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How the C-section got its name

Q: If Julius Caesar wasn’t delivered by cesarean section, as I’ve read, how did the medical procedure get its name?

A: Let’s begin with the old story that Julius Caesar was born by cesarean section, an urban legend that we discuss in Origins of the Specious, our book about language myths. (The usual spelling is “cesarean” in the US and “caesarean” in the UK.)

This fiction can be traced back to one sentence in Pliny the Elder’s Historia Naturalis, a 37-volume work on astronomy, botany, architecture, human physiology, and many other subjects. It was written in the first century.

In discussing human birth, the Roman naturalist says it’s “contrary to nature for children to come into the world with the feet first.”

To make his case, Pliny cites the emperor Nero, who was born with his feet first and “proved himself, throughout the whole of his reign, the enemy of the human race.”

If such children are delivered surgically, he adds, they “are evidently born under more favorable auspices.”

In passing, he notes that the first of the Caesars “was so named, from his having been cut from his mother’s womb (a caeso matris utero).” The Latin caeso comes from caedere, to cut.

As we explain in Origins, Pliny “was plainly referring to the first of the many Caesars who preceded the great emperor. But over the centuries a lot of readers thought the first Caesar was a reference to the emperor himself. Ergo, a myth was born!”

Gaius Julius Caesar was born on July 12 or 13 in the year 100 or possibly 102 BC. The exact date is uncertain. However, his mother, Aurelia, lived long into her son’s adulthood, which would have been impossible if she’d delivered him by cesarean.

“In ancient times, surgical deliveries were performed only on women who were dead or dying,” we write in Origins. “Back then, the child’s survival was barely possible after such an operation, but not the unfortunate mother’s.”

The first documented case of a mother’s surviving a cesarean apparently took place in Prague on Feb. 25, 1337, according to a recent article in the New York Times.

Beatrice of Bourbon, second wife of the King of Bohemia and Count of Luxembourg, survived a cesarean in giving birth to her only child, Duke Wenceslaus I, according to archival documents found by Czech researchers.

As for the cognomen “Caesar” (a cognomen is the last of a Roman citizen’s three names), its origin is still in dispute. Did it have anything to do with surgery?

It could be that the original Caesar was born surgically and that inspired the cognomen, as Pliny wrote, but several other theories have been proposed.

One of the more interesting comes from a Roman grammarian, Sextus Pompeius Festus, who believed the name came from the Latin word caesaries, or hair, and suggested the first Caesar was born with a full head of hair.

Be that as it may, the author of the earliest example for the term “cesarean section” in the OED apparently based the English usage on Pliny’s account of the surgical birth of the first Caesar.

The dictionary’s first citation is from Mikrokosmographia, a 1615 medical treatise by Helkiah Crooke, the court physician of King James I:

“Concerning this Cæsarian section, Franciscus Rossetus the French Kings Physitian hath set foorth an elegant Booke so beautified with Histories and abounding with good arguments.” (We’ve expanded the citation to put it in context.)

Elsewhere in the treatise, Crooke cites Pliny and says the birth of the first Caesar was by “the cutting of the mothers wombe, from whence the Caesars had their names.”

Finally, we should mention that Julius bears no responsibility for Caesar salad. As we point out in Origins, the king of salads was invented in 1924 by Caesar Cardini, a chef and restaurateur in Tijuana, Mexico.

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