Regulating Menstruation: Beliefs, Practices, Interpretations

by Etienne van de Walle (Editor), Elisha P. Renne (Editor)

Overview

Menstruation, seen alternately as something negative—a "curse" or a failed conception—or as a positive part of the reproductive process to be celebrated as evidence of fertility, has long been a universal concern. How women interpret and react to menstruation and its absence reflects their individual needs both historically as well as in the contemporary cultural, social, economic, and political context in which they live. This unique volume considers what is known of women's options and practices used to regulate menstruation—practices used to control the periodicity, quantity, color, and even consistency of menses—in different places and times, while revealing the ambiguity that those practices present.

Originating from an Internet conference held in February 1998, this volume contains fourteen papers that have been revised and updated to cover everything from the impact of the birth control pill to contemporary views on reproduction to the pharmacological properties of various herbal substances, reflecting the historical, contemporary, and anthropological perspectives of this timely and complex issue.

Product Details

ISBN-13:	9780226847443
Publisher:	University of Chicago Press
Publication date:	06/01/2001
Edition description:	1
Pages:	296
Product dimensions:	6.00(w) x 9.00(h) x 0.90(d)

About the Author

Etienne van de Walle is a professor of demography and a member of the Population Studies Center at the University of Pennsylvania. He coedited Mortality and Society in Sub-Saharan Africa.

Elisha P. Renne is an assistant professor in the Department of Anthropology and Center for Afroamerican and African Studies at the University of Michigan and author of Cloth That Does Not Die: The Meaning of Cloth in Bunu Social Life.


Etienne van de Walle is a professor of demography and a member of the Population Studies Center at the University of Pennsylvania. He coedited Mortality and Society in Sub-Saharan Africa.

Elisha P. Renne is an assistant professor in the Department of Anthropology and Center for Afroamerican and African Studies at the University of Michigan and author of Cloth That Does Not Die: The Meaning of Cloth in Bunu Social Life.

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Regulating Menstruation: Beliefs, Practices, Interpretations

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By Elisha P. Renne

University of Chicago Press

Copyright © 2001 Elisha P. Renne
All right reserved.
ISBN: 0226847446

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CHAPTER 1 - Menstrual Catharsis and the Greek Physician

Etienne van de Walle

Life is short, science is long; opportunity is elusive, experiment is dangerous, judgment is difficult.

--Hippocrates, Aphorisms

The corpus of Greek scientific writings, transmitted across more than two millennia, represents a singular intellectual achievement based on the accumulation and interpretation of empirical knowledge. The works of Greek physicians reflect a logical approach to disease and health, and often include the description of cases supporting it. Physicians carefully jotted down the medical history of individual patients, describing symptoms and the day-to-day course of the malady. Botanical and pharmacological lore was collected from folk traditions and organized. These ideas, transmitted through Roman and Arabic writers, exerted an enormous influence on successive generations of physicians even to our days, and still hold sway in much of the world. One topic of this volume, menstrual stimulation, owes much to the humoral theories of Hippocrates and Galen, and to the list of materia medica compiled by Dioscorides.

Because it was largely transmitted through written texts, patientlyhand copied and jealously preserved in centers of learning, the core message of the Greek tradition remained remarkably close to the original through the centuries. But inevitably, the content was interpreted and adapted. Translations and commentaries were made available to the practitioners of medicine and pharmacy. And the exact meaning of the originals (for example, the identification of Mediterranean plants for the use of British apothecaries) became the object of speculation. New diseases and new cures were traced back to the urtexts through mental gymnastics. When Renaissance physicians were confronted with the great pox in 1496, they scrutinized Galen and Hippocrates to identify its symptoms in their descriptions: it seemed impossible that this was a new disease, unknown to the Greeks (Arrizabalaga, Henderson, and French 1997:70-84).

Overinterpretations of the Greek texts still exist in present-day discussions of contraception and abortion. Some classicists and historians have seen allusions where probably none existed, as if birth control were a part of the daily life of the Greeks, and commonly alluded to in lay writings. The Greek physicians provided many recipes for gynecological problems ranging from suppressed menses to the retention of a dead fetus or of the placenta, and modern writers have tended to interpret many of those recipes as abortifacients. A historian of pharmacology, John R. Riddle (1992; 1997), has examined in two books the role of plant substances in regulating fertility in antiquity. My own interest owes much to Riddle's studies (van de Walle 1997). Since much of the present chapter is devoted to a work attributed to Hippocrates-- Diseases of Women (fifth century B.C.)--I will say immediately that I disagree with Riddle's reading on what he interprets as abortive recipes in this work. His interest was pharmacological, and he focused on the recipes rather than on the context in which they were given. He did not ask whether the author had sound reasons, based on his interpretation of the workings of the female body, to recommend these herbal products, nor what effect he intended them to have. He believed that they reflected an old tradition of esoteric female lore, transmitted by male writers without true understanding (Riddle 1992:81).

Diseases of Women is the longest and most systematic exposition of gynecological issues to appear before the academic textbooks of the late nineteenth century. It is difficult to accept that it represents the work of bumbling amateurs who did not understand what they were copying down, and were unknowingly recording widely applied folk recipes. In this chapter I will examine the context in which Greek physicians recommended menstrual stimulants. I start by considering a particular claim that pennyroyal, a mint commonly found throughout Europe, was widely known as an abortifacient, and openly alluded to by classical Greek writers.

THE CASE OF PENNYROYAL

There is mention of pennyroyal in Peace, a play by Aristophanes produced in Athens in 421 B.C., at the time of the Peloponnesian War. In the play, Trygaeus has flown on a huge dung beetle to the home of the gods. There he convinces Hermes to release Peace, who has two attendants, Oporas (bizarrely translated in the Loeb edition as Harvesthome), the goddess of fruits and agricultural abundance, and Theorias (translated as Mayfair), the goddess of festivities. To clinch the deal, Hermes gives Oporas in marriage to Trygaeus. The Loeb translation renders the next exchange as follows:

TRYGAEUS: But, Hermes, won't it hurt me if I make Too free with fruits of Harvesthome at first?

HERMES : Not if you add a dose of pennyroyal.

(Rogers 1972, 2:65)

The verb translated here as "make free with fruits of" (katelauno, literally, "to drive down") could be an obscene reference to the sex act. In fact this is the meaning adopted in another translation of Peace (The Athenian Society 1931, 1:195):

TRYGAEUS: Tell me, Hermes, my master, do you think it would hurt me to . . . her a little, after so long an abstinence?

Riddle believes that pennyroyal constitutes an allusion to contraception and abortion. Similarly, Scarborough (1991:145) maintains that Aristophanes is emphasizing "the well-known fact that pennyroyal quaffed in solution prevented pregnancies." Is Trygaeus perhaps afraid of having too many children in his marriage? On the contrary, it would be rather strange, and counter to the spirit of the play, that Trygaeus would want to restrain the fertility of his bride after the great loss of life caused by the Peloponnesian War. When the wedding is celebrated at the end of the play, the Chorus celebrates the return of abundance:

And that every field may its harvest yield,

And our garners shine with the corn and wine,

While our figs in plenty and peace we eat,

And our wives are blest with an increase sweet . . . (Rogers 1972:121)

The Loeb translation greatly embellishes the original, which consists of short and simple verses. The last verse quoted here simply says: "and our wives to bear [children]" [tas te gunaikas tiktein emin]. In any case, a contraceptive allusion would make little sense. Trygaeus is the person who is advised to take pennyroyal, after the act. It would make sense in the context if the advice were to take pennyroyal as a restorative after debilitating sex.

By what authority is pennyroyal considered a widely used contraceptive? According to Scarborough (1991:45), the mention of pennyroyal in the Homeric Hymn to Demeter confers it" quasi-mythical associations with the functions of birthing and nursing the newborn"; and "pennyroyal's reputation as a female contraceptive and abortifacient is verified in the Hippocratic writers, Dioscorides, and Galen." Pennyroyal entered into the composition of the kykeon, or drink given to new initiates, in the mysteries of the cult of Demeter at Eleusis. The modern editor of the Hymn to Demeter discounts, however, "ulterior motives for its use at Eleusis" (e.g., as an aphrodisiac) and notes that "it was in fact believed to cure a wide range of ailments, in ancient times (burning thirst, fainting, headaches, coughs, indigestion, fevers, nervous troubles, etc.)" (Richardson 1974:344). Kere´nyi (1967:179-80) discusses at length the role of pennyroyal in the kykeon, citing one opinion about possible hallucinatory properties; he does not mention any connection with fertility. Dioscorides says, as he does for some 80 other plants, that "being drank [pennyroyal] expelleth ye menstrua, & ye seconds [i.e., the placenta], & ye Embrya"; there is no suggestion of contraception, and "ye Embrya" may refer to spontaneous fetal deaths. Scarborough (1991:168) gives one reference to a Hippocratic treatise, Nature of Woman, paragraph 32, "among many refs." The paragraph is a long enumeration of recipes, mostly of potions and pessaries to restore the menstrual flow or evacuate the placenta (Hippocrates 1962, 8:347). More than 100 plants and substances are mentioned in the section, and pennyroyal is cited once in a recipe toward the end, without special emphasis, as one component among many.

Other recipes in Nature of Woman, and in the other Hippocratic treatise that covers the same ground, Diseases of Women, give no special importance to pennyroyal. It enters in the composition of a small number of potions and pessaries, but never in a contraceptive context. Its first mention in Nature of Woman (p. 17) is in a pessary for women who suffer a hysteric fit. The author comments that the best remedy would be to become pregnant, or, for a young girl, to take a husband. As elsewhere, pennyroyal seems more of a fertility enhancer than a limiter. On page 93 of Diseases of Women, it is recommended for women in case of postpartum problems, just before sleeping with their husband, to promote conception. On page 157, it enters into the preparation of an emmenagogic pessary. On page 165, for a woman who has had children and cannot conceive again, the treatise advises: "apply dry pennyroyal in a linen; the woman will drink pennyroyal at the time of going to sleep." A pennyroyal soup cooked with flour and a light decoction of pennyroyal in wine are part of another 7-day treatment to conceive (167). Dried pennyroyal, mixed with honey and applied in wool, enters in the composition of a peireterion ("fecundity test," described later) on page 179. However, pennyroyal is also part of an injection to expel a dead embryo on pages 191 and 195. The quotes from Galen are equally unconvincing. One appears in a treatise on venesection, where a number of plant substances are offered as an alternative to bloodletting in cases of a plethora of blood.

Why then was pennyroyal well known to the Athenian public attending the plays of Aristophanes? It is a striking plant, with a distinctive smell, and a reputation as something of a cure-all. It was used as an insect repellent, as the Latin ( pulegium, from pulex, "flee") and French ( pouliot evokes pou, "louse") names suggest; Pliny (1969, 6:91) says that the flowers of pennyroyal were burned to kill fleas. The author of the first treatise on botany, Theophrastus (fifth century B.C.), who does not attribute any particular property to the plant, mentions it in the description of other plants: for example, he notes that dittany looks like pennyroyal. Pennyroyal was a condiment, as attested by its popular English name of pudding grass. St. Jerome wrote that among Indians, it was more valuable than pepper. Hildegarde of Bingen had only good things to say about it, particularly as a medicine for the eyes. For the great English botanists of the seventeenth century, Gerard and Culpeper, it had pro-fertility properties. In the nineteenth century, it appears to have had a reputation as a mild emmenagogue. A concentrated extract, pennyroyal oil has caused deaths among women who used it as an abortifacient, and this may account for its bad name, applied retrospectively by modern-day exegetes to the time of Aristophanes.

The example of pennyroyal suggests that it is risky to see birth control everywhere in the texts of antiquity. It also reveals, however, the existence of a vast medical and botanical literature referring to potions and pessaries for gynecological uses. I now turn to these uses.

Diseases of Women

The Treatise

The Hippocratic treatises date mostly to the fourth or fifth centuries B.C. Although Hippocrates is a historical figure, the works attributed to him were probably written by several physicians over an extended period. Dean-Jones (1994) collectively designates the authors of the treatises as "the Hippocratics." The corpus includes more than 50 treatises, and several deal with reproduction, gynecology, and obstetrics. Foremost among these are two treatises, Nature of Woman and Diseases of Women. On linguistic grounds, they appear to be among the oldest works in the corpus, and to date to the fifth century B.C. (Dean-Jones 1994:10). I will refer to the translation of these texts by Emile Littre´, the French lexicographer who edited the Hippocratic corpus in the nineteenth century (Hippocrates 1962).

The treatises illustrate the sophistication of physicians of the time, and the use of feminine verbal forms suggests that they reflect at least in part the practices of midwives. In one of Plato's dialogues, Theaetetus, Socrates, whose mother was a midwife, asks, "Is it not true that the midwives give pharmakia and incantations to stimulate the labor pains, to facilitate a difficult delivery, or to abort the fetus if it seems necessary to abort it? [ambliskein]" (Nardi 1971:56-57). Nevertheless, incantations and pharmakia, a word that has given us pharmacy but suggests magic in many contexts, are completely absent from the Hippocratic treatises (Thivel 1975). Dean-Jones (1994:7) comments that "the Hippocratics were among the first Greek scientists to try to make close observation rather than abstract reasoning the foundation of their theories." The procedures described do not invoke the divinity or mysterious forces, but are entirely rational, supported by the detailed description of cases, and based on the logic of the humoral theory. Indeed, the knowledge is clearly that of learned physicians, not a collection of folk wisdom based on experiences passed from mothers to daughters. In a telling passage from Diseases of Women, the author denies his reliance on a female culture that would have presided over gynecology:

Among women who do not know the source of their pain, the disease often becomes incurable before the physician has been informed by the patient on the origin of her ailment. Indeed, out of modesty, they do not talk even when they know; inexperience and ignorance make them consider it shameful for them. (Hippocrates 1962, 8:127)

The organizing principle of Nature of Woman is hard to fathom. It presents a series of diagnoses and remedies for a variety of feminine conditions. As the same ground is covered in Diseases of Women in a more detailed and logical fashion, I will focus on that work, and particularly on book 1, the part devoted to the birthing process.

The traditional Greek title of the work, Gynaikeioon, means literally "Of Women's Things," but the author specifies in the very first sentence that he will discuss the diseases of women. The tone of the work is unabashedly pro-natalist; the author repeatedly indicates which conditions will result in temporary or permanent sterility, or what should be done in order to conceive. He also points out that childless women are especially vulnerable to certain diseases (for example, p. 126), and that marriage or pregnancy are the natural cures for many ailments: "there are more accidents suppressing the menstrual flow among women who have never been pregnant" (13). There is no recognition that repeated pregnancies present a health hazard, and many preparations to enhance the chances of conception are described. One isolated recipe (involving misy, probably a copper oxide, p. 170) is given for a contraceptive (atokion), but arguably none for abortifacients, although Littre´ sometimes translates ekbolion, literally "expulsive," as abortifacient.

The treatise on Diseases of Women includes three separate books-- perhaps different treatises by a common author--collected under a common title by Littre´. Book 1 is a long (the Greek text occupies 111 pages in the Littre´ edition) and systematic discourse on the nature and treatment of potential complications in the childbearing process. The second book (86 pages) discusses various pathologies that are not directly connected with childbearing, such as bloody spotting or displacements of the matrix; and the third book (62 pages) is entirely devoted to the nature and causes of sterility in women.

The first part of book 1 consists of a description of pathologies, while the second is a pharmacological appendix of corresponding recipes for treatment (see table 1.1). For instance, paragraphs 1 through 9 in the text, which address various menstrual problems, correlate with paragraph 74 in the appendix, which describes emmenagogic pessaries. There are occasional deviations from this general layout, as one would expect from a work that has been copied many times; for example, an occasional recipe is interpolated in the section on pathology, as is the case for paragraphs 23 and 31, which seem out of place. In addition, the organization of the work is obvious in the beginning, but by the end, both the main text and the appendix consist of short paragraphs in apparently random sequence. After paragraph 92, the text is altogether unrelated to diseases of women.



Continues...

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Table of Contents

Preface
Introduction: Elisha P. Renne and Etienne van de Walle
Concepts and Definitions: Stefania Siedlecky
PART 1: HISTORICAL AND CONTEMPORARY STUDIES IN THE WEST
1. Menstrual Catharsis and the Greek Physician
Etienne van de Walle
2. Colds, Worms, and Hysteria: Menstrual Regulation in Eighteenth-Century America
Susan E. Klepp
3. Menstrual Intervention in the Nineteenth-Century United States
Janet Farrell Brodie
4. Emmenagogues and Abortifacients in the Twentieth Century: An Issue of Ambiguity
Gigi Santow
5. Pharmacological Properties of Emmenagogues: A Biomedical View
Stefania Siedlecky
6. Demography, Amenorrhea, and Fertility
Ina Warriner
7. Menstrual Regulation and the Pill
Linda S. Potter
PART 2: ANTHROPOLOGICAL PERSPECTIVES: AFRICA, SOUTHEAST ASIA, AND LATIN AMERICA
8. The Meaning of Menstrual Management in a High-Fertility Society: Guinea, West Africa
Elise Levin
9. The Blood That Links: Menstrual Regulation among the Bamana of Mali
Sangeetha Madhavan and Aisse Diarra
10. "Cleaning the Inside" and the Regulation of Menstruation in Southwestern Nigeria
Elisha P. Renne
11. Means, Motives, and Menses: Uses of Herbal Emmenagogues in Indonesia
Terence H. Hull and Valerie J. Hull
12. Regulating Menstruation in Matlab, Bangladesh: Women’s Practices and Perspectives
Heidi Bart Johnston
13. Bloodmakers Made of Blood: Quechua Ethnophysiology of Menstruation
Patricia J. Hammer
14. Midwives and Menstrual Regulation: A Guatemalan Case Study
Sheila Cosminsky
Contributors
Index

Recipe

Historical and anthropological studies of the practices of women use to affect their menses have largely failed to consider their perceptions of menstruation and their intentions over the course of time. Do women view their period as something negative—a "curse," or a failed conception—or as something to be celebrated because it signals either that they are not pregnant, or that they remain fecund? This unique volume considers women's attitudes toward their menses and the ambiguities inherent in regulating them. Covering a wide range of topics from the impact of herbal substances to current views of reproduction and the Pill, this multidisciplinary work by historians, anthropologists, demographers, and health specialists sheds new light on the culture of reproduction.