The Hippocratic Oath, Abortion, and the U.S. Supreme Court

We are all familiar with Roe v. Wade and no matter what our feelings about abortion may be, we all agree that the consequences of that decision of the U.S. Supreme Court were serious. We assume that all judgments of such an august body are based on wisdom and evidence from many sources and from various backgrounds so that no single element has undue influence in the process; however, it comes as a shock to realize that one of the elements that supported Roe v. Wade was false: the interpretation of the Hippocratic Oath.

The official report of the opinion of the Court on Roe v. Wade reads as follows:

What then of the famous Oath that has stood so long as the ethical guide of the medical profession and that bears the name of the great Greek (c. 460-377 BC), who has been described as the Father of Medicine...who dominated the medical schools of his time, and who typified the sum of medical knowledge of the past? Why did not the authority of Hippocrates dissuade abortion practice in his time and that of Rome? The late Dr. Edelstein provides us with a theory: The Oath was not uncontested even in Hippocrates' days; only the Pythagorean school of philosophers frowned upon the related act of suicide. Most Greek thinkers, on the other hand, commended abortion, at least prior to viability. See Plato, Republic, V, 461; Aristotle, Politics, VII, 1335b, 25. For the Pythagoreans, however, it was a matter of dogma. For them the embryo was animated from the moment of conception, and abortion meant destruction of a living being. The abortion clause of the Oath, therefore, "echoes Pythagorean doctrines."...

Dr. Edelstein then concludes that the Oath originated in a group representing only a small segment of Greek opinion and that it certainly was not accepted by all ancient physicians. He points out that medical writings down to Galen (AD 130-200) "give evidence of the violation of almost every one of its injunctions. But with the end of antiquity a decided change took place. Resistance against suicide and abortion became common. The Oath came to be popular. The emerging teachings of Christianity were in agreement with Pythagorean ethic. The Oath "became the nucleus of medical ethics" and "was applauded as the embodiment of truth." Thus, suggests Dr. Edelstein, it is "a Pythagorean manifesto and not the expression of an absolute standard of medical conduct."

This, it seems to us, is a satisfactory and acceptable explanation of the Hippocratic Oath's apparent rigidity. It enables us to understand, in historical context, a long-accepted and revered statement of medical ethics.(1)

It is indeed sad that such an important decision as Roe v. Wade should have utilized Edelstein's assertions, which are flawed and invalid.

We have thoroughly discussed elsewhere the flaws of Edelstein's interpretation of the Hippocratic Oath as a Pythagorean manifesto.(2)

Concerning abortion, the Oath (as translated by Edelstein himself) says:

I will not give a woman an abortive remedy.

One of the arguments that Edelstein uses to show that the Oath represented a minority view, namely that of the Pythagoreans, is that, in antiquity, as he asserts, abortion was commonly accepted. The point, however, is just the contrary: in antiquity, abortion was not commonly accepted.

One can, of course, find ancient authors who considered abortion acceptable; it is not difficult, however, to find other authors supporting the opposite view. In fact, it can be shown that, in antiquity, far from being accepted by everybody, abortion was condemned by many.

Galen mentions that Lycurgus and Solon promulgated laws against abortion and asserts that their laws were based on the fact that the fetus is a living being.(3) Some historians believe (although the record is not clear) that in at least some parts of the Greek world there were laws against abortion.(4) Aristotle distinguishes abortion allowed and not allowed (to gar osion kai to me), the difference resting on whether the fetus is alive and sentient or not.(5)

In the Commentary of Sopater (4th century AD) there is reference to a work about abortion that may have been written by Lysias (c.460-c.370 BC):(6)

There are, in fact, medical and philosophical problems. A medical problem, for example, is the one that Lysias also considered: if he who caused a woman to abort committed homicide. First of all, it is necessary to know if, before the expulsion, [the fetus] was alive. This kind of thing is for physicians and natural philosophers [to decide]...(7)

Cicero (106-43 BC) describes with contempt a case of abortion motivated by greed:

Having taken the money and many gifts, overcome by greed, she sold the promise in her womb that was entrusted to her by the husband.(8)

He also reports a case that occurred in Miletus:

I remember a case...how a certain woman of Miletus, who had accepted a bribe from the alternative heirs and procured her own abortion by drugs, was condemned to death: and rightly, for she had cheated the father of his hopes, his name of continuity, his family of its support, his house of an heir, and the Republic of a citizen-to-be.(9)

Juvenal (early 2nd century AD) decries abortion as the murder of human beings within the womb:

So great is the skill and so powerful the drugs of the abortionist who murders human beings within the womb.(10)

Ovid, not known for puritanical principles concerning sexual mores, laments the practice of abortion:

Ah, women, why will you thrust and pierce with the instrument [literally: why do you dig with shafts at your vitals from below] and give dire poisons to your children yet unborn?...This neither the tigress has done in jungles of Armenia, nor has lioness had the heart to destroy her unborn young; yet tender woman does it - but not unpunished; oft she who slays her own in her bosom dies herself. She dies herself, and is borne to the pyre with hair unloosened, and all who behold cry out: "'Tis her desert."(11)

The passage is of particular interest because it underlines that it was not only Ovid himself who condemned abortion but "all who behold," that is, the people who are present at the cremation as well.

Seneca wrote with pride about his own mother:

...never, as it was common among other women...did you hide, almost as it were an indecent burden, the tumescent uterus, nor did you tear out from your viscera the conceived hopes of children...(12)

The most important evidence against general acceptance of abortion, however, is given by Soranus (98-138 AD). The greatest of the ancient gynecologists, in fact, clearly states that some physicians opposed abortion in all cases because "it is the specific task of medicine to guard and preserve what has been engendered by nature," and that even those who were not opposed to it had ethical qualms and would allow it only to preserve the health of the mother:

But [concerning abortion] a controversy has arisen. For one party banishes abortives, citing the testi-mony of Hippocrates who says: "I will give no one an abortive;"(13) moreover, it is the specific task of medicine to guard and preserve what has been engendered by nature. The other party prescribes abortives, but with discrimination, that is, they do not prescribe them when a person wishes to destroy the embryo because of adultery or out of consideration for youthful beauty; but only to prevent subsequent danger in parturition...And they say the same about contraceptives as well, and we too agree with them.(14)

Obviously Soranus, while recognizing the necessity of performing abortion to protect the health of the mother, acknowledges the moral problem by asserting that it is to be condemned if performed for trivial reasons.(15) For our purpose, it is of interest that he indicates that there were two factions among physicians and that one of the two felt that abortion had to be rejected in all cases.(16)

Scribonius Largus, a Roman physician who lived in the first half of the 1st century AD, states:

Hippocrates, founder of our profession, to inspire human feelings in the minds of the students, began his instruction with an oath in which it was decreed that no abortifacient be given or revealed to a pregnant woman by any physician.(17)

It is of interest that Scribonius Largus felt that the Oath was written "to inspire human feelings in the mind of the students," that is, that it was an ethical code for the physician.

Finally, in the entire Corpus Hippocraticum, there is but one prescription for aborting a healthy fetus. The case concerned a danseuse (owned by a procuress who was a relative of the author) who allegedly was pregnant for six days. The author of the Hippocratic treatise advised the girl to expel the "seed" by leaping so that the heels touched the buttocks, the so-called Lacedaemonian leap.(18)

The inconsistency between the Oath and the prescribing of the Lacedaemonian leap is easily explained. First of all, as it was written by many authors, the Hippocratic Corpus does not show uniformity in all points. It could very well be that the author of On the Nature of the Child had no objections to abortion. Second, it must be remembered that, in antiquity, at least by some, the Lacedaemonian leap was not considered a means to induce abortion but an "expulsive" maneuver:

And an "expulsive" some say is synonymous with an abortive; others, however, say that there is a difference because an expulsive does not mean drugs but shaking and leaping...For this reason they say that Hippocrates, although prohibiting abortives, yet in his book "On the Nature of the Child" employs leaping with the heels to the buttocks for the sake of expulsion.(19)

In any case, it must be underlined that, besides the Leap, all other prescriptions in the Hippocratic Corpus for emptying the pregnant uterus are for the expulsion of a dead, paralyzed or half-developed fetus, in other words, for the termination of an irreparably compromised pregnancy.(20)

As for the two passages from Aristotle and Plato mentioned by the Supreme Court, namely Plato, Republic, V, 461; Aristotle, Politics, VII, 1335b, 25 (see above), they do not commend abortion at all as stated by the Supreme Court report. Plato's passage says that abortion should be induced on fetuses conceived against the laws of his utopian republic, and Aristotle makes it clear that abortion can be procured before sense and life have begun but that it would be otherwise unlawful. There is nothing, in the two passages, that suggests that the two authors "commended abortion."

It would appear that, in classical times, there were those who did not object to abortion, others who felt it to be justified only in certain circumstances, others who were against it in all cases. In other words, there was a body of opinion, unrelated to Pythagorean philosophy, that condemned abortion,(21) and we believe that the Hippocratic Oath reflected this point of view.(22) This being the case, the Pythagoreans do not need to be called into the picture.

Homosexuality in Ancient Greece and the Denver District Court

Ancient history and behavior were also considered by another court, this time concerned with homosexuality.

The Denver District Court, on the 14th of December 1993, passed judgment on Evans v. Romer, generally called the Colorado amendment 2 Case. The case concerned a constitutional amendment on the status of homosexuals. We are not going to discuss here the case itself but we will mention that, once again, the Court considered, before passing judgment, the question of the degree of acceptance of a specific practice (in this case homosexuality) in ancient Greece. The court received contradictory statements from the experts(23) and therefore did not mention Greek homosexuality in the final ruling although its judgment suggests that it may have accepted as true the myth that homosexuality was common practice in ancient Greece, where, allegedly, it was considered normal behavior. In reality, things were different.

In discussing Greek male homosexuality(24) we must begin by clarifying certain basic points: first of all, homosexual relations between adult males, if not "virtually unknown in Greek homosexuality,"(25) were not particularly common and certainly not accepted by society;(26) in fact, the Greeks had no nouns corresponding to "a homosexual" or "a heterosexual."(27) The question of Greek male homosexuality is therefore limited to that particular relation that was often established between a boy and an adult male and that was, if sexual, pederasty(28) or, if not, an educational experience (the adult being an example to emulate) or an initiation ritual.

In our discussion of the main evidence concerning the nature of the adult-boy relation we will use the terms "protector" and "protégé," which, although not devoid of possible sexual meaning, do not have as definite a sexual meaning as erastes and eromenos,(29) which have been commonly used.(30) There is no question that pederasty was practiced in ancient Greece, but the picture is far from that being a society where such an activity was approved and pursued as a matter of course. For example, laws against pederasty are mentioned by several authors (e.g., Plato,(31) Lysias,(32)); the most important document about these laws, however, is Aeschines' Against Timarchus, which was composed in 346 BC.

An Athenian politician, Timarchus, was prosecuted under a law that provided that a citizen who had prostituted himself to another male (that is to say, who had accepted compensation in return for homosexual use of his body) could not participate in political life. Aeschines' Against Timarchus consists in the principal speech of the prosecution; it is of particular interest for our inquiry because it is chiefly concerned with homosexual relations and practices in contemporary Athens.

The law invoked by the prosecution debarred any citizen who had prostituted his body to another male from the exercise of civil rights because "the man who has made traffic of the shame of his own body...would be ready to sell the common interests of the city also."(33) The text of the law is as follows:

If any Athenian shall have prostituted his body, he shall not be permitted to become one of the nine archons, nor to discharge the office of priest, nor to act as an advocate for the state, nor shall he hold any office whatsoever, at home or abroad, whether filled by lot or by election; he shall not take part in debate, nor be present at the public sacrifices; when the citizens are wearing garlands, he shall wear none; and he shall not enter within the limits of the place that has been purified for the assembling of the people. If any man who has been convicted of prostitution act contrary to these prohibitions, he shall be put to death.(34)

Pederasty was also specifically forbidden and harshly punished, not only if practiced with a free-born but with a slave as well:(35)

If any Athenian shall outrage a free-born child, the parent or guardian of the child shall prosecute him before the Thesmothetae, and shall demand a specific penalty. If the court condemn the accused to death, he shall be delivered to the constables and put to death the same day. If he be condemned to pay a fine, and be unable to pay the fine immediately, he must pay within eleven days after the trial, and he shall remain in prison until payment is made. The same action shall hold against those who abuse the persons of slaves.(36)

It is also mentioned that "the lawgiver imposes the heaviest penalties if any person act as pander in the case of a free-born child or a free-born woman"(37) and that "he commands that procurers, men and women, be indicted, and if they are convicted, be punished by death."(38)

A distinction was made, in terms of degree of societal rejection, between having one or more partners, and the passive partner in a pederastic relation was considered with contempt:

Now, fellow citizens, if Timarchus here had remained with Misgolas and never gone to another man's house, his conduct would have been more decent --- if really any such conduct is "decent" --- and I should not have ventured to bring any other charge against him than that which the lawgiver describes in plain words, simply that he was a kept man...But if...I refresh your memories and show that he is guilty of selling his person not only in Misgolas' house, but in the house of another man also, and again of another, and that from this last he went to still another, surely you will no longer look upon him as one who has merely been a kept man, but...as a common prostitute.(39)

Several other passages in Against Timarchus refer to the fact that homosexual acts were considered shameful and illegal;(40) in addition, in section 195, it is underlined that pederasty was considered harmful (in the moral sense) for the people of Athens:

And as for the hunters of such young men...command them to turn their attentions to the foreigners and the resident aliens, that they may still indulge their predilection, but without injuring you [the people of Athens].(41)

Demosthenes, who defended Timarchus, suggested that the accused could not have prostituted himself, since his name was not recorded among those (male and female) who had to pay the tax on prostitution.(42) Aeschines retorts that the activity of Timarchus was common knowledge, and, therefore, such a defense should not be considered valid.(43) When the prosecutor realizes that he himself may be accused of having had relations with boys, he acknowledges them but distinguishes between dikaios ("legitimate," "honest," "law-abiding") love and erotic love between protector and protégé, and even reinterprets the story of Harmodius and Aristogiton(44) in the light of chaste love:

And just here I understand he [the defense] is going to carry the war into my territory, and ask me if I am not ashamed on my own part, after having made a nuisance of myself in the gymnasia and having been many times a lover [erastes] now to be bringing the practice into reproach and danger. And finally...he says he is going to exhibit all the erotic poems I have ever addressed to one person or another, and he promises to call witnesses to certain quarrels and pummeling in which I have been involved in consequence of this habit.

Now for me, I neither find fault with love that is honorable [dikaios]...I do not deny that I myself have been a lover [erotikos] and am a lover to this day, nor do I deny that the jealousies and quarrels that commonly arise from the practice have happened in my case. As to the poems which they say I have composed, some I acknowledge, but as to the others I deny that they are of the character that these people will impute to them, for they will tamper with them.

The distinction which I draw is this: to be in love with those who are beautiful and chaste is the experience of a kind-hearted and generous soul; but to hire for money and to indulge in licentiousness is the act of a man who is wanton and ill-bred. And whereas it is an honor to be the object of a pure love, I declare that he who has played the prostitute by inducement of wages is disgraced. How wide indeed is the distinction between these two acts and how great the difference, I will try to show you...the free man...[is] not forbidden to love a boy, and associate with him, and follow after him, nor did the lawgiver think that harm came to the boy thereby, but rather that such a thing was a testimony to his chastity...And so it was that those benefactors of the state, Harmodius and Aristogiton, men pre-eminent for their virtues, were so nurtured by the chaste and lawful love - or call it by some other name than love if you like - and so disciplined, that when we hear men praising what they did, we feel that words are inadequate to the eulogy of their deeds.(45)

He also underlines that heterosexuality is natural and homosexuality is unnatural:

Now, when your ancestors distinguished so firmly between shameful and honorable conduct, will you acquit Timarchus, when he is guilty of the most shameful practices? Timarchus, who is a man and male in body, has committed a woman's transgression (lit., "error"). Who among you will then punish a woman caught in wrongdoing? Will it not deserve a charge of insensitivity, to deal harshly with her who transgressed according to nature, yet listen to the advice (in council or assembly) of him who has outraged himself contrary to nature?(46)

Although the laws against it constitute the most important evidence indicating that pederasty was neither accepted nor condoned in Athenian society, other evidence is found in the writings of several authors. Plato and Aristotle, in some passages, indicate that they considered homosexuality as being against nature:

Whether these matters are to be regarded as sport, or as earnest, we must not forget that this pleasure [that is, sexual pleasure] is held to have been granted by nature to male and female when conjoined for the work of procreation; the crime of male with male, or female with female, is an outrage on nature and a capital surrender to lust of pleasure.(47)

Besides those things however which are naturally pleasant...there are other things, not naturally pleasant, which become pleasant either as a result of arrested development or from habit, or in some cases owing to natural depravity...Other morbid propensities are acquired by habit, for instance...sexual perversion. These practices result in some cases from natural disposition, and in others from habit, as with those who have been abused from childhood.(48)

In the Pseudo-Aristotle of the Problems we find a description of the alleged physical abnormalities responsible for the condition:

Why do some men enjoy sexual intercourse when they play an active part and some when they do not? It is because for each waste product there is a place into which it naturally secretes...just in the same way semen passes into the testicles and privates. In those whose passages are not in a natural condition, but either because those leading to the testicles are blocked...or for some other reasons, such moisture flows into the fundament...the semen collects in these parts, so that, when desire comes, then that part desires friction in which it is collected...But the naturally effeminate are so circumstanced that little or no secretion occurs in the place in which it occurs with normal persons, but it is secreted in this region [i.e., the fundament]. The reason is that such persons are unnaturally constituted [para physin sunestasin]; for though they are male this part of them has become maimed.(49)

In Polybius we find:

Agathocles in his early youth was a common prostitute, ready to yield himself to the most debauched, a jackdaw, a buzzard [lit., "very lecherous"], who would right about face to anyone who wished it [lit., "place his behind in front of anyone who wanted it"].(50)

And Aristophanes says:

He never was found in the exercise-ground, corrupting the boys: he never complied With the suit of some dissolute knave, who loathed that the vigilant lash of the bard should chide His vile effeminate boylove.(51)

Although we have discussed so far only the evidence that in ancient Greece homosexuality was condemned, as we have mentioned above there is as much evidence, however, that it was also practiced, sung by poets, and celebrated by artists (for a review of this evidence, not discussed here for reasons of space, see Chapter I in the second volume of my History of Medicine(52) and the paper presented at the International Congress of History of Medicine in Spain in 1992.(53)

All this seems indeed contradictory: on one hand, in Greece, pederasty was considered illegal, shameful and against nature; on the other, it would seem that it was commonly practiced, seen as normal, and declaimed in prose and poetry. To evaluate it, it is necessary to assess the background against which the protector-protégé relation developed and to examine the relation in detail.

The speech of the prosecutor in Against Timarchus is of particular interest because, as he won the case, his points against pederasty must have been commonly accepted by the average man, that is, by the jurors. On the other hand, the evidence that pederasty was quite commonly practiced and was considered normal behavior, at least by many, is overwhelming. The number and variety of documents describing it and approving of it is too large to be disregarded or considered the unimportant expression of the feelings of few. In addition, in the ancient world, it was widely believed that pederastic love was characteristic of the Greeks.(54)

The picture that emerges is the following: if we define male homosexuality as the disposition to seek pleasure by sexual relations between adult males, then it was neither more common nor more accepted in Greece than in, let's say, Victorian England; on the other hand, if we consider pederasty (a form of homosexuality defined as the disposition, on the part of a man, to seek pleasure by sexual intercourse with a boy as the passive partner), then the picture changes. The evidence suggests that, most likely, it was practiced much more frequently than in our time and, as mentioned above, was considered, by many, normal behavior.

The picture, however, of Greek society as a milieu where pederasty was the rule more than the exception and where its social acceptance was total(55) appears to be inaccurate. In ancient Greece pederasty was probably considered more or less as adultery is in our contemporary society: it is generally condemned but not only does it exists, it is not exactly a rarity. In the U.S., in many states, adultery is still an illegal activity,(56) as pederasty was illegal in ancient Greece, but the law is not usually enforced. This divergence between law and practice is well illustrated by Plato:

Were one to follow the guidance of nature and adopt the law of the old days before Laius --- I mean, to pronounce it wrong that male should have to do carnally with youthful male as with female --- and to fetch his evidence from the life of animals, pointing out that male does not touch male in this way because the action is unnatural, his contention would surely be a telling one, yet it would be quite at variance with the practice of your societies.(57)

Also, to continue the parallel, just as in our time adultery is usually ignored unless it is expedient to expose it (e.g., to damage the political career of a public figure) in ancient Greece pederastic activities were exposed for political or judicial advantage (e.g., in Against Timarchus).

Other characteristics of Greek pederasty were:

a) Although not all relations between protector and protégé were sexual (see the speech of Aeschines above), to assert, as some have done, that as a rule there was no sexual intimacy between the two(58) is to distort the evidence.

b) The average Athenian condemned pederasty (as shown by the trial of Timarchus) and it is probable that the activity was characteristic of the upper class.(59) This is supported by the passage of Plato's Symposium in which, referring to the boys who had been involved in pederastic relations, the author states that "on reaching maturity these alone prove in a public career to be men."(60) If indeed pederasty was more common in the upper class, as the documents that have reached us were written by members of that class, we may have a somewhat distorted picture of its frequency and acceptance.

There is no question, therefore, that in ancient Greece pederasty was practiced and to a certain extent tolerated but it was not commonly accepted as a normal activity, as is often claimed.

How abortion and homosexuality were considered in antiquity had probably no great impact on the judgments of the courts in the cases just mentioned. We find it very disturbing, however, that flawed scholarship in medical history and ethics is used to influence the judgment of our courts, including the U.S. Supreme Court.

References/Notes

1. Roe v. Wade, 410 U.S. 113, 130-132, 1973.
2. Prioreschi P. The hippocratic oath: a code for physicians, not a Pythagorean manifesto. Medical Hypotheses, XLIV, 447-462, 1995. See also: Prioreschi P. The hippocratic oath: a code for physicians, not a Pythagorean manifesto. Proceedings of the 34th International Congress of History of Medicine, Glasgow, Scotland. GB, 4-8 September 1994, pp. 99-115.
3. Galen, An animal sit quod in utero geritur, v, K XIX, p. 179-180. The work is of uncertain authenticity.
4. For a discussion on this subject, see: Moïssidés, "Contribution à l'Étude de l'avortement dans l'antiquité grecque." Janus, XXVI, 58-85, 1922.
5. Aristotle. Politics, VII, xiv, 1335b, 24-26. In Generation of Animals, it is stated that the fetus is alive and that it acquires the "sentient Soul" during its development (see: Aristotle. Generation of Animals, II, iii, 736a-b).
6. Whether the passage can be attributed to Lysias is debatable, but the text is nevertheless of interest because it suggests (together with other references to the existence of such a document by Lysias) that, in Lysias' time, there were discussions about abortion. For a review of the pertinent literature on this passage see: Enzo Nardi. Procurato aborto nel mondo greco romano, Milano, Giuffrè, 1971, pp. 82-116.
7. Quoted by Enzo Nardi, Procurato aborto nel mondo greco romano, Milano, Giuffrè, 1971, pp. 86-87. Translation by P. Prioreschi.
8. Cicero. Pro Cluentio, XII. "Quo illa pretio accepto multisque praeterea muneribus...spem illam, quam in alvo commendatam a viro continebat, victa avaritia...vendidit." Translation by P. Prioreschi. The condemnation could be considered as due to the betrayal of the husband's trust more than to the abortion itself, but, by calling the fetus "spem" (that is, hope, prospect, promise of future achievements), Cicero seems to indicate condemnation of abortion per se. For a discussion about the designation of the baby to be born as "spes," see: Enzo Nardi, Procurato aborto nel mondo greco romano, Milano, Giuffrè, 1971, pp. 354-360.
9. Cicero. Pro Cluentio, XI. Translation of H. Grose Hodge, The Loeb Classical Library, London, William Heinemann, 1927.
10. Juvenal. Saturae, VI, 595-597. "Tantum artes huius, tantum medicamina possum, / quae steriles facit atque homines in ventre necandos / conducit." Translation by P. Prioreschi.
11.Ovid. Amores, II, xiv, 27-28, 35-40. Translation by Grant Showerman, The Loeb Classical Library, London, William Heinemann, 1921.
12. "...numquam more aliarum...tumescentem uterum abscondisti quasi indecens onus, nec intra viscera tua conceptas spes liberorum elisisti..." Seneca. Dialogues, Ad Helvetiam matrem de consolatione, III, xvi, 3. Quoted by: Enzo Nardi, Procurato ahorto nel mondo greco romano, Milano, Giuffrè, 1971, p. 247. Translation by P. Prioreschi.
13. The Hippocratic Oath reads, literally: "I shall not give a woman an abortive pessary."
14. Soranus. Gynecology, XIX, 60. Translated by Owsei Temkin with the assistance of Nicholsons J. Eastman, Ludwig Edelstein, and Alan F. Guttmacher, Baltimore, The Johns Hopkins University Press, 1956, p. 63.
15. Discussing the characteristics of the good midwife, he says: "She must not be greedy for money, lest she give an abortive wickedly for payment" (Soranus. Gynecology, I, ii, 4. Translated by Owsei Temkin with the assistance of Nicholsons J. Eastman, Ludwig Edelstein, and Alan F. Guttmacher, Baltimore, The Johns Hopkins University Press, 1956, p. 7).
16. Curiously enough, Edelstein reads in this passage that Soranus "had little patience with these colleagues of his," that is, with those who rejected abortion under all circumstances, and that "he resorted to abortion whenever it seemed necessary, much as he deprecated it if performed for no other reason than the wish to preserve beauty or to hide the consequence of adultery" (L. Edelstein, "The Hippocratic Oath: Text, Translation and Interpretation," in: Ancient Medicine: Selected Papers of Ludwig Edelstein, edited by O. Temkin and C.L. Temkin, Baltimore, The Johns Hopkins Press, 1967, p. 14). It is evident that, in this passage, Soranus neither shows "little patience" with those condemning abortion, nor shows evidence that "he resorted to abortion whenever it seemed necessary, much as he deprecated...etc." What he says is that abortion should not be performed except when the safety of the mother requires it. The condemnation in other cases is clear.
17. "Hippocrates, conditor nostrae professionis, initia disciplinae ab iureurando tradidit, in quo sanctum est, ne praegnanti quidem medicamentum, quo conceptum excutitur, aut detur aut demonstretur a quoquam medico, longe praeformans animos discentium ad humanitatem." Quoted in W. H. S. Jones, The Doctor's Oath. An Essay in the History of Medicine, Cambridge, Cambridge University Press, 1924, p. 39. Translation by P. Prioreschi.
18. On the Nature of the Child, XIII, Littré, VII, p. 490. For a discussion of this case see: Plinio Prioreschi, "Quandoque bonus dormitat Hippocrates: Induced abortion and embryos' age in the Hippocratic Corpus," Acta Belgica Historiae Medicinae, V, 4, 181-184, 1992.
19. Soranus. Gynecology, I, xix, 60. Translated by Owsei Temkin with the assistance of Nicholsons J. Eastman, Ludwig Edelstein, and Alan F. Guttmacher, Baltimore, The Johns Hopkins University Press, 1956, p. 62. Undoubtedly, to us the Lacedaemonian leap seems to be a prescription for abortion.
20. For a discussion of this topic, see: Enzo Nardi, Procurato ahorto nel mondo greco romano, Milan, Giuffrè, 1978, pp. 72-82.
21. For the position of other ancient authors on the question of abortion, see: Enzo Nardi, Procurato aborto nel mondo greco romano, Milano, Giuffrè, 1971, passim.
22. It has been suggested that, in reality, the Hippocratic Oath does not prohibit abortion but only pesson phtorion, that is "toxic (or damaging, or abortive) pessary" presumably because of the ulcerations that they may have caused (John M. Riddle, "Oral Contraceptives and Early-term Abortifacients during Classical Antiquity and the Middle Ages," Past and Present, No 132, 3-32, August 1991). In this context, however, it is quite evident that phtorion means abortive and it has been so interpreted since antiquity (see, for example, the quotation from Scribonius Largus).
23. For a discussion of the controversy among experts in this case and as an indication of the extent to which scholarship seems to have lost the objectivity that it enjoyed in the past, see: John Finnis, "'Shameless Acts,' in Colorado, Abuse of Scholarship in Constitutional Cases," Academic Questions, VII, iv, 10-41, 1994.
24. We use the term homosexuality as meaning the preference for persons of the same sex as sexual partners.
25. Dover KJ. Greek Homosexuality. London, Duckworth & Co., 1978, p. 16. See also: Bernard Sergent, L'homosexualité initiatique dans l'Europe ancienne, Paris, Payot, 1986, p. 109.
26. Cohen D. Law, Sexuality, and Society The enforcement of morals in classical Athens, Cambridge, Cambridge University Press, 1991, p. 175.
27. Dover, op. cit., p. I (footnote 1).
28. By pederasty we mean a homosexual relation between a man and a boy, the latter being the passive partner, involving various acts which could include intercrural sex and anal penetration.
29. The Greek word paiderastes means "lover of boys" and is derived from pais, "boy," and erastes, "lover"; hence the use of erastes ("lover") and eromenos (the masculine passive participle of eran --- "to be in love with...", "have a desire for..." --- hence "the one being loved") to indicate, respectively, the active (man) and the passive (boy) in the pederastic relation.
30. See, for example, George Devereux, "Greek Pseudo-homosexuality and the 'Greek Miracle,' " Symbolae Osloenses, XLII, 69-92, 1967; Thorkil Vanggaard, Phallos: A Symbol and its History in the Male World, London, Jonathan Cape, 1972; K. J. Dover, Greek Homosexuality, London, Duckworth & Co., 1978; Bernard Sergent, L'homosexualité initiatique dans l'Europe ancienne, Paris, Payot, 1986; Harald Patzer, Die griechische Knabeliebe, Wiesbaden, Franz Steiner Verlag, 1982.
31. Plato. Laws, VIII, 836c.
32. Lysias. On the Murder of Eratosthenes, 32.
33. Aeschines. Against Timarchus, 29-30. Translation of Charles Darwin Adams, The Loeb Classical Library, 1919.
34. Ibid., p. 21.
35. The protection of slaves from sexual abuse was undoubtedly wishful thinking on the part of the legislator. It is difficult to see how, in a slave society, sexual abuse of slaves could be prevented by legislation. It is of interest, however, that it is often assumed that such legislation did not exist. Cohen, for example says "A man might do whatever he wished with a slave boy or foreigner; this was not the law's concern. Sons of citizen families, however, were felt to require the law's protection to help ensure their sexual integrity." See: David Cohen, Law, Sexuality, and Society: The enforcement of moruls in classical Athens, Cambridge, Cambridge University Press, 1991, p. 182.
36. Aeschines, op. cit., p.16.
37. Ibid., p. 14.
38. Ibid., p. 184
39. Ibid., p. 51-52.
40. Ibid., pp. 3, 19-20, 32, 40, 73, 89.
41. Ibid., p. 195.
42. Ibid., p. 119.
43. Ibid., p. 128-130.
44. Hipparchus, brother of the tyrant Hippias, wanted to become the lover of Harmodius who was loved by Aristogiton (Thucydides, History of the Peloponnesian War, VI, lvi-lix). The two lovers conspired to kill both Hipparchus and Hippias but succeeded in killing only Hipparchus (514 B.C.) losing their life in the attempt. When Hippias was expelled in 511/10 B.C., Harmodius and Aristogiton became popular heroes.
45. Aeschines, op. cit., pp. 135-137, 139, 140.
46. Aeschines, Against Timarchus, 185. Translation by K. J. Dover, in K. J. Dover, Greek Homosexuality, London, Duckworth & Co., 1978, p. 60.
47. Plato. Laws, 636c. Translation by A. E. Taylor in: The Collected Dialogues of Plato, edited by Edith Hamilton and Huntington Cairns, Princeton, Princeton University Press, 1963. The same passage is translated by R. G. Bury (Loeb Classical Library) as follows: "Whether one makes the observation in earnest or in jest, one certainly should not fail to observe that when male unites with female for procreation the pleasure experienced is held to be due to nature, but contrary to nature when male mates with male or female with female, and that those first guilty of such enormities were impelled by their slavery to pleasure."
48. Aristotle. Nicomachean Ethics, VII, v, 1-3. Translation by H. Rackham, The Loeb Classical Library, 1939. The Greek text ton aphrodision tois arresin, translated by Rackham as "sexual perversion," literally means "sexual pleasure with males."
49. Aristotle. Problems, IV, 26 (879b). Translation by W. S. Hett, Loeb Classical Library, 1953.
50. Polybius. The Histories, XII, 15, 1-3. Translation by W. R. Paton, The Loeb Classical Library, 1925.
51. Aristophanes. The Wasps, 1024-1027. Translated by Benjamin Bickley Rogers, The Loeb Classical Library, 1924.
52. Prioreschi P. A History of Medicine, Vol. II, Greek Medicine, Omaha, Horatius Press, 1996.
53. Prioreschi P. and Brehm E. Male homosexuality in ancient Greece, Proceedings of the XXXIIIrd International Congress of History of Medicine, Granada, Spain, September 1992, pp. 1137-1158.
54. Cicero. Tusculan Disputations, IV, xxxiii, 70. The Vulgate (II Maccabees, IV, 12) says: "...et optimos quosque ephoeborum in lupanaribus ponere," that is, "...and to put the noblest young men in brothels."
55. This was the position, for example ,of Siegerist. See: Henry E. Siegerist, A History of Medicine, Oxford, Oxford University Press, 2 vols., 1951, 1961, II, pp. 219-221.
56. Green R. Giswold's legacy: fornication and adultery as crimes. Ohio Northern University Law Review, XVI, 545 -549, 1989.
57. Plato. Laws, VIII, 836c. Translation by A. E. Taylor, in: The Collected Dialogues of Plato, edited by Edith Hamilton and Huntington Cairns, Princeton, Princeton University Press, 1963.
58. J. A. K. Thomson (Greeks and Barbarians, London, George Allen & Unwin Ltd., and New York, The Macmillan Company, 1921, pp. 174, 175, 176) states that pederasty was chiefly a Dorian vice practiced in Athens by a tiny minority among the upper classes, and that the association of older and younger friends was a noble thing. He then adds: "that it sometimes sank in the mire is no more than can be said of modern love."
59. Sergent B. L'homosexualité initiatique dans l'Europe ancienne, Paris, Payot, 1986, p. 102.
60. Plato. Symposium, 192a. Translation by W. R. M. Lamb, The Loeb Classical Library, 1932.

Dr. Prioreschi is a Professor of Pharmacology and an Assistant Professor of Medicine at Creighton University in Omaha, Nebraska, and the author of History of Medicine (Omaha, Nebraska, Horatius Press, 1995.) His address is Creighton University, School of Medicine, Department of Pharmacology, Division of History of Medicine, California Plaza, Omaha, NE 68178-0001.

Originally published in the Medical Sentinel 1997;2(2):54-60. Copyright ©1997 Association of American Physicians and Surgeons.