Two instruments answering to the above description are to be seen in the museum on the Capitol at Rome.
Another, answering more closely to the description of Celsus, is to be seen at Naples ([Pl. XXXIX, fig. 2]). It consists of a bronze tube, 9 cm. in length, 7 mm. wide at one end, narrowing to 4 mm. at the other end, which is bevelled off as described by Paul. Surrounding the tube and 2·5 cm. from the bevelled tip is a ring 2·5 cm. in diameter.
A more elaborate form of the cannula for ascites is seen in another specimen, also in the Naples Museum ([Pl. XXXIX, fig. 3]). A tube 6·5 mm. in diameter and 39·2 cm. long, has one end rounded and closed, except for a small hole in its tip and another in the side near the first. The other end carries a circular plate 2·5 cm. in diameter. Near the middle of the tube there is a slightly raised projection as if to carry a circular disc. Inside the cannula is fixed by oxidation an obturator, which carries on its end a small handle fixed on in T-fashion. Scoutetten described this to the Royal Academy of Medicine of Paris as a trocar and cannula, but the formation of the end is not such that the instrument could have pierced its own way through. It is rather an instrument which could be inserted in an incision made by a scalpel, and which could be closed after the abstraction of a certain amount of fluid—the obturator acting as an improvement on the pledget of wool described by Celsus—but otherwise inserted like the previous example. A tube on similar principles to the ascites cannula was employed in empyema (Hippocrates, ii. 259):
‘After opening let out pus once a day. After the tenth day, when everything has been evacuated, flush with wine and tepid oil. At night let out what you have put in, and when the pus becomes thin and watery insert a hollow tin tube’ (ἐντιθέναι μοτὸν κασσιτέρινον κοῖλον).
Tubes to prevent Contractions and Adhesions.
Greek, μοτὸς μολυβοῦς; Latin, plumbea fistula.
After operations on the nose, rectum, vagina, &c. it was usual to insert a tube of lead, bronze, or tin, to prevent contraction or adhesion and also to convey medicaments.
Celsus says that after the operation for occlusion of the vagina a tube of lead is to be inserted during cicatrization:
Quumque iam ad sanitatem tendet, plumbeam fistulam medicamento cicatricem inducente illinere, eamque intus dare; supraque idem medicamentum iniicere, donec ad cicatricem plaga perveniat (VII. xxviii).
A similar tube is recommended by Celsus and Paul for insertion after operations on the rectum and vagina. Hippocrates (ii. 244) and Paul (VI. xxv) direct a leaden tube to be inserted in the nostril after the abstraction of nasal polypus.