Rufus describes the symptoms of vesical calculus at length and finishes with instructions for searching the bladder. The word he uses (μήλωσις) at first sight seems to indicate that this was done with a sound, but it turns out to be bimanual rectal examination only which he describes. The use of the sound as a staff in lithotomy, or as a dilator of a strictured urethra, was not known to the ancients, and thus we have no evidence from the literature that a solid bougie existed. Some instruments have come down to us, however, which seem undoubted solid bladder sounds. There are three sounds of bronze in the Naples Museum, which have the identical appearance of our modern bladder sounds. It might be argued that these have not quite the shape of the catheter described by the ancients, but there is an instrument in the Mainz Museum against which even this objection cannot be brought. It is a solid sound of the double curvature described by Celsus, and is identical in shape with the catheter from the Pompeian surgeon's house (Pl. XLV, fig. 3). _Lithotomy Scoop._ Greek, λιθουλκός; Latin, _uncus_, _ferramentum quo in sectione calculus protrahitur_. Celsus thus describes the extraction of calculus through a perineal incision by means of a lithotomy scoop: Quum vero ea patefacta est, in conspectum calculus venit; in cuius colore nullum discrimen est. Ipse si exiguus est, digitis ab altera parte propelli, ab altera protrahi potest; si maior, iniiciendus a superiore parte uncus est, eius rei causa factus. Is est ad extremum tenuis, in semicirculi speciem retusae latitudinis; ab exteriore parte laevis, qua corpori iungitur; ab interiore asper, qua calculum attingit. Isque longior potius esse debet; nam brevis extrahendi vim non habet. Ubi iniectus est in utrumque latus inclinandus est, ut appareat an calculus teneatur; quia si apprehensus est, ille simul inclinatur. 'When it is opened there comes into view the calculus, the colour of which is unmistakeable. If it is small it is to be pushed by the fingers from one side and pulled from the other. If too large the hook for the purpose is to be put in above it. The hook is slender at the end and flattened out in the shape of a semicircle, smooth externally where it comes in contact with the tissues, rough internally where it meets the calculus. The hook should be pretty long, for a short one has no power of extraction. When it has been inserted it should be inclined to either side, so that it may be seen whether the calculus is caught, because if it is held it also is inclined to the side' (VII. xxvii). The above passage gives a very complete account of the lithotomy scoop. The only thing it leaves undecided is the breadth. Was it a broad, spoon-like scoop, or was it a hook-like instrument? That the latter was the case is proved by the following passage also from Celsus (VII. xxvi):