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 flat chisel is referred to by Celsus in his description of the
levelling of an elevation on one side of a depressed fracture of the
cranium:
Ergo, si ora alteri insedit, satis est id quod eminet plano scalpro
excidere; quo sublato, iam rima hiat quantum curationi satis est
(VIII. iv).
Numerous references occur in other authors. There is a fine example of a
flat chisel in the Cologne Museum (Pl. XLI, fig. 2). It is all of steel,
and delicately ornamented with spiral indentations. This interesting
little instrument was found in the surgeon's outfit already described, and
is one of the best authenticated instruments--as regards its having been
the property of a surgeon--we possess. The chisel figured by Vulpes,
consisting of a cylindrical bronze handle and a flat blade, is, I believe,
a variety of scalpel.
We have many interesting references to the use of the chisel in bone work.
It was used as an osteotome to divide the bone in distorted union:
'If the callus be of stony hardness incise the skin with a scalpel,
and divide the union with chisels' (ἐκκοπεῦσι) (Paul, VI. cix).
In the removal of supernumerary digits we are to cut away the flesh all
round, and either chop the bone through with a chisel (τῷ ἐκκοπεῖ), or
remove it by sawing (Paul, VI. xliii). In using the chisel as an
osteotome one chisel was often placed behind the bone to steady it while
it was being struck by another in front. This method of applying two
chisels, which is only described by the Greek authors, is always referred
to by the phrase ἐκκοπέων ἀντιθέτων.
The following passage from Galen fully describes the manipulation (ii.
687):
'Separate off the membranes adhering to the bone, which being properly
done, divide the bone of the rib by means of two chisels placed in
opposition to each other _secundum artem_' (ἀντιβαλλομένων δυοῖν
ἀλλήλοις ἐκκοπέων ὡς ἔθος).
The following passage from Paul shows the chisel used for a similar
purpose:
'If part of the clavicle is broken off and unconnected, and if we find
it irritating the parts, we must make a straight incision with a
scalpel and remove the broken portion and smooth it with chisels (δι'
ἐκκοπέων), taking care that the instrument called 'meningophylax' (q.
v.), or another chisel, be put under the clavicle (μηνιγγοφύλακος ἢ
ἑτέρου ἐκκοπέως) to steady it' (VI. xciii).
Public-domain text, read in full here on John Shaqi.
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