These writers, then, all take note of the possibility of wounding the vein, but give no clue that they knew of the utility of a cloven plate in preventing the accident. Further, the Arabs, timid operators all and fond of describing safeguards such as this, give no mention of it, although Albucasis, Rhases, Avicenna, and Haly Abbas all describe the operation. I can find no reference to the use of a guard for this purpose until quite recent times.
Ear specillum.
Greek, μηλωτίς, -ίδος, μηλωτρίς, ἀπυρομήλη, τῇ πυρῆνα μὴ ἐχούσῃ τούτεστι τῇ μηλωτρίδι (Galen, Lexicon); ὠτογλυφίς, μήλην ἐξωτίδα (Galen, Lexicon); Latin, oricularium specillum (Celsus); auriscalpium (Scrib. Largus); German, Ohrlöffel.
Of all the specilla this is one of the most frequently mentioned by name. It consists of a small narrow scoop at one end and a simple probe without olivary enlargement at the other. We shall discuss the scoop first. The following passage from Archigenes describes it (Galen, xii. 652):
‘If a bean, stone, &c., fall into the ear remove it with the small narrow scoop of the ear specillum’ (κυαθίσκῳ στενῷ μικρῷ μηλωτρίδος).
Again Galen (loc. cit.) and Paul (VI. xxiv) say that in cases where foreign bodies cannot be got out of the ear by more simple methods, we must incise behind the ear and remove them by means of the ear scoop. The removal of foreign bodies from the ear by means of this instrument is very frequently referred to and shows that the scoop was small. Celsus says (VI. vii):
‘When a person begins to experience a dullness of hearing, which very often happens after long continued headaches, first of all we must examine the ear itself, for there will appear either a scab such as occurs upon ulcers, or a collection of sordes. If there is a scab it ought to be fomented with warm oil or with verdigris in honey, or leek juice or a little nitre in hydromel, and when the scabs have been detached from the part, the ear is to be washed out with tepid water, in order that being spontaneously separated it may be the more easily extracted with the ear specillum (oriculario specillo). If there is cerumen and it is soft, it is to be extracted with the same specillum, or if it is hard vinegar with a little water is to be put in, and when it is softened the ear is to be washed out and evacuated in the same way.’
In VI. vii he says:
Ubi vero vermes orti sunt, protrahendi oriculario specillo sunt.
‘Where worms have arisen they are to be extracted with an ear specillum.’