Roman Ptolemaic instruments

• Infection
• optics and refraction
• cornea
• anterior chamber
• ocular surface
• neoplasia, choroid
• ciliary body
• eye lids
• degeneration
• treatment surgery
• inflammation
• medical education
• wound healing
• eye (tissue) banking

Surgical intervention in the management of diseases afflicting the human race is probably as old as Medicine itself. Ancient Roman medicine had prominent divisions such as Internal Medicine, Ophthalmology and Urology.1 Ancient ‘surgeons’ had access to a variety of instruments that were crafted with elegance and precision. The instruments were made of iron, bronze or a combination of the two metals.2 These instruments were used for a variety of procedures and often had multiple uses. Scalpels, hooks, drills, holding and crushing forceps, sharp pointed needles and retracting specula were all available.2

Handles of scalpels were designed to be thin or thick, short and long to enable incisions to be ‘artistically’ fashioned according to need. Hooks were either blunt tipped for probing, dissection and lifting vessels or nerves, or sharp tipped for prising out foreign bodies or retracting tissue. Bone drills were driven by a thong twirled around the drill handle. Linear motion of the thong imparted clockwise and anticlockwise rotary motion to the drill as the thong was moved back and forth. Ancient surgeons used drills to make holes in the skull and in thick bone to remove pieces of weaponry. A forceps designed with fine teeth was used to crush the uvula (and haemorrhoids)3 before cutting it off, to prevent bleeding. The purpose of this operation is not clear. Elongated needle like instruments with a fine sharp point were used as probes and for removing corneal foreign bodies.

The rather perfect set of instruments depicted on the cover of this issue (see figure 1) is an illustration of the technology and variety that existed. These instruments were also used for cosmetic procedures and for rituals as associated with funerals. The sharp pointed instrument is an example of what might have been used for removing fine particles impacted on the cornea.

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Figure 1

A set of bronze and iron Roman Ptolemaic instruments, dated around 1BC.

Examples of these instruments can be found in various museums across the world and accounts of their description and use are given in several ancient texts such as the Ebers Papyrus (1553–1550 BC) and the Sushruta Samhita (3rd or 4th century AD). The latter contains a description of 1120 illnesses and several remedies and surgical procedures spread over 184 chapters.4