Ancient Roman surgical practices developed from Greek techniques. Roman surgeons and doctors usually learned through apprenticeships or studying. Ancient Roman doctors such as Galen and Celsus described Roman surgical techniques in their medical literature, such as De Medicina. These methods encompassed modern oral surgery, cosmetic surgery, sutures, ligatures, amputations, tonsillectomies, mastectomies, cataract surgeries, lithotomies, hernia repair, gynecology, neurosurgery, and others. Surgery was a rare practice, as it was dangerous and often had fatal results. To perform these procedures, they used tools such as specula, catheters, enemas, bone levers, osteotomes, phlebotomes, probes, curettes, bone drills, bone forceps, cupping vessels, knives, scalpels, scissors, and spathas.
History Roman medical practices, including surgery, were borrowed from the Greeks, with many Roman surgeons coming from Greece. In the 2nd century CE, Galen, a Greek physician advanced Roman surgical knowledge by combining Greek and Roman medical knowledge.
Aulus Cornelius Celsus was a Roman encyclopedist notable for his work De Medicina. The text describes operations such as tonsillectomies and cataract surgery. Alongside these surgeons and doctors, Soranus of Ephesus introduced technology such as the birthing chair.
Surgeons were attracted to ancient Rome due to the potential for success and wealth. Doctors learned through private courses from other doctors, their relatives, in the city of Alexandria, or through self-teaching.
Charlatans and malpractice were common in ancient Rome, as any individual, regardless of their training or qualifications could practice medicine. This resulted in the general public becoming distrustful of doctors. Higher-quality surgeons often served the upper classes.
According to Celsus the perfect surgeon would be a younger man with strong and steady hands, sharp eyes, a strong spirit, and a strong sense of empathy and compassion. Surgery was rare in ancient Rome, it was rare for a patient to recover, and the procedure was dangerous. Most surgical procedures were limited to skin lacerations or amputations.
Tools Cupping vessels Cupping vessels were round suction cups usually made of bronze or horns. They were made of different materials and had different designs and purposes. Bronze vessels were also used. They usually contained burning lint and were closed at one end and open at the other. Horn cups had small foramens at the ends and cavities closed off with wax. Cups had holes that were placed over injured areas and sweat glands. Following this, the tool would be used to draw out pus and "vicious humor." Cupping vessels were also used to aid bloodletting. First, heat was applied to the area to warm it up. Then, the skin was cut with a scalpel, following this, the cup would be fastened to the area to draw blood. Larger cupping devices were used for larger parts of the body, such as the back. Smaller cups were used for smaller parts of the body, such as the arms or the neck.
Chisels and raspatories Raspatories, also called rugines, were made of a blade fixed to a shaft at a right angle. They were used to treat bone fractures. In this procedure, the wound was filled with black ointment, then a linen rag filled with oil, and finally, it was used to scrape the bones. They would make incisions into and remove the skin to hold it or the bones in place. These tools were made of steel and covered in spiral decorations. Chisels were used during surgeries on teeth or bones. One kind of chisel, known as the lenticular, was used in neurosurgery. It was made of a rounded smooth knob, which was inserted into the open cranium or meninges. Hammers and blocks would be used alongside the chisels. To amputate a limb, it was placed on a block, then a chisel would be used to cut it off. Lithorites were kinds of chisels designed to remove calculus from the bladder. They would be struck through the calculus, eventually breaking it.
Drills and levers
In ancient Rome, there were two kinds of surgical drills. One type was driven by a leather cord, the other type used a guard and a collar. This was designed to stop the instrument from penetrating too deeply into the bone. It was thought that this would minimize the risk of damage to the brain and meninges. Drills would also be frequently dipped in water to reduce heat, which was supposed to limit the danger of the surgery. The primary purpose of a drill was to remove large diseased portions of skulls. For example, drills were used to remove weapons lodged into the skull. Small drills were used to perforate the nasal bone. Which would create a "passage for the fluid or matter to the nose," thus treating the fistula. Drills were shaped like wine corkscrews. Bone levers were ancient steel tools shaped like rods with flattened and curved tips resembling stone cutters. They were used to level fractures, extract teeth, and realign broken bones."Ancient medicines and bone lever in rare Roman medical kit." Premium Official News, 26 Feb. 2016. Gale OneFile: News.
Saws and trephines Saws were primarily used to cut through bone. In one procedure for treating gangrene, a band was used to retract the skin to prevent the saw from tearing through the flesh. Then the saw could amputate the infected limb. Trephines were in the form of a circular saw. Doctors believed it needed to be frequently removed from the skull and placed in cold water during an operation. This was designed to alleviate the "heat" in the "bone." Trephines were used to saw the bone to the meninges thus treating injuries to young people's heads.
Forceps
Bone forceps were used to extract injured bones from the body.Harvey, Ailsa. "WHAT THE ROMANS TAUGHT US: How ancient Roman technologies have influenced the modern world." How It Works Magazine, no. 161, Feb. 2022, pp. 40+. Gale General OneFile. They were common tools, despite the Roman preference for using fingers instead of tools to fix bone injuries. Bone forceps were primarily used for instances in which pieces of bone were too small for fingers to remove. They would also cut off broken parts of the skull, or even drill through to the brain. Another kind of forceps, called Epilation forceps was primarily used to remove hair. Polypus forceps were used to remove polyps or tumors from the nose.
Tumor vulsellums, also known as Myzons, were toothed forceps that were used to remove tumors. In one procedure, they were used to "seize" the clitoris and cut off the tumor. To amputate the uvula, they used a tool known as uvula forceps to crush it and prevent bleeding. Following this, the vulsellum was used to twist it until a torsion was created. Then the uvula was cut off. Forceps could also be used to apply corrosive substances to the uvula to destroy it. These tools were made of two crossing branches which were fixed to the middle of the tool with a rivet.
Pharyngeal forceps were made of fishbones and they were used to remove entities from the pharynx. Varix extractors were a type of forceps used to extract varicose veins, which is a medical condition characterized by abnormally large veins."Varicose Veins". National Heart, Lung, and Blood Institute (NHLBI). Retrieved 20 January 2019. This procedure would be conducted by mapping out the locations of the afflicted veins, then the skin would be held and divided. Following this the extractor would hold and cut the skin, allowing for the veins to be removed. Tooth and stump forceps were used to extract teeth. This operation, and hence these tools were rarely employed due to how dangerous the operation was.
Probes and curettes
Probes and curettes were used to mix and apply medication to the skin or to lift tissue. When pushed into the fistula they were used to measure their dimensions. Roman probes had parts known as the nucleus. The nucleus was used primarily to apply medication. Sodium hydroxide was applied to the nucleus, which would then be used to burn out the eyelid. Wax was warmed on the nucleus of the probe, and then it was used to apply pomade to the face.
One type of probe consisted of a rod rounded off at one end. Another type was slender with enlarged ends. It was used to burn tissue and for organ transplantation. The largest probes were known as spathomeles. These tools were very common, with almost every ancient Roman medical writer mentioning them. Cyathiscomeles were types of spathomeles with large nuclei and a plain or fluted shaft overlaid with silver. Screw probes were designed to wrap around wool. Rasping probes were used to curette granular lids. Another kind of probe, called styli or styloid probes was used to puncture bladders. Grooved directors were instruments used to make incisions into the skin. These tools were usually made out of boxwood. Eyed probes were made from a rod of tin, and they were used to treat fistula. Bifurcated probes and retractors were used to extract weapons buried in the flesh.
Ear probes, also known as ear specilla, were made of a narrow scoop and an enlargement at each end. These tools had no nucleus or tip. They could also be used as curettes. Their primary purposes was cutting the interior of the chalazion and applying medications or liquids. The sharp end of the ear probe was used to treat fistula. A large ball of wood would be saturated with water and wrapped around the probe. Once squeezed, the liquid would drip onto the ear canal, which was thought to extract entities from the canal. A larger version of the ear probe, possibly with a slight enlargement at the ends, was used for treating wounds. This would be done through an incision behind the ear, following this the ear scoop was used to remove the objects. A common symptom of this procedure was dullness of hearing, often preceded by persistent headaches. Scabs and ulcers were other common side effects. To treat this, they were typically fomented with warm water, or verdigris drenched in honey, leek juice, and niter in mead. Following this, water was used to wash the ears. This tool could also be used as a curette.
Scalpels
Scalpels were tools made of a steel blade and a bronze handle. The bronze handle could be round, square, horizontal, or trapezoidal. Some scalpels had handles made of copper alloys with grips, dissectors, and an iron blade. This design was used to maximize efficiency. A slot was placed at one of the ends to connect to the steel blade. On the other end of the handle was connected to a leaf-shaped spatula. This spatula functioned as a blunt tool for dissection. A groove or a long and narrow indentation was located near the end of the handle. Alternatively, a cylindrical roll perforated with a hole could be used instead. Threads, wires, rolls, and perforations were used to attach the blade to the handle. Handles would have been decorated with moldings or inlay. The blade was made detachable to allow for cleaning and the usage of several blades. There were a variety of kinds of blades. One was straight, sharp, and pointed. Another was curved with sharp or blunt points. Blades were secured to the handles using simply sockets or key-hole shaped sockets using an alloy known as solder. The scalpel had great flexibility and performed a wide variety of functions, such as tearing away muscle and tissue during amputation, severing the umbilical cord, removing nasal polyps, mastectomies, making incisions, cutting through bone, and hernia repair.
Specula