Surgical Instruments in Greek and Roman Times — John Shaqi
Surgical Instruments in Greek and Roman TimesMilne, John Stewart
History
Surgical Instruments in Greek and Roman Times
Milne, John Stewart
Surgery -- History; Surgical instruments and apparatus
The phlebotome appears to have been a convenient instrument for all sorts
of operations besides phlebotomy, especially for the opening of abscesses
and the puncture of cavities containing fluid, and for fine dissecting
work. Paulus Aegineta mentions its application for the excision of fistula
lachrymalis (VI. xxii), the removal of warts (VI. lxxxvii), slitting the
prepuce in phimosis (VI. lv), incising the tunica vaginalis in excision of
hydrocele sac (VI. lxii), opening abscesses (VI. xxvii), dissection of
sebaceous cysts (VI. xiv). Galen (xiv. 787) mentions its use in dissecting
open an imperforate vagina. Celsus has no special word for phlebotome. He
always refers to it by the general term scalpellus. Theodorus Priscianus,
whose Latin takes curious forms, gives us a transliteration of the Greek
term:
Convenit interea prae omnibus etiam his flebotomum adhibere, convenit
etiam eos ventris purgatione iuvari (_Euporiston_, xxi. 66).
Hippocrates in the famous passage on the surgical treatment of empyema
(ii. 258) says:
'Incise the skin between the ribs with a bellied scalpel, then let a
phlebotome (ὀξυβελεῖ) which has been wound round with a rag, leaving
the breadth of the thumb nail at the point, be pushed in.'
Ὀξυβελής literally means sharp-pointed. The term occurs in the _Iliad_, e.
g. applied to an arrow (iv. 126), but Galen in his Lexicon expressly
states that Hippocrates by it means the phlebotome. In his treatment of
empyema Paulus Aegineta uses not the phlebotome but a sharp curved
bistoury; however, in opening the abdomen for ascites it is the phlebotome
he recommends:
'We take a curved bistoury or a phlebotome and, having with the point
of the instrument dissected the skin that lies over the peritoneum, we
divide the peritoneum a little higher up than the first incision, and
insert a tube of bronze.'
All these various applications of the phlebotome are consistent with the
supposition that the phlebotome was the same as that figured in the
catalogues of the present day. Heister says:
Spectant huc primo loco ea quae Tab. 1 sub litt. A & B (Pl. VII, figs.
6, 7) exhibentur, _scalpellum_ nempe minus et maius; vulgus
_lancettas_ eadem nominant. Serviunt eadem, praesertim minora, venis
incidendis, quare phlebotoma Graecis vocantur; sed et abscessibus
aperiendis, imprimis maiora; ideoque Gallis etiam _lancettes a
l'absces_ appellari consueverunt.
A bronze blade of this shape is shown in Pl. VII, fig. 3. It was found
near Rome.
Public-domain text, read in full here on John Shaqi.
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