In Soranus (Bib. II. xviii. par. 59, p. 359, ed. Rose) there occurs mention of an instrument for puncturing the membranes where they do not rupture spontaneously:
Χόριον δὲ μὴ ἀναστομούμενον κατιάδι προσεχόντως διαιρεῖν τῷ δακτύλῳ προκοιλάναντα τι μέρος.
The Latin version of Moschion has:
Folliculum verum non ruptum ante digito impresso formantes locum phlebotomo sollicite dividimus omnibus praedictis post encymatismis utimur (xviii. 10, p. 83, ed. Rose).
However, we cannot accept this as conclusive evidence that the katias was the same as the phlebotome, as I have already pointed out that this version of Moschion is a late retranslation into Latin of a Greek translation of the original Moschion. While the meagre references to the katias point to its having been a similar instrument to the phlebotome, it is by no means certain that the instruments were identical. The next writer who notices the instrument is Aretaeus, who mentions it in the cure of headaches (Cur. Morb. Diut. i. 2):
‘We abstract blood from the nostrils, and for this purpose push into them a long instrument named κατειάδιον, or the one called the scoop’ (τορύνη).
In a note to his edition of Celsus, Lee says Aretaeus ‘invented an instrument having at the end a blade of grass, or made like a blade of grass, which was thrust into the nostrils to excite an haemorrhage in some affections of the head. This instrument is named κατειάδιον, from κατά and εἴα a blade of grass’.
I have shown, however, that Soranus, who wrote a century before Aretaeus, used the term, and a comparison of the various forms in which the word appears seems to me to point rather to a connexion with καθίημι, one meaning of which is ‘to let blood’. The next writer who mentions it is Aetius (II. iii. 2, and again II. iv. 14), where he refers to its use in opening quinsy, in a chapter copied from Leonidas:
‘If the patient be adult make him sit down, and, opening his mouth, depress the tongue with a spatula or a tongue depressor, and open the abscess with a scalpel or katias’ (σμιλαρίῳ ἢ κατιάδι).
Paul says that abscess of the womb is to be exposed with a speculum and opened with a scalpel or katias (σπαθίῳ ἢ κατιάδι). Paul also refers to it in perforating the foetal cranium in delivery obstructed through hydrocephaly (πολυπικῷ σπαθίῳ ἢ καθιάδι ἢ σκολοπομαχαιρίῳ) (VI. lxxiv).