The object of this book is to lay before the student of medical history an account of the various instruments with which the ancient Greek and Roman surgeons prosecuted their craft. It is self-evident that no clear conception of a medical operation, ancient or modern, can be formed from written description without some previous knowledge of the instruments intended to be used. Many interesting operations described in detail in the classical authors are rendered obscure or quite unintelligible from lack of this knowledge. The learned Adams gives an accurate translation of a long and involved chapter by Paulus Aegineta on the use of the vaginal speculum, but remarks that owing to our want of knowledge of the specula possessed by the ancients the chapter is unintelligible. Daremberg says it is impossible to say what was the shape of any of the cutting instruments mentioned by Hippocrates. The steady progress of archaeological discovery has gradually added find after find of surgical instruments, till now there is scarcely a museum with any considerable number of antique petits bronzes which does not number among its contents a few surgical instruments, and in the Naples Museum alone there are hundreds. In several cases we know even the name of the original possessor of these and the special branch of surgery which he practised. There are thus open to us materials which were not available to the men of learning to whom I have referred above, and the time seems opportune to undertake a systematic review of all the materials at our disposal, and attempt to reconstruct the surgical armamentarium of the ancients. Considering the importance of the subject, it is surprising that no such systematic attempt has previously been made. Indeed, comparatively little attention has been given to this department of archaeology. Literature bearing on it is comparatively scarce. What we have is entirely continental, and consists of a series of reports of different finds with attempts to indicate the uses of the instruments described. In addition to these reports and the actual instruments scattered over various museums, we have at our disposal the writings of the ancient authors themselves. In these a fair number of instruments are minutely described, while many others are named, and here and there points about their shape are mentioned in different places; and by piecing these particulars together and deducing other facts from the nature of the manipulations the instruments are employed in, we can describe in detail, with a tolerable amount of certainty, a surprisingly large number of instruments. It must be confessed that these ancient classics are rather difficult of access, surprisingly so considering that until a few decades ago they were reverenced as works of authority for medical practice; but the fact seems to be that our predecessors were largely content to draw their knowledge of these authors from mediaeval Latin translations. Part of one of the most interesting authors has never been published in the original Greek, and for our knowledge of it we are dependent on a sixteenth-century Latin translation, supplemented, it may be, by fugitive consultations of codices in libraries and museums.
Others of the Greek texts have not been reprinted since the sixteenth century, and bristle with the ingenious but at first perplexing shorthand contractions with which the Renaissance typographer imitated the Compendia of the manuscripts. These difficulties can be got over with patience, however, and the waste of gray matter necessary as a preliminary is not out of proportion to the results to be obtained. Even as a quarry for philological materials the medical classics are far from being worked out, and it is surprising how many words one meets with which are not to be found in the best Greek-English dictionaries.
The method pursued in the present investigation was to make a complete examination of the classical medical, surgical, anatomical, and pharmaceutical writings which have been preserved to us, copying out the portions in which an instrument was mentioned. These extracts were then rearranged in ledger form, each extract being classified under the heading of the instrument it referred to. Out of the enormous number of references thus obtained, those passages were selected which seemed to throw any light on the shape and size of the instrument to which they referred. Next an examination was made of the reports of finds in various localities; as many specimens in various museums were examined as possible; and annotations of classical texts were searched for any further information they might give. The total information thus gained is so arranged that under the heading of each instrument will be found a series of selected extracts from different authors, with the deductions from them which it is possible to make regarding the appearance of the instrument, and an illustration is given of it from some ancient specimen where such is inexistence. Failing actual ancient specimens, I have fallen back on mediaeval or ancient Arabian authors for illustration.
I have omitted a discussion of the many interesting mechanical contrivances for the reduction of deformities due to fracture and dislocation, and also of the splints, pads, and bandages for maintaining these injuries in position. These form such a well-defined group that they might fitly form the subject of a special monograph, and the illustrations required are of a different nature from those in the present volume. The majority of these contrivances will be found described in a chapter by Heliodorus preserved in Oribasius. I have omitted also all reference to the numerous forms of vessels in which the ancients prepared and stored their medicaments, with the exception of those which are intended for carrying on the person. Some of these merge into forms which are common to both drug and instrument cases, and it is impossible to separate them. It has been necessary also to include as far as possible the instruments involved in the preparation and application of medicaments, as most of these are either actually or potentially implements of minor surgery.
The volume opens with a short account of the ancient authors whose writings have any bearing on the subject in hand. At the end of the book will be found a bibliography of reports on finds, and a list of the most interesting instruments to be found in various museums. The latter makes no pretence of being a complete inventory, although it might serve as a skeleton for the construction of a more comprehensive list at some future date. The bibliography, on the other hand, is believed to be fairly complete. The bulk of the book consists of an attempt to reconstruct, in the manner described above, the different instruments used in classical times.
The books from which I have drawn most information are Brunner’s Die Spuren der römischen Ärzte auf dem Boden der Schweiz, Deneffe’s Étude sur la Trousse d’un Chirurgien Gallo-Romain du IIIe Siècle, Adams’ translation of Paulus Aegineta, and the papers of Vulpes in the volume for 1851 of the Memorie della Regale Accademia Ercolanese di Archeologia.
During the five or six years which I have spent on this investigation I have unsparingly laid all my friends under contribution whenever opportunity occurred; but among those to whom I am particularly indebted I may mention Mr. M. G. Swallow of Baden, who has given me much assistance in working up the Swiss finds, Professor Alexander Ogston, under whom I spent many happy days as house-surgeon, and who has all along kept a fatherly eye on the progress of the work and encouraged me to proceed to the end with a task which at times seemed inclined to swamp me, Mr. R. C. Bosanquet, late director of the British Archaeological School at Athens, who procured for me photographs of the instruments in the Athens museum, and Mr. H. R. Nielsen of Hartlepool, who has been the companion of my wanderings among the continental museums. I have also to thank my father, John Milne, LL.D., for much help at many different points.
The expense of visiting the museums in the North of France and of obtaining photographs of the instruments in them has been borne by a grant from the Carnegie University Research Fund.
This monograph was presented as the thesis which forms part of the examination for the degree of M.D. of the University of Aberdeen, and it was successful in gaining ‘Highest Honours.’
April 19, 1907.