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Hippocrates · On Superfetation §1-6

Mechanism of Superfetation and Management of Difficult Births

Passage 1 of 7 · Greek

Summary

This section explains the mechanisms of embryo development and expulsion in superfetation based on uterine positioning, and details manual interventions and vapor-bath treatments for difficult births and fetal deaths.

§1## ΠΕΡΙ ΕΠΙΚΥΗΣΙΟΣ. 1.
## ON SUPERFETATION 1.
Ὁκόταν ἐπικυΐσκηται γυνὴ, ἢν μὲν ἐν τῷ μέσῳ τῆς μήτρης τὸ πρῶτον ἔχῃ παιδίον, τὸ ἐπικύημα προσπίπτει ὑπὸ τοῦ ἀρχαίου ἐξωθεύμενον·
When a woman superfetates, if she has the first fetus in the middle of the uterus, the superfetated embryo falls out, being pushed out by the older one.
ἢν δὲ ἐν τῷ κέρατι τῷ ἑτέρῳ τὸ κύημα ἔχῃ, ἐπιτίκτει ὕστερον οὐ γόνιμον, ἐπὴν χαλάσῃ ἡ μήτρη καὶ ὑγρανθῇ, τοῦ γονίμου ἀπολυθεῖσα.
But if she has the fetus in one of the two horns, she later gives birth to a non-viable embryo, when the uterus relaxes and becomes moist, having been released from the viable one.
Ἢν δὲ μὴ αὐτίκα ἀποχωρέῃ τὸ ἐπικύημα, ὀδύνας τε παρέχει καὶ ῥεῦμα δυσῶδες καὶ πυρετὸν, καὶ οἰδεῖ τὸ πρόσωπον καὶ τὰς κνήμας καὶ τοὺς πόδας καὶ τὴν νηδὺν, καὶ ἀσιτέει ἕως ἂν ἐκπέσῃ.
If the superfetated embryo does not come away immediately, it causes pains, a foul-smelling discharge, and fever, and her face, shins, feet, and abdomen swell, and she loses her appetite until it falls out.
Ἐπικυΐσκονται δὲ τῶν γυναικῶν ὧν ἂν ὁ στόμαχος μετὰ τὸ πρῶτον κύημα ξυμμεμύκῃ οὐ κάρτα ἢ μὴ ἐπιφαινομένων τῶν σημηΐων ξυμμεμύκῃ.
Women superfetate whose cervix does not close very tightly after the first conception, or closes without the signs of pregnancy appearing.
Τὰ δὲ ἐπικυήματα τὰ ἐπιτικτόμενα ὕστερον, ἢν μήπω διάκρισιν ἔχῃ, ἀλλὰ σὰρξ ᾖ, οἰδέει μὲν οὒ, ἀλλὰ κατασήπεται μέχρι ἂν ἐξέλθῃ τῆς μήτρης.
As for the superfetated embryos born later, if they do not yet have differentiation but are just flesh, they do not swell but decay until they come out of the uterus.
§22.
2.
ᾟ τινι ἂν ἐκδύῃ τὸ παιδίον τοῦ χορίου ἐν τῇσι μήτρῃσι, πρὶν ἔξω ἄρχεσθαι χωρέειν τὸ παιδίον, δυστοκέει μᾶλλον καὶ ἐπικινδύνως, ἢν μὴ ἡ κεφαλὴ ἡγέηται.
In any woman where the child slips out of the chorion within the uterus, before the child begins to come outward, she experiences a more difficult and dangerous birth, unless the head leads.
ᾟ τινι δὲ ἂν χωρέῃ ἔξω σὺν τῷ χορίῳ τὸ παιδίον καὶ προχωρῆσαν ἐς τὸν στόμαχον ἐκδύῃ τοῦ χορίου ῥαγέντος, εὐτοκέει μᾶλλον· καὶ τὸ μὲν παιδίον θύρῃφι χωρέει· τὸ δὲ χόριον ἴσχεται καὶ ἀνασπᾷ ἑωυτὸ καὶ μένει αὐτοῦ.
But in any woman where the child comes out together with the chorion and, having advanced into the cervix, slips out of the ruptured chorion, she experiences an easier birth; and while the child comes out of the doors, the chorion is retained, draws itself up, and remains there.
§33.
3.
Ὁκόταν [οὐ] γόνιμον γένηται τὸ παιδίον, τουτέου ἡ σὰρξ ὑπερέχει τῶν ὀνύχων, οἱ δὲ ὄνυχες ἐλλείπουσι τῶν χειρῶν καὶ τῶν ποδῶν.
When the child is non-viable, its flesh extends beyond the nails, and the nails are deficient on the hands and feet.
§44.
4.
Ὁκόταν γονίμου γενομένου τοῦ παιδίου χεὶρ ὑπερέχῃ, πρῶτον ἀνωθέειν ὀπίσω μέχρις ἂν ἀπώσῃς· καὶ ἢν ἀμφότεραι, ἀμφοτέρας ἀνῶσαι· καὶ ἢν τὸ σκέλος ὑπερέχῃ, ἀνωθεῖν καὶ τοῦτο·
When, with the child being viable, a hand protrudes, first one must push it back until you have pushed it away; and if both, both must be pushed back; and if a leg protrudes, this too must be pushed back.
ὁκόταν δὲ ἀμφότερα τὰ σκέλεα προφανέντα μείνῃ καὶ μηδετέρωσε προχωρέῃ, πυριήματι δέον χρῆσθαι, ἀπὸ τεῦ ὑγροτάτη ἔσται ἡ ὑστέρη· ὀδμὴν δὲ ἐχέτω τὸ πυρίημα.
But when both legs appear and remain, and advance in neither direction, one must use a vapor bath, by which the uterus will become extremely moist; and let the vapor bath have an odor.
Καὶ ὁκόταν ἡ μὲν κεφαλὴ προφανῇ, τὸ δ’ ἄλλο σῶμα ἐνῇ, καὶ ὧδε πυριῇν·
And when the head appears but the rest of the body is inside, one must also apply a vapor bath in this way.
καὶ ὁκόταν τὸ μὲν ἐν τῇσι μήτρῃσι τοῦ σώματος ᾖ, τὸ δὲ ἐν τοῖσιν αἰδοίοισι, τὸ δὲ ἔξω τῶν αἰδοίων οἰδέῃ καὶ μείνῃ, καὶ οὕτως πυριῇν·
And when part of the body is in the uterus, and part in the vagina, and the part outside the vagina is swollen and remains there, one must also apply a vapor bath in this way.
καὶ ἢν μὲν ἀπὸ τῆς πυριήσιος ἀποχωρήσῃ· εἰ δὲ μὴ, περιαλείψας τὸ στόμα τῆς μήτρης ἐλατηρίῳ παχεῖ, διεὶς ὕδατι, ὅκως ὠδῖνα ἐμποιήσῃ· καὶ ἀπὸ τῶν ποτῶν καὶ ἐδεστῶν ὠδῖνα ἐμποιέειν· καὶ τὰ αἰδοῖα αὐτὰ ἀλείφειν κηρωτῇ, ἤν σοι δοκέῃ ξηροτέρη εἶναι τοῦ καιροῦ.
And if it comes away as a result of the vapor bath, well; but if not, smear the mouth of the uterus with thick elaterium dissolved in water, so as to induce labor pains; and induce labor pains also by means of drinks and foods; and smear the vagina itself with cerate, if it seems to you to be drier than proper for the occasion.
§55.
5.
Ὁκόταν τοῦ παιδίου τῆς κεφαλῆς προφανείσης ἐκ τοῦ στομάχου μηκέτι ἐθέλῃ τὸ ἄλλο σῶμα προχωρεῖν, τὸ δὲ παιδίον τεθνήκῃ, τοὺς δακτύλους βρέξας ὕδατι, μεταξὺ τοῦ στομάχου καὶ τῆς κεφαλῆς παραβύσας τὸν δάκτυλον, ἐν κύκλῳ περιάγειν· εἶθ’ ὑποβάλλων τὸν δάκτυλον ὑπὸ τὸ γένειον, διαβύσας ἐς τὸ στόμα, ἔξω ἕλκειν.
When, the child's head having appeared from the cervix, the rest of the body is no longer willing to advance, and the child is dead, having moistened your fingers with water, and having inserted your finger between the cervix and the head, pass it around in a circle; then, placing your finger under the chin, and pushing it into the mouth, draw it out.
§66.
6.
Ὁκόταν δὲ τὸ μὲν ἄλλο σῶμα θύρῃφι ᾖ τῶν αἰδοίων, ἡ δὲ κεφαλὴ εἴσω, ἐπὶ πόδας φερομένου τοῦ ἐμβρύου, ἐπὴν περιάγῃς τὸν δάκτυλον ἐν κύκλῳ, ἀμφοτέρας τὰς χεῖρας παρεὶς μεταξὺ τοῦ στομάχου καὶ τῆς κεφαλῆς, βρέξας ὕδατι, ἐξελκύσαι.
But when the rest of the body is outside the vagina, but the head is inside, the fetus being delivered by the feet, when you have passed your finger around in a circle, slip both hands, having moistened them with water, between the cervix and the head, and draw it out.
Ἢν δὲ τοῦ στομάχου ἔξω ᾖ, τῶν δὲ αἰδοίων εἴσω, παρεὶς τὰς χεῖρας, περιλαβὼν τὴν κεφαλὴν, ἐξέλκειν.
If it is outside the cervix but inside the vagina, slip your hands in, clasp the head, and draw it out.

Notes

  1. 1τοῦ γονίμου ἀπολυθεῖσα — The participle ἀπολυθεῖσα (aorist passive participle feminine nominative singular of ἀπολύω, 'to release') modifies the subject μήτρη (uterus). The genitive τοῦ γονίμου functions as a genitive of separation (ablative genitive), referring to the first, viable fetus.
  2. 1ὧν ἂν ὁ στόμαχος ... ξυμμεμύκῃ — The relative pronoun ὧν refers to the antecedent τῶν γυναικῶν, forming a general conditional relative clause with ἄν and the subjunctive ξυμμεμύκῃ (perfect subjunctive active third-person singular of συμμύω).
  3. 4ἀνωθέειν — The infinitives ἀνωθέειν, ἀνῶσαι, ὧδε πυριῇν, and ἐμποιέειν all function as infinitives of command, expressing practical medical instructions and procedures to the physician.
  4. 4ἀπὸ τεῦ — The Ionic genitive form τεῦ (equivalent to Attic τοῦ or τινός) is combined here with the preposition ἀπὸ, meaning 'by which' or 'from which.' It introduces a relative clause indicating the cause of the uterus becoming moist.
  5. 6τοῦ στομάχου ¦p.480¦ ἔξω ᾖ — The genitive τοῦ στομάχου is governed by the prepositional adverb ἔξω. It refers to being 'outside the cervix' (i.e., in the birth canal after passing through the uterine mouth).

Cite this passage

Hippocrates, On Superfetation §1-6. Humanitext Reader, https://reader.humanitext.ai/en/text/urn:cts:greekLit:tlg0627.tlg038.humanitext-grc1:1-6

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