The Social History of the Caul *

The history of obstetrics, perhaps more than that of many sciences, includes a large measure of superstition. In earlier centuries the normal phenomena of pregnancy and labor were understood, if at all, incompletely; related abnormalities were even more puzzling. Before adequate scientific explanations were available, speculation had to suffice, and superstition was often a result. Infrequently, in past ages as now, a baby is born with a thin, translucent tissue, a fragment of the amniotic membrane, covering its head. The remnant is known as a caul.' The modern obstetrician quickly removes the membrane (it may be interfering with the infant's efforts to begin respiration) and discards it. His professional predecessors, the physicians and midwives of earlier centuries, would have been more interested, for strong magic and strange beliefs were once related to the caul. In countries all over the world it was expected that the membrane would bring fame and fortune to its owner.9 "50 67, 80, 107 Aelius Lampridius, a classical historian, related that the emperor Antonius Diadumenianus or Diadematus (born 19 September 208 A.D.) was so called because at birth his head was encircled with a fillet (diadema), twisted like a bowstring and so strong it could not be broken. ' " 69 One supposes that the caul in this case had been rolled into a band. Although the possession of the fillet was expected to bring him good luck, Diadumenianus was assassinated while a youth.'5 Caul superstitions were recorded again after the Dark Ages. Cornelius Gemma, a sixteenth century physician, scorned belief in the powers of the caul.' He described it quaintly as being ". . . nothing other than the remnant of another membrane, much softer than the amnion, but nevertheless more solid, bound with a purple border or fringe, and wrapped around the whole head down to the umbilicus, not without great danger to the baby unless the membrane was removed as quickly as possible; thus I myself have observed it in my first-born son who came helmeted [galeatus] into the world." Van der Spiegel, a Belgian anatomist, explained