Surgical Instruments

Roman

replicas

gift of: Albert David Mason

date of the originals: 1st century AD

provenance of the originals: House of the Surgeon, Strada del Consulare, Pompeii

description: The city of Pompeii, located a few miles south of Naples in Italy, was a large city by ancient standards. Destroyed and buried by the eruption of Mount Vesuvius in AD 79, Pompeii has since been extensively excavated by archaeologists.

The city had been considerably Romanized from the 1st century BC onwards, and by the time of its demise, was a prosperous market town, port and industrial centre where Romans and local families lived side by side.

These instruments are accurate replicas of five surgical instruments found in the so-called House of the Surgeon (or Physician) in the Strada del Consulare in Pompeii. The house was discovered during excavations in 1818. A large number of medical instruments uncovered there, now housed in the National Museum of Naples, led to the conclusion that it was a physician’s house.

#1: Shears

Shears, called forfex by the Romans, were used regularly for cutting hair before a medical procedure was undertaken. Celsus, who lived in the reign of Tiberius (AD 14-37), tells us that cutting hair was also sometimes considered in itself a therapeutic treatment.

It is possible the edges of shears in the ancient world were never able to be made sharp enough to be of use in surgery. However, apparently Celsus occasionally used shears in the treatment of abdominal injury:

When all [the intestines] have been returned, the patient is to be shaken gently, so that of their own accord the various coils are brought into their proper places and settle there. This done, the omentum too must be examined, and any part that is black and dead is to be cut away with shears.

A large number of shears have survived from ancient times, the majority made of steel. This pair was made of bronze.

#2: Cautery

This instrument, called a ferrum candens (literally “glowing iron”) by the Romans, was usually made of iron, and of bronze in special cases. (Because iron deteriorates easily, few iron cauteries have survived from the ancient world.) This tile shaped bronze cautery was heated and then used for various purposes: as a counterirritant--an agent for producing irritation in one part of the body to relieve pain or inflammation in another part; as a haemostat--applied to treat bleeding vessels in order to stop haemorrhage; as a bloodless knife; and to destroy tumours.

In the early sixth century AD, Aetius composed a medical treatise which he compiled from earlier records; he described one of the uses of the cautery:

I put the patient lying on her back, then I incise the sound part of the breast outside the cancer and burn the incision with cauteries until the eschar [scab] produced stops the flow of blood. . . the first cauterization is for the sake of stopping the haemorrhage, the second for eradicating all traces of the disease.

#3: Elevator or Lever

This instrument, called a vectis by the Romans, was a bone lever used for levering a fractured bone into place or raising a depressed bone. The surfaces at the ends were ridged for better gripping. It is also possible this instrument was used for levering out teeth. Paul of Aegina, a writer of the sixth and seventh centuries AD who compiled medical knowledge from ancient times, wrote a description of a bone lever:

. . .on the first day before inflammation has come on, or about the ninth day after inflammation has gone off, we may set [bones] with an instrument called the lever. It is an instrument . . . about seven or eight fingers breadth in length, of moderate thickness that it may not bend during the operation, with its extremity sharp, broad and somewhat curved.

#4: Knife

Roman surgeons used many different kinds of knives. This particular knife is a phlebotome, called phlebotomus or scalpellus by the Romans. It was a type of lancet used for venesection, the opening of veins. The practice of bleeding a patient was one of the most common treatments for ailments. Celsus described the technique:

. . . if the scalpel is entered timidly, it lacerates the skin but does not enter the vein; at times, indeed, the vein is concealed and not readily found. . . the vein ought to be cut half through. As the blood streams out its colour and character should be noted. For when the blood is thick and black, it is vitiated, and therefore shed with advantage, if red and translucent it is sound, and that blood letting, so far from being useful, is even harmful.

The phlebotome was also used for opening abscesses and puncturing cavities containing fluid, and for dissection. The point of this particular phlebotome has a guard below it so that it cannot cut too deeply.

#5: Bone Forceps

These forceps, called ostagra by the Greeks, were specifically used on bones. Paul of Aegina described one of their uses:

If the bone is strong it is first to be perforated with the drills called abaptista and the fractured bone is to be removed in fragments, with the fingers if possible, if not, with a tooth forceps or bone forceps.

Soranus of Ephesus, who lived in the reign of Trajan (AD 97-118) used bone forceps to remove pieces of the skull after impaction of the foetal cranium. Bone forceps may also have been used for extraction of arrow or lance heads from wounds; the grips on the tips of the forceps would make grasping such objects easier.