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
Soranus (II. x) describes plugging for uterine haemorrhage by means of the
sound:
Καὶ τρυφερὸν ἔριον ἑνί τινι τῶν εἰρημένων χυλῶν διάβροχον διὰ δακτύλου
ἢ μήλης παρεντιθέσθω τῷ στόματι τῆς ὑστέρας. καὶ πολὺ μᾶλλον ἐντεῦθεν
τῆς αἱμορραγίας ὑπαρχούσης.
Hippocrates (iii. 34) alludes to applying medicament to the internal os
with the sound:
'Grind the pulp of colocynth, &c., and rub it up with honey and smear
it on the sound (περὶ μήλην) making the consistence such that it can
enter the os and always be pushed beyond until it has penetrated to
the interior of the uterus. When the medicament has liquefied extract
the sound, and again in the same way apply elaterium.'
If pus collect in the uterus post partum, or after abortion or from any
other cause, it is good practice to pass a sound (μήλην ὑπαλειπτρίδα) into
the cervix (i. 471). In another place we are directed to draw off gas in
the uterus by fomenting the whole body and the uterus with vinegar and
water, warmed specilla being afterwards inserted (μήλας διαπύρους
ἐμβάλλοντα).
Again we find the sound applied to correct malposition of the uterus (iii.
140):
'When the semen is extruded on the third day and the woman
consequently fails to conceive, take small soft feathers and tie them
together, and foment the uterus as we do the eyes. Make the feathers
even at the tips and tie the ends with a very fine thread, and anoint
with much rosaceum. Also place the patient on her back on a couch, and
place a pillow under the loins, and, the woman's thighs being extended
and separated, insert a sound and turn it to this side and that till
it project.'
In all these cases there is no special instrument designated as being used
for a uterine sound, only the spathomele (ὑπάλειπτρον) and the olivary
probe named. With both of these we have met before. However, I have
thought it of historical interest to cast these passages together. It will
also clear the way for the discussion of other instruments, whose use is
entirely reserved for the purpose of dilation of the cervix.
A more questionable use of the sound is referred to by many authors.
During the Empire the death of the foetus was frequently procured both by
abortifacients and instruments. Frequent references to the use of drugs
for this purpose may be found in the lay writers such as Juvenal and
Suetonius (_Domitian_), and the later medical authors do not hesitate to
describe the composition of abortifacient pessaries. It will be remembered
that the Hippocratic oath specially forbids this practice.
_Uterine Dilators--Solid, graduated wooden._
Greek, διαστομωτρίς, μήλην τὴν διαστέλλουσαν--τὸν διαστολέα (Galen,
_Lexicon_).
Public-domain text, read in full here on John Shaqi.
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