Myzo vel sarcolabo haemorrhoides teneantur ita ut in aliquantum extensas scalpello prius radices earum scarifes, et in aliquantum artifex sarcolabo convertat.
Here, in all probability, Soranus, from whom Moschion is copying, has simply used μύδιον, and the added ‘vel sarcolabo’ is simply a gloss, for the terms μύδιον and σαρκολάβος are synonymous. However this part of Soranus is lost. Extant specimens of the vulsellum are common. A simple variety is formed by folding a plate of bronze on itself, as in [Pl. XXVIII, fig. 1], which shows a specimen in the British Museum. The jaws are finely toothed.
More usually the myzon is formed by sawing a plate of bronze partly along its midline as in [Pl. XXIX, fig. 2], which is taken from the find of the oculist Severus.
An interesting variation is seen in the specimen shown in [Pl. XXVIII, fig. 3] which is from my own collection. The line of junction of the jaws instead of being in the median plane is sloping. The object of this arrangement is not quite clear. A small variety of the vulsellum is referred to by Aetius:
‘Epulis we seize with a small vulsellum and excise with a small scalpel’ (ἡ ἐπουλὶς μυδιοσκέλλῳ ἀποταθεῖσα ἐκτεμνέσθω σμιλαρίῳ στενῷ, vii. 24, 25).
We have one or two of these instruments. They remind one of fixation forceps. I illustrate one in [Pl. XXIX, fig. 3]. It is from the Mainz Museum. There are four similar ones in the Frankfort Historical Museum. The specimen shown in Pl. [XXVIII, fig. 2], from the Naples Museum, is interesting as being stamped with the name of the maker, Acachcolus.
We have now to consider an interesting variation produced by extending the extremity of the blade to one side so as to increase the width of the blade (coudée type). This is a rare type.
[Pl. XXIX, fig. 1] represents one of two from the find of the surgeon of Paris. It is 17 cm. long, and the legs of the forceps are 8 mm. wide. The jaws debouch to one side at an obtuse angle for a distance of 2 cm. and end in a fairly sharp point. The jaw is thus increased to 2 cm. in breadth. They are finely toothed. They are concave internally and convex externally. The other forceps was 14·5 cm. long and 8 mm. wide. The Museum at Naples has a forceps of this type, but having a sliding ring to fix the jaws after they have been applied ([Pl. XXIX, fig. 4]).
This angled type of forceps may be the one referred to by Paul in his description of the plastic operation on the eyelid for trichiasis (VI. viii), when he directs us to raise the redundant skin of the lid with a fixation forceps and cut it off with a scalpel (βλεφαροκατόχῳ μυδίῳ, τοῦτ' ἔστι πρὸς τὴν περιφέρειαν τοῦ βλεφάρου ἐσχατισμένῳ ἀνατείναντες τὸ περιττὸν δέρμα, σμιλίῳ ἀποκόπτουσι). It may be noted that this coudée type of forceps has considerable affinity with the type of forceps presently to be described for strangling haemorrhoids and the relaxed uvula, the only essential difference being that the blades are not crossed here.
Uvula Forceps.