; rocket seed and cow parsnip mixed in oxymel. He warns that “these medicines”—apparently designating thereby the several potions just described—“not only impede conception, but also destroy what is already conceived.” He adds that they also cause a heavy head, indigestion, and vomiting.

Oribasios gives variants of the fern root and willow leaf potions in Dioscorides and adds another recipe of cabbage blossoms in wine. These drinks are to be taken after coitus (Books for Eunapius 4.114). The prescription of postcoital use suggests an intention to have the drinks work either as contraceptives or as abortifacients. Aëtios repeats the Cyrenaic sap potion of Soranos. Moreover, Cyrenaic sap in water and wine, drunk once a month, will prevent conception and cause menstruation. He recommends copper water in which iron has been extinguished, possibly because of his understanding of Hippocratic misy; it is to be used by women, especially after menstruation. A mixture of aloes, stock seed, ginger, pepper, and saffron drunk after menstruation is also effective. Other plant potions ar...

Table of contents

• Cover
• Title Page
• Copyright
• Acknowledgments
• Contents
• Dedication
• Abbreviations
• Introduction
• Part One: Shaping of the Doctrine 50–450
• Part Two: The Condemnation Ingrained 450–1450
• Part Three: Innovation and Preservation 1450–1750
• Part Four: Development and Controversy 1750–1965
• Appendix: Natural Law, the Teaching of the Church, and the Regulation of the Rhythm of Human Fecundity
• Index