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Medicine and Anatomy

348. The dangerous first and sixth 40-day periods during pregnancy. (Hippocrates, On the Seventh-Month Child 3-4=VII 438-42 Littré. G)

The author shows some impatience for the women who do not seem to understand the logical medical explanation for miscarriages during the early stages and for still-births in the later stages of pregnancy.[1]

(3.1) At the age of seven months most foetuses, when the membranes relax, move to the yielding part of the body and get their nourishment there. There they spend the first forty-day period [after the move],[2] for better or for worse, because of the transition they have made from the places that had nourished them [previously], and because the umbilical cord is pulled and displaced, and because of the discomfort suffered by the mother. (3.2) When the membranes are stretched and the umbilical cord is pulled, it gives pain to the mother. The foetus, once released from its old binding, becomes heavier. Many women develop fevers when this happens, and others even die, along with their foetuses. All women agree on this point. For they say that during the eighth month[3] it is most difficult for them to carry their bellies, and they are correct. But this eighth month is not the only critical time; there are also the days that are added from the seventh month and the ninth month [to make up the 40-day period].

(3.3) But women do not talk about these [additional] days in the same way and do not know about them. They lose track because the period is not always the same, since sometimes a greater number of days from the seventh month are added to the forty-day period and sometimes from the ninth month. It all depends on when during the month and on the time of day that she happens to have conceived. The eighth month, however, is unambiguous, because this is the critical time, and the month is a unit among ten, so that it is easily remembered.

(4.1) You cannot disregard what women say about child-bearing. For they are talking about what they know and always inquiring about; they could not be persuaded either by deed or word that they do not know rather more [than you do] about what is happening in their own bodies. It is possible for those [doctors] who wish to say something different, but it is the women who make the judgments and who award the prize, and they always will inquire about this subject and will insist that they give birth to seventh-month and eighth-month and ninth-month and tenth-month and eleventh-month babies, and that the eighth-month babies do not survive, but the others do. (4.2) For they confirm that the majority of miscarriages occur in the first 40 days.[4]

When the membranes are broken in the seventh month, and the embryo descends, the discomfort begins that is said to arise around the time of eighth month and the sixth forty-day period. After that time has passed, in women for whom matters go well, the inflammation of the foetus and mother disappears, and the belly is softer. And the weight descends from the upper abdomen and the flanks to the lower region for its convenience in turning for birth. (4.3) During the seventh forty-day period, the foetus rests there for most of the time; there is a soft place for it, and its movements are easier and more frequent. Women carry their bellies in the last days of this forty-day period most easily until the foetus tries to turn. After this there are labour pains and discomfort until the mother is delivered of the child and the after-birth.


Notes:

1. Cf. Hanson, 1987; Garland, 41-4.

2. On the significance of the number 40, cf. Parker 1983, 48-9.

3. As usual in ancient texts, calculations are based on lunar months of 28 days; hence a normal birth would occur in the tenth month.

4. Cf. the third-century A.D. Roman writer Censorinus: 'In Greece they treat fortieth days as important. For the pregnant woman does not go out to a shrine before the fortieth day' (On Days of Birth 11.7). Cf. Parker 1983, 48.