I have neglected this blog for a long time, owing to my deteriorating health since last autumn. This experience, albeit very unpleasant, has led me to see ancient women’s sufferings in a new light: having perhaps internalised misogynistic prejudice in my own research, I never quite got genuinely interested in ancient gynaecology, although I teach the subject regularly, with some success. It is a dissertation topic of choice for Finalists.
When diagnosed with a large uterine fibroid in November 2017, I didn’t think much of it. I was exhausted and bleeding horribly, but as a benign tumour of the womb I thought it would be quickly treated and sorted. I did not realise then that I was embarking on a long journey of suffering: pain, swelling, bloating, and more importantly uncontrollable and unpredictable haemorrhaging were my lot for 7 months. An immediate physiological consequence, severe anaemia settled in, making a complete slob of my once energetic self. I gradually abandoned all physical activity. As I dragged myself around, from home to campus and back on my exhausting commute, I tried to maintain my usual level of productivity at work, acting normal or trying to do so. Treatments (basically: heavy hormonal therapy) were suspended or didn’t work. Come May, I was on my knees, and still pretending. I even went on a research trip to the Netherlands: there, I could barely walk. In June, the collapse happened as I ended up having an emergency transfusion that only raised me from critical to severe anaemia, leaving me safe but absolutely exhausted. For weeks, as it turned out, I had unwittingly risked heart failure. One thing that is hard to realise for those who have not suffered this level of anaemia (my haemoglobin level fell to 41 when a healthy level is 120) is that the lack of oxygen even affects your brain. I remember staring blankly at my computer screen, unable to process information. Being barely able to articulate thoughts as I attended meetings. Not writing anything of worth. It had become clear that the fibroid had to go, and surgery was scheduled for after the end of term. Waking up from the procedure, thinking the damn thing had been cut out, broken down in pieces and removed from my wretched body, was a relief.
As a female ailment, fibroids are extremely banal. They may or may not produce symptoms, only a few fibroids are large enough to cause concern or threaten your life. Some are hidden cancers, but this is extremely rare. But a nasty fibroid can ruin your life – from crippling pain to dangerous haemorrhaging. Yet it is very difficult to discuss openly what is a slightly disgusting all-female problem. Many women suffer, yet cope in silence.
As my womb manifested itself in this implacable way, I could not help but think of classical descriptions of the uterus as a living being in Plato and Hippocrates. It does move around and forces its mood on you. It compresses nearby tissues and organs and causes symptoms. It soaks up moisture like a big sponge, and releases it in surprisingly large quantities when pressed or squeezed (and even when neither pressed nor squeezed!). It reacts badly to all forms of stress. It prevents you from sleeping, and punishes you when you eat certain foods or too much food. It prevents you from moving in certain ways, and from lying on your front. Sometimes even from sitting properly. This power of nuisance must have puzzled ancient women and those (male and female) who treated them. Large fibroids can be discovered through a basic examination – no need for sophisticated instruments, even though they help a lot nowadays. Therefore, ancient healers must have been aware of them, but in many cases they would have been powerless to control their growth, let alone shrink them or deal with the most dangerous symptoms. Traditional Chinese medicine uses plants that are effective up to a certain size of fibroid – natural remedies can help a lot if the illness is caught early enough.
Evidence for anaemia in the ancient world is often associated with malaria and other diseases, or malnutrition. Iron-deficiency anaemia also existed. Sequels can be observed in the bones of ancient people. While fibroids may have been less prevalent in the ancient world than in our hormone-saturated environment, they would have wreaked havoc in a number of bodies and caused some deaths. I now feel for the many ancient women who suffered and died from uncontrollable bleeding or unexplained organ failure.
Do you know of evidence of fibroid treatment in early medicine? Feel free to email me at firstname.lastname@example.org or share stories and references on Twitter @GalenOfPergamum.