The earliest medical writing from Egypt, the Kahun Medical Papyrus, dates from 1850 b.c.e. It includes three fragments of prescriptions designed to prevent pregnancy. All of them deal with suppositories. One provides for the feces of crocodile to be smashed up and mixed with fermented dough; another provides for honey mixed with soda or saltpeter; a third one with unreadable ingredients instructs to mash them up and mix them with fermented dough.
The crocodile feces recipe is difficult to explain, although its use might have kept the squeamish away, and dung from various animals is used in other ancient cultures. Certainly any sticky barrier might hinder the penetration of some sperm. But some substances might have encouraged contraception. For example, the pH of crocodile dung is 7.9, which makes it somewhat alkaline, and by lessening the vaginal acidity it increases the chance of pregnancy because the optimum conditions for pregnancy are pH 8.5 to 9.5 and the normative pH for the vagina is 3.86 to 4.45. It might be, however, that crocodile dung was used for religious reasons because the crocodile is associated with the Egyptian god Seth, who in turn is associated with hemorrhaging, miscarriage, and abortion.The other two prescriptions include soda or saltpeter, which besides serving as barrier methods might well change the pH level, but not as much as crocodile dung.
Other medical papyruses including the Ramesseum Papyrus (1784—1662 b.c.e.) also advise crocodile dung as a suppository. Quite different is the Ebers Medical Papyrus (1875 b.c.e.), which describes a mixture of acacia berries and colocynth mixed with honey to form a suppository that is placed in the vagina. When acacia is compounded, lactic anhydride is produced and lactic acid is often a component in modern contraceptive jellies. Colocynth is usually interpreted as being Citrullus colocynthis Schrad, which is known to have abortifacient properties and is still taken by modern Arabic women. Other prescriptions for abortifacients include the use of fumigants, salves, and drinks, as well as the suppositories. The earliest description of an oral contraceptive dates from 1300 b.c.e. in the Berlin Medical Papyrus and includes among other things celery seeds, oil, and sweet bear (Riddle, 1992).
The realization of the Egyptian medical writers that certain agents can prevent conception and cause an abortion emphasizes the antiquity of human efforts to prevent or destroy unwanted pregnancies. Although there is less surviving evidence from the Tigris-Euphrates valley, there are tantalizing references. A Sumerian tablet written earlier than the Kahun Medical Papyrus has a fragment of a recipe for a woman who wants to abort a fetus, but the instructions are lost. A cuneiform recipe from Assur advises inserting wool soaked in pomegranate juice in the uterus probably as a abortifacient or contraceptive.
Indirect evidence indicates that the Sumerians and their successors knew that certain diets, such as ergot-infected wheat, caused abortions. Ergot is a toxin derived from a fungus that grows on many plants including rye. Its growth is heavily influenced by climatic factors such as cold winters, and there are references in cuneiform texts of predictions of miscarriages based on climatic factors and predictions with a different set of weather conditions that women would carry their fetuses to full term.
A chief source of information about the attitudes of people in Mesopotamian civilization and their successors are the surviving law codes, some dating from 2110 b.c.e. These law codes give credence to John Riddle, a historian of contraception who argued that there is little indication that the people of either Egypt or the Tigris-Euphrates valley regarded the fetus as a human persona. Damaging a fetus was damaging a woman, and the rights to compensation belonged to the father, not the mother. Miscarriages caused by others required reimbursement to the husband of the woman. A late Assyrian law prescribed a penalty of impalement of a woman for procuring her own abortion and it is clear that what was being protected was the asserted right of the husband to receive a child he sired. In general, greater penalties existed for what might be called late-term abortions than for early ones.
In China, coitus interruptus was believed to strengthen the store of the male yang and ultimately lead to more male children. Although not done for contraceptive purposes, it probably had contraceptive value. Ancient Chinese believed that the key to a long life for males was preserving the yang that was lost through sexual intercourse. By using coitus interruptus, or withdrawal, the man could gain some of the woman’s yin (if she had orgasm) without losing his yang. Besides advocating coitus interruptus, the Taoists also advocated blocking the male urethra by pressing the point between the scrotum and anus and diverting the semen from the vas into the bladder instead of the urethra.
Intellectually and culturally the ancient Chinese were much more centralized than the other early civilizations. There was one polity and one elite culture and historical records were accumulated in a single language. The record of the past was conceived as that of a single people and the early availability of paper and the development of printing made literature much more subject to ideological control and more central to political and social concerns. The plethora of varied source materials available in either Egypt or Mesopotamia is therefore less evident in China. Because birth control and abortion were subjects not usually discussed in the official literature, we have less information on those subjects. One of the earliest references is in the historical annals Shi Chi, compiled by Ssu Ma Ch’ien (second century b.c.e.). He noted that a mythical founder of China, Shen Nung, adopted a policy of population control (Watson, 1961, Ssu-Mac Chien, ii, 188), but what that entailed is unclear.
The earliest references to actual methods date from the seventh century c.e. work of Sun Ssu-ma entitled Ch’ien chin fang (literally Thousand of Gold Prescriptions), which might describe the prescriptions and methods used as birth control or abortifacients or “menstrual regulators” earlier in China as well. One involves mixing oil and quicksilver (mercury) and taking it as a potion on an empty stomach. It was said to prevent pregnancy without harming the individual, a rather dubious claim. Another involves taking a mixture of barley gruel, and still another involves rape seeds. Obviously the Chinese from an early date were attempting to prevent pregnancy or have abortions.
Sex texts are plentiful in India but they do not always contain information on contraception or abortion.There is, however, considerable discussion of nonprocreative sexual activities such as oral-genital contacts, much more so than in the other cultural areas discussed. Some Tantric sects of Hinduism also practiced the coitus interruptus methods discussed in China as a means of avoiding conception, although this might not have been the motivating purpose of such procedures.
The Ananga Rama dates from the fifteenth century of the modern era but it includes recipes and concepts from earlier periods including several to make a woman sterile. The twelfth century Koka Shastra, compiled by Kakkoka, has a whole section devoted to abortifacients and contraceptives.There are many other similar collections. Norman Himes, in his summary of the various recipes, held that most were not particularly effective. However, as indicated in the article on herbal remedies, many might have been more effective than he realized. In addition to various concoctions taken orally, the Indians used vaginal fumigations and various kinds of obstructive devices including insertion into the vagina of honey and ghee (oil), rock salt dipped in oil, and tampons of ground ajowan seeds and rock salt with oil. The use of rock salt was a particularly effective spermicide (and could be used even today) because an eight percent solution kills sperm rapidly.
The difficulty with all the prescriptions is that some were effective and others were not and there was really no way for the ancients to determine which except by trial and error. Moreover, even if some were more effective than others, dosages also were important and these often remain unclear. We know that the ancient peoples wanted to control pregnancies or eliminate unwanted fetuses but they were not always successful.