SURGICAL INSTRUMENTS
IN GREEK AND ROMAN TIMES
BY
JOHN STEWART MILNE, M.A., M.D. ABERD.
KEITH GOLD MEDALLIST IN CLINICAL SURGERY
WITH ILLUSTRATIONS
OXFORD
AT THE CLARENDON PRESS
1907
HENRY FROWDE, M.A.
PUBLISHER TO THE UNIVERSITY OF OXFORD
LONDON, EDINBURGH
NEW YORK AND TORONTO
PREFACE
The object of this book is to lay before the student of medical history an
account of the various instruments with which the ancient Greek and Roman
surgeons prosecuted their craft. It is self-evident that no clear
conception of a surgical operation, ancient or modern, can be formed from
a written description without some previous knowledge of the instruments
intended to be used. Many interesting operations described in detail in
the classical authors are rendered obscure or quite unintelligible from
lack of this knowledge. The learned Adams gives an accurate translation of
a long and involved chapter by Paulus Aegineta on the use of the vaginal
speculum, but remarks that owing to our want of knowledge of the specula
possessed by the ancients the chapter is unintelligible. Daremberg says it
is impossible to say what was the shape of any of the cutting instruments
mentioned by Hippocrates. The steady progress of archaeological discovery
has gradually added find after find of surgical instruments, till now
there is scarcely a museum with any considerable number of antique _petits
bronzes_ which does not number among its contents a few surgical
instruments, and in the Naples Museum alone there are hundreds. In several
cases we know even the name of the original possessor of these and the
special branch of surgery which he practised. There are thus open to us
materials which were not available to the men of learning to whom I have
referred above, and the time seems opportune to undertake a systematic
review of all the materials at our disposal, and attempt to reconstruct
the surgical armamentarium of the ancients. Considering the importance of
the subject, it is surprising that no such systematic attempt has
previously been made. Indeed, comparatively little attention has been
given to this department of archaeology. Literature bearing on it is
comparatively scarce. What we have is entirely continental, and consists
of a series of reports of different finds with attempts to indicate the
uses of the instruments described. In addition to these reports and the
actual instruments scattered over various museums, we have at our disposal
the writings of the ancient authors themselves. In these a fair number of
instruments are minutely described, while many others are named, and here
and there points about their shape are mentioned in different places; and
by piecing these particulars together and deducing other facts from the
nature of the manipulations the instruments are employed in, we can
describe in detail, with a tolerable amount of certainty, a surprisingly
large number of instruments. It must be confessed that these ancient
classics are rather difficult of access, surprisingly so considering that
until a few decades ago they were reverenced as works of authority for
medical practice; but the fact seems to be that our predecessors were
largely content to draw their knowledge of these authors from mediaeval
Latin translations. Part of one of the most interesting authors has never
been published in the original Greek, and for our knowledge of it we are
dependent on a sixteenth-century Latin translation, supplemented, it may
be, by fugitive consultations of codices in libraries and museums.
Others of the Greek texts have not been reprinted since the sixteenth
century, and bristle with the ingenious but at first perplexing shorthand
contractions with which the Renaissance typographer imitated the Compendia
of the manuscripts. These difficulties can be got over with patience,
however, and the waste of gray matter necessary as a preliminary is not
out of proportion to the results to be obtained. Even as a quarry for
philological materials the medical classics are far from being worked out,
and it is surprising how many words one meets with which are not to be
found in the best Greek-English dictionaries.
The method pursued in the present investigation was to make a complete
examination of the classical medical, surgical, anatomical, and
pharmaceutical writings which have been preserved to us, copying out the
portions in which an instrument was mentioned. These extracts were then
rearranged in ledger form, each extract being classified under the heading
of the instrument it referred to. Out of the enormous number of references
thus obtained, those passages were selected which seemed to throw any
light on the shape and size of the instrument to which they referred.
Next, an examination was made of the reports of finds in various
localities; as many specimens in various museums were examined as
possible; and annotations of classical texts were searched for any further
information they might give. The total information thus gained is so
arranged that under the heading of each instrument will be found a series
of selected extracts from different authors, with the deductions from them
which it is possible to make regarding the appearance of the instrument,
and an illustration is given of it from some ancient specimen where such
is in existence. Failing actual ancient specimens, I have fallen back on
mediaeval or ancient Arabian authors for illustration.
I have omitted a discussion of the many interesting mechanical
contrivances for the reduction of deformities due to fracture and
dislocation, and also of the splints, pads, and bandages for maintaining
these injuries in position. These form such a well-defined group that they
might fitly form the subject of a special monograph, and the illustrations
required are of a different nature from those in the present volume. The
majority of these contrivances will be found described in a chapter by
Heliodorus preserved in Oribasius. I have omitted also all reference to
the numerous forms of vessels in which the ancients prepared and stored
their medicaments, with the exception of those which are intended for
carrying on the person. Some of these merge into forms which are common to
both drug and instrument cases, and it is impossible to separate them. It
has been necessary also to include as far as possible the instruments
involved in the preparation and application of medicaments, as most of
these are either actually or potentially implements of minor surgery.
The volume opens with a short account of the ancient authors whose
writings have any bearing on the subject in hand. At the end of the book
will be found a bibliography of reports on finds, and a list of the most
interesting instruments to be found in various museums. The latter makes
no pretence of being a complete inventory, although it might serve as a
skeleton for the construction of a more comprehensive list at some future
date. The bibliography, on the other hand, is believed to be fairly
complete. The bulk of the book consists of an attempt to reconstruct, in
the manner described above, the different instruments used in classical
times.
The books from which I have drawn most information are Brunner's _Die
Spuren der römischen Ärzte auf dem Boden der Schweiz_, Deneffe's _Étude
sur la Trousse d'un Chirurgien Gallo-Romain du III{e} Siècle_, Adams'
translation of Paulus Aegineta, and the papers of Vulpes in the volume for
1851 of the _Memorie della Regale Accademia Ercolanese di Archeologia_.
During the five or six years which I have spent on this investigation I
have unsparingly laid all my friends under contribution whenever
opportunity occurred; but among those to whom I am particularly indebted I
may mention Mr. M. G. Swallow of Baden, who has given me much assistance
in working up the Swiss finds, Professor Alexander Ogston, under whom I
spent many happy days as house-surgeon, and who has all along kept a
fatherly eye on the progress of the work and encouraged me to proceed to
the end with a task which at times seemed inclined to swamp me, Mr. R. C.
Bosanquet, late director of the British Archaeological School at Athens,
who procured for me photographs of the instruments in the Athens museum,
and Mr. H. R. Nielsen of Hartlepool, who has been the companion of my
wanderings among the continental museums. I have also to thank my father,
John Milne, LL.D., for much help at many different points.
The expense of visiting the museums in the North of France and of
obtaining photographs of the instruments in them has been borne by a grant
from the Carnegie University Research Fund.
This monograph was presented as the thesis which forms part of the
examination for the degree of M.D. of the University of Aberdeen, and it
was successful in gaining 'Highest Honours.'
HARTLEPOOL,
_April 19, 1907_.
CONTENTS
PAGES
CHAPTER I
INTRODUCTORY 1-9
Hippocrates--Celsus--Rufus of Ephesus--Aretaeus of
Cappadocia--Galen--Oribasius--Soranus of Ephesus--Moschion--
Caelius Aurelianus--Aetius--Pliny the Younger--Scribonius
Largus--Marcellus Empiricus--Theodorus Priscianus--Alexander
Trallianus--Paulus Aegineta--Hero of Alexandria--Christian
Fathers--The Arabs--Paré--Scultetus--Heister.
CHAPTER II
MATERIAL, EXECUTION, AND ORNAMENTATION 10-23
Steel and Iron--Bronze--Copper--Brass--Tin--Lead--Gold--
Silver--Horn--Wood--Bone--Ivory--Stone--Execution and
Ornamentation--Ringed Ornamentation--Inlaying--Plating--
Patina--Finds of Instruments--Herculaneum and Pompeii--Find
of Surgeon of Paris--Oculist Severus of Rheims--Oculist
Sollemnis of Fonviel--Military Hospital at Baden--Surgeon
of Cologne.
CHAPTER III
KNIVES 24-50
Cutting instruments--The scalpel handle--Typical form
rectangular, with blunt dissector--Round--Octagonal--Mounting
the blade--Varieties of blade--Classification--Straight
blades with one cutting edge--Scalpel--Bistoury--Scarificator
single or multiple--Razor type--Blunt-pointed bistoury--Ring
knife for dismembering the foetus--Straight two-edged
knives--Galen's long dissecting knife--Phlebotome--Fleams--
Katias--Spathion--Hemispathion--Polypus knife--Lithotomy
knife--Knife for lithotomy invented by Meges--Perforator for
foetal cranium--Probe-pointed bistoury with two edges--Curved
bistoury--Crow-bill--Pterygium knife--Knife for plastic
operation for entropion--Uvula knife--Tonsil knife--Fistula
knife--Curved two-edged blades--Galen's cartilage knife--
Curved myrtle-leaf-shaped blade--Shears.
CHAPTER IV
PROBES 51-89
Specilla or probe-like instruments--Definition of specillum--
κοπάριον--μήλη--ὑπάλειπτρον--Materials--Bronze--Silver--Gold--Tin--
Wood--Bristle--Flower-stalk--Specillum as sound--Combination
of instruments on one shaft--Plain rods--Double olive--
Spathomele or spatula-probe--Cyathiscomele or spoon-probe--
Ear specillum--Probe with screw thread--Specillum
vulnerarium--Handled needle--Ophthalmic probe--Rasping
specillum--Trachoma curette (Blepharoxyston)--Styli and
styloid specilla--Grooved director--Surgical needle--Dressing
needle--Bodkin--Eyed probes--Ligula--Spoons for warming and
pouring salves--Tongue depressor--Uterine sounds--Uterine
dilators--Bifurcated probe--Y probe--Blunt dissector--Curved
dissectors--Sharp hooks--Blunt hooks--Aneurism needle--
Strigil--Spoon for applying liquid to uvula.
CHAPTER V
FORCEPS 90-100
Epilation--Polypus--Tumour vulsellum--Eyelid fixation
forceps--Uvula (Staphylagra)--Forceps for applying caustic to
uvula--Pharyngeal.
CHAPTER VI
BLEEDING CUPS, CLYSTERS, ETC. 101-115
Bleeding cups--Materials--Glass--Silver-Bronze--Shapes--
Syringes--Principles--Rectal--Vaginal and uterine--Bladder--
Nose--Sinus--Ear--Insufflator--Cannula for ascites and
empyema--Leaden tubes to prevent contraction and adhesion--
Calamus scriptorius--Quill.
CHAPTER VII
CAUTERIES 116-120
Cautery knife--Trident--Olivary--Gamma-shaped--Obol--
Lunated--Nail--Tile--Button--Wedge--Needle--Cautery with
tube--Wood--Moxa.
CHAPTER VIII
BONE AND TOOTH INSTRUMENTS 121-142
Raspatory--Chisel--Gouge--Lenticular--Hammer--Block--
Meningophylax--Drill--Drill with guard (Abaptista)--Saw--
Trephine--Perforator for fistula lachrymalis--Bone elevator--
Sequestrum forceps--Varix extractor--Blacksmith's tongs--
Tooth forceps--stump forceps--Tooth elevator--Tooth scalers--
File--Forceps for extracting weapons--Periosteal elevator for
the pericranium--Impellent--Arrow scoop.
CHAPTER IX
BLADDER AND GYNAECOLOGICAL INSTRUMENTS 143-160
Catheter--Male--Female--Child--Bladder sounds--Lithotomy
scoop--Forceps--Lithotrite--Speculum--Rectal--Vaginal--
Trivalve--Quadrivalve--Traction hook--Decapitator--
Cranioclast--Cephalotribe--Midwifery forceps--Uterine
curette--Instrument for destroying foetus in utero--
Apparatus for fumigating uterus and vagina--Vaginal
pessaries.
CHAPTER X
SUTURES, ETC. 161-167
Sponge--Sutures--Serres fines--Band of Antyllus--Sieves and
strainers--Mortar--Pestle--Whetstone.
CHAPTER XI
ÉTUI, ETC. 168-173
Portable outfit--Probe cases--Scalpel box--Ointment box--
Boxes for collyrium sticks--Ointment slabs--Boxes for drugs.
APPENDIX
I. INVENTORY OF CHIEF INSTRUMENTS IN VARIOUS MUSEUMS 174-177
II. BIBLIOGRAPHY 177-178
CHAPTER I
INTRODUCTORY
The earliest classical writer on medical subjects is Hippocrates, who was
born in 460 B. C. and who practised in Athens and other parts of Greece.
The 'Hippocratic Collection' is well known to consist of works which are
not all by Hippocrates himself; but as the pseudo-Hippocratic works all
belong to the classical period they are all admissible as evidence for our
purpose, and for the sake of brevity I shall throughout refer to them as
if all were by Hippocrates. Many interesting instruments are named in the
comparatively small collection of treatises which make up the admittedly
genuine list of Hippocratic works, but, taking these along with the
pseudo-Hippocratic works, the number of instruments named in the whole
collection is surprisingly large, comprising as it does trephines, bone
drills, probes, needles, tooth forceps, uvula forceps, bone elevators,
uterine sounds, graduated dilators, cranioclasts, and others. After
Hippocrates there is a break in the continuity of the literature, and for
some hundreds of years Greek medicine is represented almost entirely by
the Alexandrian Schools. The first printed edition of the Hippocratic
works was a Latin translation printed at Rome in 1525, followed by the
Aldine edition of the Greek text printed at Venice in the following year.
Other editions are the edition of Föes (1595), Van der Linden (1665), Kühn
(Leipzig, 1821). Later editions are the text with a French translation by
Littré (10 vols., 1849-61), a scholarly edition by Ermerins with a Latin
rendering (1859-64), and an excellent translation of the genuine works of
Hippocrates by the world-famous Dr. Adams of Banchory (Sydenham Soc.
Trans., 1849). The best edition, however, is the edition of Kuehlewein,
begun in 1894 and at present in course of publication by Teubner, Leipzig.
The later volumes have not yet appeared. For the portion of the text which
is not contained in the first two volumes of Kuehlewein I have relied on
the edition of Kühn for most of the readings, although occasionally those
of Van der Linden or Föes are to be preferred. The references given are to
the volumes and pages of Kühn's edition, but in this edition indications
are given of the corresponding localities in the other editions so that
cross-references to these can easily be made. There seems to be a
different arrangement in different editions of Föes, for Liddell and Scott
say the references in their Lexicon are to the pages in Föes but they do
not correspond in any way to the pagination of the edition before me
(Frankfort, 1595).
Aulus Cornelius Celsus is the next writer we have. His system of medicine
in eight books is a marvel of lucid arrangement, and his beautiful style
makes it a pleasure to read any of his works. The seventh book gives a
most interesting review of the surgery of the Alexandrian School. He
describes many instruments in detail, although he names fewer special
instruments than some of the Greek writers as the Latin language lends
itself less well to the formation of compound words than the Greek does.
To take one example only, Celsus has practically one word for all
varieties of forceps--vulsella, while the Greeks use many compounds like
hair forceps (τριχο-λαβίς), flesh forceps (σαρκο-λάβος), tooth forceps
(ὀδοντάγρα), stump forceps (ῥιζάγρα). Indeed, in the case of the two
latter words Celsus falls back on Greek to express himself. Celsus was
first published in 1478. Another edition is that of Targa, 1769. The
editions before me are those of Daremberg, published at Leipzig in 1859,
and Védrènes (Paris, 1876). The latter contains illustrations of a
considerable number of specimens from Italian and French museums.
Rufus of Ephesus (98-117 A. D.) has left little to interest us for our
particular purpose, as he merely mentions, without describing, a few
instruments, all of which are already known to us from other sources. The
best edition is that of Daremberg, Paris, 1879. A Latin translation of his
works will be found in _Medicae Artis Principes_ (Stephanus).
Aretaeus of Cappadocia has left us a work on Acute and Chronic Diseases.
He has few references to instruments, but such as they are they are
interesting, as he names some which are given by no other author. He has a
tantalizing allusion to a work by himself on surgery which has not been
preserved. There is a fine edition of the text, with an English
translation by Adams of Banchory, in the Transactions of the Sydenham
Society.
Galen (130-200 A. D.) was a most voluminous writer, much of whose work
remains and teems with matter of interest to us. Much information about
instruments is to be gained from even his purely anatomical writings. The
most accessible edition is that of Kühn (20 vols., Leipzig, 1821), but it
is slipshod in the text, and even more so in the translation, which is in
Latin.
Oribasius (325 A. D.) wrote an encyclopaedia of medicine, which is called
Συναγωγαὶ Ἰατρικαί--Collecta Medicinalia, in seventy books, only about one
third of which remain. This is the most interesting of his works from our
point of view, but he has left also a synopsis of the encyclopaedia called
Σύνοψις, and a sort of first aid manual called Εὐπόριστα. I have used the
edition of Daremberg and Bussemaker (1851-76).
Soranus of Ephesus has left us a most valuable treatise on obstetrics and
gynaecology, which, though written only for midwives, contains many
interesting references to instruments such as the speculum, uterine sound,
cephalotribe, decapitator, and embryo hook. He lived in the reign of
Trajan. Some of the chapters, of which the Greek is lost, have been
preserved to us by his abbreviator Moschion. I have used the edition of
Rose published at Leipzig in 1882.
Moschion (fifth century) translated into Latin the gynaecological and
obstetrical part of the works of Soranus for the benefit of midwives who
could not speak Greek. This version is now lost, but we have a translation
of it into Greek, made after the fall of the Western Empire and the
development of the Greek-speaking Empire at Constantinople in the sixth
century. There is an Edition of this by Gesner (Basle, 1566). Finally,
this Greek version of Moschion was translated back into barbarous Latin at
some early date, Barbour thinks by some member of the Schola Salernitana.
This was published at Venice by Aldus in the sixteenth century, and Rose
has prefaced his edition of Soranus with it. This work of Moschion is only
of interest to us from the fact that he preserves to us the substance of
some chapters of which the original in Soranus is wanting.
Caelius Aurelianus Siccensis, an African of the fourth or fifth century,
translated the works of Soranus, both those on gynaecology and those on
general diseases, and he preserves some of Soranus which we would not
otherwise possess; but he writes in a barbarous Latin which, like the
Latin of some other African writers on medical subjects, is calculated to
cause great pain to any one not familiar with this particular style.
Aetius lived in the first half of the sixth century, and compiled a
voluminous treatise on medicine in sixteen books. He worked entirely with
scissors and paste, but the result is the preservation to us of a large
number of extracts from writers whose works would otherwise have entirely
disappeared, and his work is of great value for the study of instruments.
In 1534 an Aldine Edition of the first eight books was published, and,
though a translation of the whole work was published by Cornarius in
1533-42 in Latin, six of the last eight books were never published in the
original Greek. This is unfortunate for us, as for our purpose the
original is the only thing of any great value, Greek being, as I have
already pointed out, a language richer in compounds than Latin is, and
lending itself better to the coining of special names for special
instruments. Not that the sixteenth-century translator is ever at a loss
for a turn by which to express himself in Latin, but the turn, as often as
not, is by periphrasis just at the very point when we would have liked a
very exact equivalent for the Greek. The translation of the part of the
work of which we have the Greek shows that we cannot entirely depend on
some of these periphrases even where they appear definite, as in some
cases an unwarrantable assumption is made about the form of an instrument.
Thus λιθουλκῷ is translated 'forcipe ad id facta' because in Cornarius's
time the instrument used for extracting stone from the bladder was a
forceps, whereas it is doubtful whether there was in the Roman period
anything more than a scoop, and, therefore, we are not entitled to
translate λιθουλκός by anything more definite than 'stone extractor', its
etymological equivalent. Although, therefore, I have examined the latter
eight books of Aetius in the Latin translation, and although they contain
some of the most interesting information to be found in the whole work, I
have been very chary about laying stress on any deductions drawn from the
Latin translation only. It may be noted that there are two ways of
referring to the different books in Aetius, according to whether the Greek
text or the translation of Cornarius is meant. Cornarius arranged his
version in four tetrabibli of four books each, whereas the Greek text is
simply numbered from i-viii. 'No vii.' of the Greek text is, therefore,
called by Cornarius 'Tetr. ii. lib. iii.' The eleventh book was published
by Daremberg in his edition of Rufus (1879), and the twelfth book was
published by Costomeris at Paris in 1892.
Pliny the Younger. Plinius Secundus (Rose, Leipzig, 1875). The writings of
Pliny contain little information of any kind and are absolutely of no use
for our purpose.
Scribonius Largus (45 A. D.). The edition I have examined is named
'Scribonii Largi Compositiones' and is edited by Helmreich, Leipzig, 1887.
The work of Scribonius Largus is entirely pharmaceutical, but he gives
many references to appliances by which medicaments were prepared in the
surgery.
Marcellus Empiricus (300 A. D.) wrote a work on pharmacy, of large size
but little value, and in a poor style. There are a few passages bearing on
implements of minor surgery. A good deal is copied from Largus. Aldus
published the text by Cornarius at Venice in his collection of Medici
Antiqui (1547), republished by Stephanus (_Medicae Artis Principes_),
1567. The edition I have used is that of Helmreich (Leipzig, 1889).
Theodorus Priscianus, alias Octavius Horatianus, lived in the fourth
century and has left a work, in three books, called _Euporiston_. It is a
compilation in African Latin of extracts from Galen, Oribasius, &c. The
style of the Latin is so barbarous that it really must be seen to be
believed. There is a little information to be gathered about minor
instruments. The edition I have used is that of Rose, Leipzig, 1894. To
this edition are tacked on the medical remains of Vindicianus Afer, mere
fragments without anything to interest us.
The works of Alexander Trallianus (526-605 A. D.) contain practically no
surgery at all, although I have managed to extract a few references of
minor interest.
The last of the eminent Greek writers is Paulus Aegineta, a writer who
probably lived in the sixth and seventh centuries. This is getting rather
late in the day, it is true, but to omit the works of Paulus, or Paul, as
he is affectionately called by his admirers, would be to omit some of the
most valuable knowledge of ancient medicine we possess. Paul, like most of
his time, was a compiler, but he was a skilful one, and while he entirely
depends on Galen, Archigenes, Soranus, &c. for his information, he has
gathered up the best of the medical knowledge of his time in a little
encyclopaedia whose artistic completeness and orderly arrangement are not
surpassed by any work of a corresponding nature at the present day. The
work is divided into seven books, the sixth of which deals with surgery
and teems with information about instruments. Aldus published the entire
Greek text at Venice in 1527. A fine English translation, with a most
valuable commentary, was published by Adams of Banchory for the Sydenham
Society in 1846. No one who reads it can wonder that Adams had a worldwide
reputation for his knowledge of medical history. The important sixth book
was published along with a translation in French by Briau at Paris in
1855.
I have obtained a description of two very important instruments from the
works of Hero of Alexandria (285-222 B. C., ed. 1575). There are a few
interesting references to instruments in the works of the early Christian
fathers. Tertullian is the only one of these I can claim to have
systematically searched, but in one of his sermons he refers to no less
than four surgical instruments, one of which is not described by any other
author.
It were a work of supererogation to recount the names of the other Greek
and Roman writers whose works I have run through in a profitless search
for references to instruments. Some of these, such as Dioscorides, are of
great importance in themselves though valueless for our purpose. Others,
such as many of the minor Greek writers contained in the collection by
Ideler entitled _Physici et Medici Graeci Minores_ (Berlin, 1841), and the
minor Latin writers contained in the collection of _Medici Antiqui Omnes_
(Aldus, 1547), are of little value of any kind.
Before the capture of Alexandria by Omar in 651, many Greek medical
writings had been translated into Syrian. At a later date such of these as
had escaped destruction were turned into Arabic by the scholars of Bagdad
(Honain and his School), in the ninth century. These, introduced into
Spain in the Middle Ages by the Moors, were again translated into Latin
and supplied for many a day the greater part of the medical knowledge of
Europe, until the study of the few Greek texts which had escaped
destruction showed the true origin of Arabian medicine. It will thus be
seen that there is some information, in fact a great deal, to be had from
the study of the works of the Arabs, but the barbarous style of the Latin
and the roundabout way in which the works have been preserved, having
passed through translations of three different languages, preclude any
very exact deductions being drawn from them. Some of these works are
profusely illustrated with figures of instruments, but I have been careful
not to fall back on any of the Arabs except to support deductions drawn
from more direct sources.
The chief Arab writers of interest to us are:--Serapion (800), Rhases
(882), and Ali Abbas (after 950), all of Honain's School at Bagdad. The
huge work of Avicenna (born 980), _The Canon_, was much used by the Arabs.
It was published at Cordova, which became the Bagdad of the West after the
Arabs crossed to Spain in 811.
The work of Albucasis (ob. 1106) was also published at Cordova, and
contains much surgical information and has many illustrations of surgical
instruments, but these must be used with due caution. I have used the
edition published at Strasburg in 1532.
A word must be said of the later writers such as Paré (1509-90), Scultetus
(1650), and Heister (1739). The works of these are profusely illustrated
with instruments, some of which can plainly be seen to tally exactly with
the descriptions of the classical authors. In other cases, although the
names given to the instruments are those of classical times, it is, to say
the least, doubtful whether they are of the same form as the ancient
instruments whose names they bear. That was an age of great activity in
the manufacture of new forms of surgical instruments, and we must accept
with caution illustrations professing to indicate ancient forms of
instruments. At the same time it is very interesting to note the large
number of primitive arrangements which remained in use till nearly 1800.
The enema syringe figured by Heister is exactly the same as we find
described in the Hippocratic works--the bladder of an animal affixed to a
tube--and many practitioners alive at the present day have seen the same
simple arrangement in actual use.