Theodorus Priscianus, alias Octavius Horatianus, lived in the fourth century and has left a work, in three books, called Euporiston. It is a compilation in African Latin of extracts from Galen, Oribasius, &c. The style of the Latin is so barbarous that it really must be seen to be believed. There is a little information to be gathered about minor instruments. The edition I have used is that of Rose, Leipzig, 1894. To this edition are tacked on the medical remains of Vindicianus Afer, mere fragments without anything to interest us.
The works of Alexander Trallianus (526-605 A. D.) contain practically no surgery at all, although I have managed to extract a few references of minor interest.
The last of the eminent Greek writers is Paulus Aegineta, a writer who probably lived in the sixth and seventh centuries. This is getting rather late in the day, it is true, but to omit the works of Paulus, or Paul, as he is affectionately called by his admirers, would be to omit some of the most valuable knowledge of ancient medicine we possess. Paul, like most of his time, was a compiler, but he was a skilful one, and while he entirely depends on Galen, Archigenes, Soranus, &c. for his information, he has gathered up the best of the medical knowledge of his time in a little encyclopaedia whose artistic completeness and orderly arrangement are not surpassed by any work of a corresponding nature at the present day. The work is divided into seven books, the sixth of which deals with surgery and teems with information about instruments. Aldus published the entire Greek text at Venice in 1527. A fine English translation, with a most valuable commentary, was published by Adams of Banchory for the Sydenham Society in 1846. No one who reads it can wonder that Adams had a worldwide reputation for his knowledge of medical history. The important sixth book was published along with a translation in French by Briau at Paris in 1855.
I have obtained a description of two very important instruments from the works of Hero of Alexandria (285-222 B. C., ed. 1575). There are a few interesting references to instruments in the works of the early Christian fathers. Tertullian is the only one of these I can claim to have systematically searched, but in one of his sermons he refers to no less than four surgical instruments, one of which is not described by any other author.
It were a work of supererogation to recount the names of the other Greek and Roman writers whose works I have run through in a profitless search for references to instruments. Some of these, such as Dioscorides, are of great importance in themselves though valueless for our purpose. Others, such as many of the minor Greek writers contained in the collection by Ideler entitled Physici et Medici Graeci Minores (Berlin, 1841), and the minor Latin writers contained in the collection of Medici Antiqui Omnes (Aldus, 1547), are of little value of any kind.
Before the capture of Alexandria by Omar in 651, many Greek medical writings had been translated into Syrian. At a later date such of these as had escaped destruction were turned into Arabic by the scholars of Bagdad (Honain and his School), in the ninth century. These, introduced into Spain in the Middle Ages by the Moors, were again translated into Latin and supplied for many a day the greater part of the medical knowledge of Europe, until the study of the few Greek texts which had escaped destruction showed the true origin of Arabian medicine. It will thus be seen that there is some information, in fact a great deal, to be had from the study of the works of the Arabs, but the barbarous style of the Latin and the roundabout way in which the works have been preserved, having passed through translations of three different languages, preclude any very exact deductions being drawn from them. Some of these works are profusely illustrated with figures of instruments, but I have been careful not to fall back on any of the Arabs except to support deductions drawn from more direct sources.
The chief Arab writers of interest to us are:—Serapion (800), Rhases (882), and Ali Abbas (after 950), all of Honain’s School at Bagdad. The huge work of Avicenna (born 980), The Canon, was much used by the Arabs. It was published at Cordova, which became the Bagdad of the West after the Arabs crossed to Spain in 811.
The work of Albucasis (ob. 1106) was also published at Cordova, and contains much surgical information and has many illustrations of surgical instruments, but these must be used with due caution. I have used the edition published at Strasburg in 1532.
A word must be said of the later writers such as Paré (1509-90), Scultetus (1650), and Heister (1739). The works of these are profusely illustrated with instruments, some of which can plainly be seen to tally exactly with the descriptions of the classical authors. In other cases, although the names given to the instruments are those of classical times, it is, to say the least, doubtful whether they are of the same form as the ancient instruments whose names they bear. That was an age of great activity in the manufacture of new forms of surgical instruments, and we must accept with caution illustrations professing to indicate ancient forms of instruments. At the same time it is very interesting to note the large number of primitive arrangements which remained in use till nearly 1800. The enema syringe figured by Heister is exactly the same as we find described in the Hippocratic works—the bladder of an animal affixed to a tube—and many practitioners alive at the present day have seen the same simple arrangement in actual use.