University of Virginia Historical Collections at the Claude Moore Health Sciences Library

Surgery and Surgical Instruments

Advance of Surgery in the Roman Empire

Recovered surgical instruments used during the Roman Empire indicate that the art of surgery progressed and proliferated greatly during this time. Both Galen and Celsus emphasized the importance of surgery in the training of the conscientious physician, although they came from divergent medical traditions (Celsus, prooemium VII; Galen, II, 272).

Technical competence in surgery became better as new medical tools were devised. New metals and alloys were found to provide sharper edges and cheaper equipment. Most instruments were made of bronze, or occasionally of silver. Iron was rarely used because, as in most ancient cultures, it was considered a religious taboo by both the Greeks and Romans. The full repertoire of Roman surgical equipment is still far from completely known.

Bas Relief Fragment

Bas Relief Fragment, 4th Century CE, Athens, National Museum. This shows a doctor performing an operation on a patient’s head while Asclepius (identifiable by his superhuman size and the caduceus in his right hand) looks on.

Occasionally instruments not originally manufactured for surgical purposes were implemented. Galen and Celsus both mention that the strigil, a curved piece of metal with a handle used for scraping oil and sweat off the body after exercise, was often used to get into small openings. Galen instructs, “after having heated the fat of a squirrel in a strigil, insert it into the auditory canal” (Galen, XII, 623).

While a cursory reading of Celsus’s summaries on surgery indicate a sure knowledge of human anatomy, doctors still needed good tools and experience (and patients, courage) for surgery to go smoothly. The patient’s chances of recovery increased if the head and abdomen were not involved.

Archaeological remains of what appear to be surgeons’ “shops” are common enough to indicate that some physicians specialized in surgery. Particularly famous is the so-called House of the Surgeon at Pompeii, where most of the surgical tools now housed in Naples were found. Philological evidence seems to support the idea that there was at least some distinction, even if not a rigid one, between general practitioner and surgeon. Medieval texts distinguish the two positions with different terms: medicus for a doctor, and magister for a surgeon.

Stele from Herculaneum

Detail of a Stele from Herculaneum, 1st Century BCE. Here, a surgeon excises an arrow from a wounded soldier. Both men are depicted nude, suggesting that the episode stems from a mythic tale.

Galen wrote detailed instructions on the use of surgical instruments, the variety of which proliferated under the Romans. Yet, the makers of these medical instruments are at best shadowy figures. It seems improbable that there would have been sufficient demand for craftsmen dealing exclusively in medical instruments, and there is no known inscription naming such a specialist. The well-known relief pictured to the left suggests that some medical instruments may have been manufactured by specialist blade makers rather than by craftsmen specializing in medical instruments.