Bone Forceps.
Greek, ὀστάγρα.
Galen (x. 450) says, in comminuted fracture of the skull we must make a way for the lenticular with the bone forceps (διὰ τῆς ὀστάγρας); and in depressed fracture Paul (VI. xc) says:
‘If the bone is strong it is first to be perforated with the drills called abaptista and the fractured bone is to be removed in fragments, with the fingers if possible, if not, with a tooth forceps or a bone forceps’ (ὀδοντάγρα ἢ ὀστάγρα).
Soranus (lxiv. p. 366) says that in impaction of the foetal cranium the head may be opened with a sharp instrument and the pieces of the skull removed with tooth or bone forceps (ὀδοντάγρας ἢ ὀστάγρας). Aetius copies this (IV. iv. 24) and so does Paul (VI. lxxiv).
An excellent specimen of the sequestrum forceps was found in the house of the physician at Pompeii, and is now in the Museum at Naples (No. 78,029). It is formed of two crossed branches moving on a pivot. The handles are square, the jaws are curved, and have across the inside of them parallel grooves which oppose each other accurately ([Pl. XLIII]). It is classed in the catalogue as an instrument for crushing calculus of the bladder. This is, however, not a manipulation which is described by the ancients. The only case in which splitting of calculi is referred to is in Celsus, and then a chisel is used.
Varix Extractor.
An instrument, apparently a forceps, for extracting varicose veins in segments is mentioned by Galen:
‘And with regard to varices in the legs, first having mapped them out on the surface with scarifications, then setting about the operation, taking hold of the skin we divide it first. Then pulling up the varix with a hook we tie it, and, doing this at all the cuts in the skin, and cutting the ends, we either remove it with a varix extractor (κιρσουλκῷ) or, taking hold of it with a doubled thread, we draw it through the channel of the varix after the manner of flaying’ (xiv. 790).
Celsus (VII. xxxi) directs us to expose the vein and raise it by a blunt hook at intervals of four finger breadths, and divide the vein at one hook and pull the vein out at the next place. Galen, however, indicates that there was a special instrument for the purpose, and this can scarcely have been anything else than a forceps of some kind. The operation must have been excessively painful. Pliny (xi. 104) remarks that C. Marius was the only man who had undergone it in the upright position.