It is interesting to find that we have at least one grooved director extant to prove that this instrument was known to the Romans. It is in the Section of Surgical Antiquities of the Musée de Cinquantenaire, Brussels, and it was discovered, along with several other surgical instruments, in a surgeon’s case of the usual cylindrical form.
It is 15 cm. long, 2 mm. in diameter. A deep groove runs for 6 cm. from one end. The other end terminates in a small button. It is of silver, as also were the other contents of the case. It is possible that grooved specilla may have been in quite common use, but may have been made of wood or tin, and have therefore not survived; because we learn from Galen’s Manual of Dissection that probes which were used as directors in dissecting work were generally of wood, such as boxwood, so that they might not chip the scalpel (ii. 711).
Surgical Needle (three cornered).
Before discussing the eyed probes it will be well to clear the way by disposing of the needles, and of these, as the most easily defined class, it will be best to take the surgical needles first. We have innumerable references to the surgical needle though we have no actual description of it. There must have been many different sizes of it, for the manipulations vary greatly in magnitude. I shall content myself with giving two quotations describing respectively one of the largest and one of the smallest of these. Both passages are from Celsus. He thus describes the operation of suturing the abdominal parietes:
Sutura autem neque summae cutis neque interioris membranae per se satis proficit; sed utriusque: et quidem duobus linis iniicienda est, spissior quam alibi; quia et rumpi facilius motu ventris potest, et non aeque magnis inflammationibus pars ea exposita est. Igitur in duas acus fila coniicienda, eaeque duabus manibus tenendae; et prius interiori membranae sutura, iniicienda est sic ut sinistra manus in dexteriore ora, dextra in sinisteriore a principio vulneris orsa, ab interiore parte in exteriorem acum immittat: quo fit ut ab intestinis ea pars semper acuum sit quae retusa est. Semel utraque parte traiecta, permutandae acus inter manus sunt, ut ea sit in dextra quae fuit in sinistra, ea veniat in sinistram quam dextra continuit: iterumque eodem modo per oras immittendae sunt: atque ita tertio et quarto, deincepsque permutatis inter manus acubus plaga includenda. Post haec, eadem fila eaedemque acus ad cutem transferendae similique ratione ei quoque parti sutura iniicienda; semper ab interiore parte acubus venientibus, semper inter manus traiectis: dein glutinantia iniicienda (VII. xvi).
In the next case, where Celsus describes the treatment of staphyloma of the cornea, a very small needle must have been used:
Haec fere circa oculum in angulis palpebrisque incidere consuerunt. In ipso autem oculo nonnunquam summa attolitur tunica, sive ruptis intus membranis aliquibus sive laxatis; et similis figura acino fit: unde id σταφύλωμα Graeci vocant. Curatio duplex est: altera, ad ipsas radices per mediam transsuere acu duo lina ducente; deinde alterius lini duo capita ex superiore parte, alterius ex inferiore adstringere inter se; quae paulatim secando id excidunt: altera in summa parte eius ad lenticulae magnitudinem excidere (VII. vii).
Now for suturing tissues, and more especially tissues of such toughness and thickness as the abdominal parietes, a round needle is absolutely of no use. A surgical needle not only requires to have cutting edges, as our three-cornered needles have, but these edges need to be in good condition to work well. Three-cornered surgical needles were in use from very early times. They are fully described in the Vedas of the Hindoos (Wise, Hindoo System of Medicine, p. 171). A few three-cornered needles of Roman origin have been found, although they are rare. Those which exist are of bronze. Probably the majority were of steel, and of these none have survived. I give a photograph of a three-cornered needle from my collection ([Pl. XVII, fig. 4]). It is imperfect at the point. It measures 7·2 cm. in length, and the sides are each 2 mm. in breadth. It is important to emphasize the fact that only needles with cutting edges are to be looked on as surgical, because it is not unusual to find needles, which are round and of large calibre, described as surgical, although they are quite unfitted for surgical work. Such is the one figured by Vulpes (op. cit.).
Needles of this kind are sometimes found, as this one was, among surgical instruments. But they are not surgical needles in the sense that they are intended for suturing tissues. They are for fixing bandages. I shall describe them in the next section.