Insufflation in powder form was a common method of applying medicaments to the throat and nose. All writers mention this, but the fullest description of the tube used is given by Oribasius, who says (Collect. xii):
‘Those things which evacuate the head we use in the following manner. A reed slender and with a straight bore, six inches in length, and of such a size that it can be placed in the nares, is taken and its cavity entirely filled with medicament. The reed may be either natural or of bronze. This being placed in the nares, we propel the medicament by blowing into the other end.’
Alexander Trallianus (IV. viii) describes the insufflation of the woolly hairs of the platanus to stop epistaxis, and Aretaeus mentions the insufflation of sternutatories (459, vol. ii), and again (408, vol. ii) he says medicines may be blown into the pharynx by a reed, or quill, or wide long tube (καλάμῳ ἢ πτίλῳ ἢ καυλῷ παχεῖ καὶ ἐπιμήκει).
A fine example of a bronze insufflator was discovered among the instruments of the surgeon of Paris. It is 15½ cm. in length, and 5 mm. in diameter. It is formed by a plate of bronze bent round and soldered. It terminates in a little elliptical shovel slightly cup-shaped, of which the transverse diameter is 3 cm. and the longitudinal 3 mm.; it had originally been overlaid with gold ([Pl. XL, fig. 4]).
Cannulae for draining Ascites and Empyema.
Celsus describes the cannula for draining ascites (VII. xv):
Ferramentum autem demittitur magna cura habita ne qua vena incidatur. Id tale esse debet ut fere tertiam digiti partem latitudo mucronis impleat; demittendumque ita est ut membranam quoque transeat qua caro ab interiore parte finitur; eo tum plumbea aut aenea fistula coniicienda est vel recurvatis in exteriorem partem labris vel in media circumsurgente quadam mora, ne tota intus delabi possit. Huius ea pars quae intra paulo longior esse debet quam quae extra, ut ultra interiorem membranam procedat. Per hanc effundendus humor est; atque ubi maior pars eius evocata est claudenda demisso linteolo fistula est; et in vulnere si id ustum non est relinquenda. Deinde per insequentes dies circa singulas heminas emittendum, donec nullum aquae vestigium appareat.
The following passage from Paul shows that the tip was bevelled off like a writing pen:
Χαλκοῦν καλαμίσκον ... καθίσομεν ἔχοντα τὴν ἐκτομὴν παραπλησίαν τοῖς γραφικοῖς καλάμοις.
‘We introduce through the incision in the abdomen and peritoneum, a bronze cannula having a tip like that of a writing pen’ (VL. l).