Surgical Instruments in Greek and Roman Times Part 19

xxii) says, 'Some after excision of the flesh use a perforator, and make a pa.s.sage for the fluid or matter to the nose, but we are content with burning alone, using the cauteries for fistula lachrymalis (a?????p?????

?a?t??????) and burning down till a lamina of bone exfoliates.'

_Gamma-shaped Cautery._

Paul (VI. lxii), describing the radical cure of hernia, says:

'Wherefore having heated ten or twelve cauteries shaped like the Greek letter G (?a?e?d?? ?a?t????) and two cautery knives, we must first burn the s.c.r.o.t.u.m through with the G-shaped ones, &c.'

_Obol Cautery._

In the treatise on haemorrhoids (iii. 340) Hippocrates says:

'I order, therefore, seven or eight instruments to be prepared, a palm long, and the thickness of a thick specillum, bent towards the end and flattened on the point like a small obol' (?? ?p? ????? ?????).

_Lunated Cautery._

Greek, ???e?d?? ?a?t?????.

Paul says in cases of sloughing of the prepuce we must cut it off, and if there be haemorrhage we must use lunated cauteries (???e?d?s?

?a?t??????). They both stop the haemorrhage and prevent the spreading of the sore (VI. lvii).

_Nail, Tile and b.u.t.ton Cautery._

Treating of bubonocele, Paul says (VI. lxvi):

'Make a triangular mark over the centre of it and apply to the mark nail-shaped (???t???) cauteries heated in the fire, and afterwards burn the triangle with gamma-shaped cauteries, and afterwards level the triangle with cauteries shaped like bricks (p?????t???) or lentils (fa??t???).'

Cauteries of nail shape are also referred to by Hippocrates in the treatment of recurrent dislocation of the shoulder:

'Raise up the skin. Burn with cauteries which are not thick nor much rounded but of an elongated shape (p?????). For thus they pa.s.s more readily through' (iii. 151).

Galen has a long note in explanation of this term:

Fa?a??? ??????e t? pe??f??e?a? ????ta ?at? t? p??a? ???? ?? ?at? t??

as???a? ????s? p????a? ?t?? t? d?ap????a ?a???e?a ?a? a?

spa????a?, p????? d? t? t??t??? ??a?t??? d?a?e?e?a p??s????e?se?, ?? ??? ?st? pe??fe??? t? p??a? ???' ???te?a? pe?' ?p????a pa?ap??s??? p?? t??? e?? t?? pa?a?e?t?se?? ?p?t?de???? ????????.

'He (Hippocrates) calls fa?a??? (globose) those having a ball at the tip, such as those for the axilla, which have olivary points and also those which are called double olivary probes and spathomeles. But those which are the reverse he calls p?????, i. e. those which have the end not globose but rather sharp, exactly like the instruments for paracentesis' (xviii. 376).

In the Naples Museum there are three tile-shaped cauteries, one of iron and two of bronze. One of the latter is shown in Pl. XL, fig. 1.

_Wedge-shaped Cautery._

Hippocrates (iii. 223) says that the oblique veins of the head are to be burned with wedge-shaped cauteries (sf???s???s? s?d?????s?).

_Needle Cautery._

Celsus (VII. viii) says:

At ubi aures in viro puta, perforatae sunt et offendunt, traiicere id cavum celeriter candente acu satis est, ut leviter eius orae exulcerentur.

Treating of trichiasis he says (VII. vii. 8):

Si pili nati sunt qui non debuerunt tenuis acus ferrea, ad similitudinem spathae lata, in ignem coniicienda est; deinde candens, sublata, palpebra sic ut eius perniciosi pili in conspectum curantis veniant, sub ipsis pilorum radicibus ab angulo immittenda est, ut ea tertiam partem palpebrae transsuat; deinde iterum, tertioque usque ad alterum angulum; quo fit ut omnes pilorum radices adustae emoriantur.

This indicates a needle beaten out into the shape of one of our spuds for removing foreign bodies from the eye. The needle handles from the find of the oculist Severus are well adapted for this work, but are dealt with elsewhere (p. 69).

_Cautery guarded by a Tube._

In the treatise on haemorrhoids (iii. 345) Hippocrates says:

'We must make a [tubular] cautery like a writing reed and fit it to a well-fitting iron' (?a?t??a ??? p???sas?a? ???? ?a?a?s??? f?a??t??, s?d????? d? ??a??sa? ?a??? ??????).

Again, in the treatment of polypus of the nose, he says:

'When that occurs we must insert a tube and cauterize with three or four irons'(?ta? ??t?? ???, ?????ta ??? s?????a ?a?sa? s?d?????s?? ?

t???s?? ? t?ssa?s??) (ii. 244).

Celsus says this tube may be a calamus or a tube of pottery:

Apud quosdam tamen positum est, vel fictilem fistulam vel enodem scriptorium calamum in narem esse coniiciendum, donec sursum ad os perveniat: tum per id tenue ferramentum candens dandum esse ad ipsum os (VII. xi).

_Wood dipped in boiling Oil._

Hippocrates, in diseases of the liver, says that cauterization may be performed with boxwood spindles dipped in boiling oil (p??????s??

?t???t??s? ?pt?? ?? ??a??? ????) (ii. 482). Aetius (XII. iii) says that the root of the birthwort (aristolochia) may be used in the same way.

_Ignited Fungi, &c._

In the pa.s.sage in Hippocrates on cauterizing for disease of the liver, Hippocrates, as an alternative to the hot iron, says that eschars may be produced by fungi. This must mean that they were set on fire like the old moxa.

This is probably what is meant by Paul when, in treating of cauterizing over the stomach, he says (VI. xlix):

'But some do not burn with iron but with the substances called iscae.

The iscae (?s?a?) are spongy bodies forming on oaks and walnut trees, and are mostly used among the barbarians.'

Aetius (II. iii. 91) says iscae are the medullary wood of the walnut tree.

In Hippocrates (ii. 482) the word ????, a fungus, is used--? ???s?? ??t?

?s???a? ?a?sa? (or with fungi burn eight scars).