In addition to textual descriptions of operations, archaeological evidence provides us with fascinating, if grizzly, insight into ancient surgical practice. Doctors—even physicians who did not identify primarily as surgeons—typically owned a large number of instruments, and these tools were so important to practitioners that they were frequently included in their tombs. Some instruments are elegantly designed artifacts with inscriptions, while others are more utilitarian. The Roman satirist Lucian (ca. 125–after 180 CE) warned of quacks who disguise their ignorance with silver cups and elaborate tools, and wrote that the skilled surgeon with the rusty blade is better than the foolish one with a gold-inlaid scalpel. Galen, too, had an interest in medical instruments, and even designed a number of new implements (he laments the loss of their prototypes in the Great Fire).
Many ancient instruments look familiar today. Probes are among the most common medical tools from antiquity, and examples have been found in a variety of shapes, sizes, and materials. Probes had many different applications, for surgery, in compounding drugs, to apply cosmetics, for personal hygiene, and even to mix paints. Some probes had thin handles ending in the shape of an olive and were likely intended to function like an eyedropper: a medication-saturated cloth could be wrapped around the olive-shaped finial and squeezed to send a drop down the length of the handle for measured administration. Probes with spatulas were useful for spreading medicinal ointments and plasters. Obstetrics texts describe the use of a probe in cauterizing an umbilical cord. Probes with blunt ends were used to clean ears and to remove foreign bodies; the Roman encyclopedist and medical writer Celsus reports, “When maggots have appeared, if they are near the surface, they must be extracted by an ear scoop.”
Some forceps resemble tweezers, and extant examples have smooth or toothed edges. Smooth ones may have been used for epilation (hair removal) while Celsus tells us that the toothed version was for the removal of tumors. Hooks were employed in the same way as retractors or aneurysm needles are used today—to hold wounds open or to keep veins out of the way, giving a surgeon space to operate—while other, sharper hooks seized tonsils or removed bladder stones. Bone levers set broken bones into position and may also have been used for tooth extractions.
Specula are among the most sophisticated ancient medical tools—with dovetailing valves and elaborate screw mechanisms—and the rarest instruments to survive from antiquity, perhaps because the amount of bronze used for an instrument of this size favored recycling. The first mention of a rectal speculum occurs in Hippocrates’ treatise on fistula, while the first written account of a vaginal speculum is found in Soranus. The design of the modern vaginal specula has not changed dramatically from ancient examples.