I.A (a) Straight blade cutting on one edge, sharp-pointed.
1. Ordinary scalpel.
2. Scalpel with tip turned back.
3. Bellied scalpel.
4. Scolopomachaerion.

Ordinary Scalpel.

The ordinary scalpel had apparently a straight, sharp-pointed blade. The word which Galen, Aetius, and Paulus Aegineta use to denote scalpel is σμίλη. Latin authors use scalpellus, the diminutive of scalper. From the etymology of these terms we can learn nothing as to the shape of the blade; they are merely general terms denoting a cutting blade of any kind—chisel, graving tool, knife, &c. The word Hippocrates uses, μάχαιρα or μαχαίριον, has a more definite meaning. It is from μάχαιρα, the old Lacedaemonian sword, a broad blade cutting on one edge, sharp-pointed, and straight or with the tip turned slightly backwards. Thus, even in Hippocratic times the scalpel was apparently much of the same shape as it is now. Good examples of the ordinary scalpel may be seen in [Pl. V, figs. 1 and 2] from the British Museum. They are all of steel. A variety with the point turned back at the tip is seen in one of the scalpels in the scalpel box from the Acropolis ([Pl. IV]).

A more bellied form is seen in [Pl. V, fig. 5], which is from the Naples Museum, and is all of bronze, handle and blade. At the Scientific Congress held at Naples in 1845 Vulpes showed this specimen, and described it as the lithotomy knife invented by Meges and mentioned by Celsus (VII. xxvi).

Later I shall discuss in detail the instrument of Meges, but I believe the instrument shown by Vulpes is only an ordinary scalpel with a somewhat bellied shape.

Hippocrates refers to a bellied scalpel in a well-known passage on empyema (ii. 258):

Ὅκως σοι ἡ ἔξοδος τοῦ πύους εὐρὺς ᾖ τάμνειν δεῖ μεταξὺ τῶν πλευρῶν στηθοειδεῖ μαχαιρίδι τὸ πρῶτον δέρμα.

‘Incise the outer integument between the ribs with a bellied scalpel.’

Στηθοειδής means rounded like the breast of a woman. Galen translates it in his lexicon τῷ σμιλίῳ ἰατρικῷ γαστρωδεῖ, ‘the bellied surgical knife.’ It is quite a serviceable instrument for several kinds of work, and it seems to have been a common form. Three out of the six scalpels depicted in the votive tablet from the Acropolis are of this form, and there are now in the Naples Museum four others of the same shape as the one described by Vulpes. These have blades of steel and handles of bronze. The figures of three of these ([Pl. V, figs. 3-6]), show the gradual evolution from a common scalpel into the bellied form. I have seen a scalpel with a blade similar to [Pl. V, fig. 3] in use in Scotland for castrating piglings and calves.

Scarificator for wet cupping.