John Riddle: Eve's Herbs: A History of Contraception and Abortion in the West Harvard University Press 1997

While it may well be that women over the centuries have had some kind of knowledge available to them for controlling fertility, ignored if not suppressed by 'high' medical culture, Professor Riddle does an interesting thesis severe disservice by overstatement, inaccuracies, and sweeping assumptions. I hesitate to count up the times phrases such as 'Probably did', 'could have', 'must have' appear in these pages. Admittedly it is hard to find evidence for something by definition excluded from the record. This, however, tends to lead Professor Riddle to place more weight on any 'hard' evidence he can come up with than it can comfortably bear.

Basic assumptions which seriously militate against the wholesale acceptance of this book's contentions are: that 'natural' fertility has been constant, rather than variable, during the centuries covered; that the level of sexual activity likely to result in conception has likewise been constant; and that 'males as a rule are less concerned about family size' (p.177). All somewhat dubious propositions. The natural rate of spontaneous abortion seems grossly underestimated and apparently conflated with stillbirth. Even today in Western societies enjoying reasonable health standards, nearly 25% of pregnancies are believed to end in miscarriage (some so early as only to be detectable by hormonal assay tests): a good deal more than the 10-20 per 1000 quoted (p. 179). And before the 1930s even doctors could not always tell whether a woman was actually pregnant prior to quickening. Riddle ignores broader contexts within which fertility decisions were made: there is no reference to Angus McLaren's superb History of Contraception from Antiquity to the Present Day (Oxford: Basil Blackwell 1990) which argued that in many epochs of history fertility has seemed inadequate and requiring encouragement, rather than overwhelming.

The case for the efficacy of classical prescriptions for fertility control would be stronger if some attention had been given to the effects of prescriptions for other conditions. It would have been interesting to see what was recommended for increasing fertility: did the same herbs figure? Infant mortality and infanticide seem to have been omitted in accounting for the relative smallness of families. Not being a classicist I hesitate to make any detailed critique of this section, except to wish for more sense of the conceptual framework of medical thought in antiquity; but was rather surprised to see (p.32) that Artemisia was named for the goddess of love!

The idea that the 'unfortunate and unholy marriage' of 'witchcraft, midwifery, and birth control' (p.110) underlay the suppression of witchcraft is not exactly novel, but probably no longer current among contemporary historians of early modern Europe. There seems a somewhat uncritical use of sources, with Margaret Murray (whose views on witchcraft are surely long discredited?) cited alongside respected modern scholars such as Alan MacFarlane and Lyndal Roper. Since Leslie Reagan's work on the linking of midwives and abortion in the Progressive Era (Bulletin of the History of Medicine, 1995, 69), a study of the attack on (mainly immigrant) midwives by the North American medical profession at a specific period for historically contingent motives, is cited to demonstrate an almost transhistorical association of midwife and abortionist, one wonders to what extent other studies have been selectively quoted.

It is also startling to read that (by implication during the Later Middle Ages) 'With the greater urbanization of Europe and the development of an industrial, commercialized society, people increasingly bought their... drugs from an apothecary' (p.123). Domestic medical practice even in a rapidly-commercializing society such as Britain persisted up to the early nineteenth century. Similarly questions of medical marketplace competition appear surprisingly early in the timescale: élite physicians were surely not drawing on the same patient constituency as wise-women. But there are several passages where the precise era discussed is far from clear.

Riddle tends to exaggerate the effectiveness of empirical reasoning and plays down 'irrational' beliefs. He suggests that 'if a woman ate something and subsequently had a miscarriage, she made an association between the two events'. However, connections were made between other events during pregnancy and its outcome, which are no longer accepted, e.g. the theory of maternal impressions. His anecdote about the geranium suggests that even its presence in the room is seen as dangerous to a pregnant women: this in the late twentieth century (p. 144-5).

Yes, there are interesting continuities of traditions concerning certain plants' effects, and remarkable evidence of the fragmentary persistence of knowledge over centuries, tantalising, evocative, suggestive. It is dubious, however, that these support the edifice here erected upon them.

Lesley A. Hall
Wellcome Institute for the History of Medicine

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