This passage clearly proves that there were two scalpels of a set, each having opposite curvatures after the manner of our right and left vesicovaginal fistula knives. _Curved blade cutting on one side, blunt-pointed.--Fistula Knife._ Greek, συριγγοτόμον, from σῦριγξ, 'a fistula.' This was a falciform blade whose end was blunt, but the handle end was prolonged into a slender, rounded sound-like portion with a sharp point (Pl. IX, fig. 1). The narrow point was passed into a fistula, caught, and the whole instrument pulled outwards by means of it, thus dividing the overlying tissues with the falciform blade. This instrument remained in use till comparatively recent times. Heister figures a large number of varieties, and from him I have taken the figure shown, although it is also described and figured by Fabricius. The two following passages, taken in conjunction with each other, show that the classical instrument was of the form I have indicated. The first passage, from Galen, shows that the end of the blade was blunt, and that there was only one cutting side. The second, from Paul, shows that the blade was falciform and was operated in the manner I have stated. Galen (x. 415) says that in enlarging an abdominal wound we use a fistula knife (συριγγοτόμῳ). 'But the scalpels which are two-edged or have a point are distinctly to be avoided' (τὰ δ' ἀμφήκη τῶν μαχαιρίων ἢ κατὰ τὸ πέρας ὀξέα παντὶ τρόπῳ φευκτέα). Secondly, Paul (VI. lxxviii) says: 'Having perforated the bottom of the fistula with the point of the falciform part of the syringotome (τοῦ δρεπάνου τοῦ συριγγοτόμου) bring the instrument out of the anus and so divide all the intervening space with the edge of the falciform part' (τῇ ἀκμῇ τοῦ δρεπάνου). Another passage in the same chapter indicates that some of the syringotomes had an eye in the instrument: Τινὲς δὲ ἐν τῷ τρήματι τοῦ συριγγιακοῦ δρεπάνου τὸ λίνον ἐνείραντες. There was also a straight variety of the instrument (τὰ καλούμενα ὀρθὰ συριγγοτόμα, Paul, VI. lii). _Curved blade cutting on two edges._ A curved blade of a somewhat unusual type is described by Galen in discussing the dissection of the thorax (ii. 673). However, the description is unmistakably clear. He says: Χρῆσθαι δ' αὐτῆς μάλιστα τῷ κυρτῷ μέρει κεχαλκευμένης ὁμοίως ἑκατέρωθεν, ὥστε ἀμφικύρτους ἔχειν ἀμφότερας τὰς τεμνούσας γραμμὰς ἀλλὰ κατὰ μὲν τὴν ἑτέραν σιμῆς, κατὰ δὲ τὴν ἀντικειμένην ταύτῃ κυρτῆς. 'It is best to have the curved part forged alike on both sides so that the cutting edges are curved in two ways, viz. one concave and the other convex.' A smaller variety for fine dissection is referred to in the same book (εἰς ὅπερ ἐστὶν ἐπιτηδειοτάτη μυρσίνη κυρτή, ii. 674). _Shears._ Greek, ψαλίς; Latin, _forfex_.