Forceps for applying Caustic to Uvula.
Greek, σταφυλοκαύστης.
A remarkable variety of forceps, of which there is only one extant specimen (which is in the Vienna Museum) is shown in [Pl. XXXII, fig. 2]. It is formed of two branches which cross and are fixed by a rivet near the middle of the instrument. The jaws are 3·5 cm. long, concave internally, and fit accurately together, enclosing an oval cavity 1 cm. in diameter. This forceps is, I believe, the one which Paul describes as used for destroying the uvula with caustic. He says (VI. xxi) that if from timidity the patient decline excision of the uvula, we are to take the caustic used for operations on the eyelids, or some such caustic, and fill with it the hollows of the caustic holder for the uvula (τοῦ σταφυλοκαύστου τὰς κοιλότητας), and directing the patient to gape wide, and getting the tongue pressed down with a tongue depressor, we open the instrument sufficiently and grasp with it as much of the uvula as we cut off in the other operation. The medicament must neither be of too liquid consistence, lest it run down from the uvula and burn the adjoining parts, nor very hard, that it may quickly act on the uvula. And if from one application the uvula becomes black this will be sufficient, but if not, we must use it again. In VI. lxxix he says that some, filling the hollows of the staphylocaustes (τὰς κοιλίας σταφυλοκαύστου) with caustic, burn off haemorrhoids in the same way as they do the uvula. An interesting use of this instrument is mentioned by the same author in the chapter above referred to, while describing the method of treating haemorrhoids by the ligature:
‘By means of the forceps for applying caustic to haemorrhoids, or the forceps for applying caustic to the uvula (τῷ αἱμορροϊδοκαύστῃ ἢ τῷ σταφυλοκαύστῃ), we surround them close to the jaws of the instrument (πρὸς τὰ χείλη) with a five-ply thread of lint, and strangle the haemorrhoids separately with this ligature.’
It would seem then that, just as there was a long instrument for crushing the uvula and a short one for crushing haemorrhoids, there were corresponding instruments for cauterizing these parts, probably differing from each other only in the length of the handle.
The passage above quoted has given much trouble to the scribes and commentators apparently from a lack of knowledge of the instrument referred to. About a third of the codices omit τῷ αἱμορροϊδοκαύστῃ, and Cornarius and Dalechamps reject the words τῷ αἱμορροϊδοκαύστῃ ἢ τῷ σταφυλοκαύστῃ as superfluous and interpolated. Apparently they were unaware that both instruments were forceps of similar principle but different lengths, and quite suitable for putting a haemorrhoid on the stretch. The reason why these instruments are preferred, for this purpose, to the staphylagra is apparently that not being toothed like the latter instrument they would be both less painful and less likely to cause bleeding.
Pharyngeal Forceps.
Greek, ὁ ἀκανθοβόλος.
Paul (VI. xxxii) describes a forceps for removing foreign bodies from the pharynx:
‘Prickles, fish-bones and other substances are swallowed in eating and stick in different places. Wherefore such as can be seen we are to extract with the special fish-bone forceps’ (τοῖς ἰδίως ἀκανθοβόλοις προσαγορευομένοις ἐξέλκομεν).