Surgery in ancient Rome

Roman medical practices, including surgery, were borrowed from the Greeks, with many Roman surgeons coming from Greece. In the 2nd century CE, Galen, a Greek physician advanced Roman surgical knowledge by combining Greek and Roman medical knowledge.

{{Cite book |last=Barry |first=Krause |title=Ancient Roman medical instruments |publisher=Antiques & Collecting Magazine}} Aulus Cornelius Celsus was a Roman encyclopedist notable for his work De Medicina. The text describes operations such as tonsillectomies and cataract surgery. Alongside these surgeons and doctors, Soranus of Ephesus introduced technology such as the birthing chair.

Surgeons were attracted to ancient Rome due to the potential for success and wealth. Doctors learned through private courses from other doctors, their relatives, in the city of Alexandria, or through self-teaching.

Charlatans and malpractice were common in ancient Rome, as any individual, regardless of their training or qualifications could practice medicine.{{Cite journal |last1=Dobanovački |first1=Dušanka |last2=Milovanović |first2=Ljiljana |last3=Slavković |first3=Anđelka |last4=Tatić |first4=Milanka |last5=Mišković |first5=Sanja |last6=Škorić-Jokić |first6=Svetlana |last7=Pećanac |first7=Marija |year=2012 |title=Surgery Before Common Era (B.C.E.*) |url=http://www.doiserbia.nb.rs/img/doi/0354-7310/2012/0354-73101202028D.pdf |journal=Sremska Kamenica |volume=20 |issue=1–2 |publisher=Oncology Institute of Vojvodina |publication-place=Vojvodina |pages=33 |doi=10.2298/AOO1202028D}} This resulted in the general public becoming distrustful of doctors. Higher-quality surgeons often served the upper classes.

According to Celsus the perfect surgeon would be a younger man with strong and steady hands, sharp eyes, a strong spirit, and a strong sense of empathy and compassion. Surgery was rare in ancient Rome, it was rare for a patient to recover, and the procedure was dangerous.{{Cite journal |last=Westphalen |first=N |date=July 2020 |title=Roman Warfare, Ships and Medicine |url=https://jmvh.org/article/roman-warfare-ships-and-medicine/ |journal=Journal of Military & Veterans' Health |location=Italy |volume=28 |issue=3 |page=16 }} Most surgical procedures were limited to skin lacerations or amputations.{{Cite journal |last1=Martin |first1=Elia |last2=Boschetto |first2=Francesco |last3=Pezzotti |first3=Giuseppe |date=March 12, 2020 |title=Biomaterials and biocompatibility: An historical overview |journal=Processes |volume=9 |issue=11 |pages=1617–1633 |doi=10.3390/pr9111949 |doi-access=free }}

File:Roman Cupping Vessel.jpg

Cupping vessels were round suction cups usually made of bronze or horns.{{Cite journal |last=Belfiglio |first=Valentine |date=January 1, 2014 |title=Treatment of Flesh Wounds in the Roman Army (27 B.C.–A.D.476) |journal=International Journal of Interdisciplinary Social Sciences: Annual Review |page=5}}{{Sfn|Milne|1907|p=101}} They were made of different materials and had different designs and purposes. Bronze vessels were also used. They usually contained burning lint and were closed at one end and open at the other. Horn cups had small foramens at the ends and cavities closed off with wax. Cups had holes that were placed over injured areas and sweat glands. Following this, the tool would be used to draw out pus and "vicious humor."{{Cite book |last=Michaelides |first=D. |title=Medicine and Healing in the Ancient Mediterranean |date=2014-05-30 |publisher=Oxbow Books |isbn=978-1-78297-235-8 |pages=132 |language=en}} Cupping vessels were also used to aid bloodletting.{{Cite book |last=Wynbrandt |first=James |url=https://books.google.com/books?id=ek7ABQAAQBAJ&dq=tooth+extraction+ancient+Rome&pg=PT28 |title=The Excruciating History of Dentistry: Toothsome Tales & Oral Oddities from Babylon to Braces |date=2015-01-27 |publisher=St. Martin's Publishing Group |isbn=978-1-4668-9014-5 |language=en}}{{Cite book |last=Ferris |first=Iain |url=https://books.google.com/books?id=juUgCwAAQBAJ&dq=Surgical+Saws+ancient+Rome&pg=PT133 |title=An Illustrated Introduction to Ancient Rome |date=2015-10-15 |publisher=Amberley Publishing Limited |isbn=978-1-4456-4573-5 |language=en}} First, heat was applied to the area to warm it up. Then, the skin was cut with a scalpel, following this, the cup would be fastened to the area to draw blood.{{Cite book |last=Chirali |first=Ilkay Z. |url=https://books.google.com/books?id=guDTBQAAQBAJ&dq=Cupping+vessels+ancient+rome&pg=PA18 |title=Traditional Chinese Medicine Cupping Therapy - E-Book |date=2014-06-27 |publisher=Elsevier Health Sciences |isbn=978-0-7020-5834-9 |pages=18 |language=en}}{{Cite book |last=Baker |first=Patricia A. |url=https://books.google.com/books?id=eZfqAAAAQBAJ&dq=Cupping+vessels+ancient+rome&pg=PA74 |title=The Archaeology of Medicine in the Greco-Roman World |date=2013-09-30 |publisher=Cambridge University Press |isbn=978-1-107-29213-0 |pages=74 |language=en}}{{Sfn|Milne|1907|p=101-102}} Larger cupping devices were used for larger parts of the body, such as the back. Smaller cups were used for smaller parts of the body, such as the arms or the neck.

File:Roman Chisels.jpg

Raspatories, also called rugines, were made of a blade fixed to a shaft at a right angle. They were used to treat bone fractures. In this procedure, the wound was filled with black ointment, then a linen rag filled with oil, and finally, it was used to scrape the bones. They would make incisions into and remove the skin to hold it or the bones in place. These tools were made of steel and covered in spiral decorations. Chisels were used during surgeries on teeth or bones. One kind of chisel, known as the lenticular, was used in neurosurgery. It was made of a rounded smooth knob, which was inserted into the open cranium or meninges. Hammers and blocks would be used alongside the chisels. To amputate a limb, it was placed on a block, then a chisel would be used to cut it off.{{Sfn|Milne|1907|p=121-126}} Lithorites were kinds of chisels designed to remove calculus from the bladder. They would be struck through the calculus, eventually breaking it.{{Sfn|Milne|1907|p=148-149}}

File:Ancient roman folding handle for a surgical drill.jpgFile:Roman Sawblades.jpg

In ancient Rome, there were two kinds of surgical drills. One type was driven by a leather cord, the other type used a guard and a collar. This was designed to stop the instrument from penetrating too deeply into the bone. It was thought that this would minimize the risk of damage to the brain and meninges. Drills would also be frequently dipped in water to reduce heat, which was supposed to limit the danger of the surgery. The primary purpose of a drill was to remove large diseased portions of skulls. For example, drills were used to remove weapons lodged into the skull.{{Sfn|Milne|1907|p=126-130}} Small drills were used to perforate the nasal bone. Which would create a "passage for the fluid or matter to the nose," thus treating the fistula.{{Sfn|Milne|1907|p=133}} Drills were shaped like wine corkscrews.{{Cite book |last=Ermatinger |first=James W. |url=https://books.google.com/books?id=9rI6CgAAQBAJ&dq=surgery+scissors+ancient+rome&pg=PA268 |title=The World of Ancient Rome: A Daily Life Encyclopedia [2 volumes]: A Daily Life Encyclopedia |date=2015-08-11 |publisher=ABC-CLIO |isbn=978-1-4408-2908-6 |pages=258, 691 |language=en}} Bone levers were ancient steel tools shaped like rods with flattened and curved tips resembling stone cutters.{{Sfn|Milne|1907|p=135}} They were used to level fractures, extract teeth, and realign broken bones.{{Cite book |last1=Synovitz |first1=Linda Baily |url=https://books.google.com/books?id=KY1n5jKiSD4C&dq=Bone+drills+ancient+rome&pg=PA72 |title=Complementary and Alternative Medicine for Health Professionals: A Holistic Approach to Consumer Health |last2=Larson |first2=Karl L. |date=2013 |publisher=Jones & Bartlett Publishers |isbn=978-0-7637-6595-8 |pages=72 |language=en}}"Ancient medicines and bone lever in rare Roman medical kit." Premium Official News, 26 Feb. 2016. Gale OneFile: News.

Saws were primarily used to cut through bone. In one procedure for treating gangrene, a band was used to retract the skin to prevent the saw from tearing through the flesh. Then the saw could amputate the infected limb. Trephines were in the form of a circular saw. Doctors believed it needed to be frequently removed from the skull and placed in cold water during an operation. This was designed to alleviate the "heat" in the "bone." Trephines were used to saw the bone to the meninges thus treating injuries to young people's heads.{{Sfn|Milne|1907|p=130-131}}

File:Forceps, bone saw and bleeding cup.jpg

Bone forceps were used to extract injured bones from the body.Harvey, Ailsa. "WHAT THE ROMANS TAUGHT US: How ancient Roman technologies have influenced the modern world." How It Works Magazine, no. 161, Feb. 2022, pp. 40+. Gale General OneFile. They were common tools, despite the Roman preference for using fingers instead of tools to fix bone injuries. Bone forceps were primarily used for instances in which pieces of bone were too small for fingers to remove.{{Cite book |last=DK |url=https://books.google.com/books?id=k0uJAwAAQBAJ&dq=Bone+levers+ancient+rome&pg=PA129 |title=Pocket Genius: Ancient Rome: Facts at Your Fingertips |date=2014-06-02 |publisher=Penguin |isbn=978-1-4654-3108-0 |pages=129 |language=en}}{{Cite book |last=Stokes |first=Jonathan W. |url=https://books.google.com/books?id=BbykDwAAQBAJ&dq=Bone+forceps+ancient+rome&pg=PA43 |title=The Thrifty Guide to Ancient Rome: A Handbook for Time Travelers |date=2019-08-20 |publisher=Penguin |isbn=978-1-101-99810-6 |pages=43 |language=en}}{{Cite journal |last=Tebala |first=Giovanni |date=2015 |title=History of colorectal surgery: A comprehensive historical review from the ancient Egyptians to the surgical robot |journal=International Journal of Colorectal Disease |volume=30 |issue=6 |pages=723–48 |doi=10.1007/s00384-015-2152-7 |pmid=25687247 |s2cid=1715543|doi-access=free }} They would also cut off broken parts of the skull, or even drill through to the brain. Another kind of forceps, called Epilation forceps was primarily used to remove hair. Polypus forceps were used to remove polyps or tumors from the nose.{{Sfn|Milne|1907|p=93-94}}

Tumor vulsellums, also known as Myzons, were toothed forceps that were used to remove tumors. In one procedure, they were used to "seize" the clitoris and cut off the tumor. To amputate the uvula, they used a tool known as uvula forceps to crush it and prevent bleeding. Following this, the vulsellum was used to twist it until a torsion was created. Then the uvula was cut off. Forceps could also be used to apply corrosive substances to the uvula to destroy it. These tools were made of two crossing branches which were fixed to the middle of the tool with a rivet.

Pharyngeal forceps were made of fishbones and they were used to remove entities from the pharynx.{{Sfn|Milne|1907|p=94-100}} Varix extractors were a type of forceps used to extract varicose veins, which is a medical condition characterized by abnormally large veins."[https://www.nhlbi.nih.gov/health/varicose-veins Varicose Veins]". National Heart, Lung, and Blood Institute (NHLBI). Retrieved 20 January 2019. This procedure would be conducted by mapping out the locations of the afflicted veins, then the skin would be held and divided. Following this the extractor would hold and cut the skin, allowing for the veins to be removed.{{Sfn|Milne|1907|p=135-136}} Tooth and stump forceps were used to extract teeth. This operation, and hence these tools were rarely employed due to how dangerous the operation was.{{Sfn|Milne|1907|p=136-138}}

File:Curettes ? MET DP20529.jpg

Probes and curettes were used to mix and apply medication to the skin or to lift tissue. When pushed into the fistula they were used to measure their dimensions. Roman probes had parts known as the nucleus. The nucleus was used primarily to apply medication. Sodium hydroxide was applied to the nucleus, which would then be used to burn out the eyelid. Wax was warmed on the nucleus of the probe, and then it was used to apply pomade to the face.

One type of probe consisted of a rod rounded off at one end. Another type was slender with enlarged ends. It was used to burn tissue and for organ transplantation.{{Sfn|Milne|1907|p=55-57}} The largest probes were known as spathomeles. These tools were very common, with almost every ancient Roman medical writer mentioning them. Cyathiscomeles were types of spathomeles with large nuclei and a plain or fluted shaft overlaid with silver. Screw probes were designed to wrap around wool.{{Sfn|Milne|1907|p=58-63, 68}} Rasping probes were used to curette granular lids. Another kind of probe, called styli or styloid probes was used to puncture bladders. Grooved directors were instruments used to make incisions into the skin. These tools were usually made out of boxwood.{{Sfn|Milne|1907|p=71-73}} Eyed probes were made from a rod of tin, and they were used to treat fistula.{{Sfn|Milne|1907|p=76-77}} Bifurcated probes and retractors were used to extract weapons buried in the flesh.{{Sfn|Milne|1907|p=83-84}}

Ear probes, also known as ear specilla, were made of a narrow scoop and an enlargement at each end. These tools had no nucleus or tip. They could also be used as curettes. Their primary purposes was cutting the interior of the chalazion and applying medications or liquids. The sharp end of the ear probe was used to treat fistula. A large ball of wood would be saturated with water and wrapped around the probe. Once squeezed, the liquid would drip onto the ear canal, which was thought to extract entities from the canal. A larger version of the ear probe, possibly with a slight enlargement at the ends, was used for treating wounds.{{Sfn|Milne|1907|p=65-69}} This would be done through an incision behind the ear, following this the ear scoop was used to remove the objects. A common symptom of this procedure was dullness of hearing, often preceded by persistent headaches. Scabs and ulcers were other common side effects. To treat this, they were typically fomented with warm water, or verdigris drenched in honey, leek juice, and niter in mead. Following this, water was used to wash the ears. This tool could also be used as a curette.{{Sfn|Milne|1907|p=55, 58-65}}

File:Bronze scalpel MET DP9053.jpg

Scalpels were tools made of a steel blade and a bronze handle. The bronze handle could be round, square, horizontal, or trapezoidal. Some scalpels had handles made of copper alloys with grips, dissectors, and an iron blade. This design was used to maximize efficiency. A slot was placed at one of the ends to connect to the steel blade. On the other end of the handle was connected to a leaf-shaped spatula. This spatula functioned as a blunt tool for dissection. A groove or a long and narrow indentation was located near the end of the handle. Alternatively, a cylindrical roll perforated with a hole could be used instead. Threads, wires, rolls, and perforations were used to attach the blade to the handle. Handles would have been decorated with moldings or inlay.{{Cite book |last=Michaelides |first=D. |url=https://books.google.com/books?id=WF3dCQAAQBAJ&dq=surgery+scalpel+ancient+rome&pg=PA130 |title=Medicine and Healing in the Ancient Mediterranean |date=2014-05-30 |publisher=Oxbow Books |isbn=978-1-78297-238-9 |pages=130–143 |language=en}} The blade was made detachable to allow for cleaning and the usage of several blades.{{Sfn|Milne|1907|p=24-26}} There were a variety of kinds of blades. One was straight, sharp, and pointed. Another was curved with sharp or blunt points.{{Sfn|Milne|1907|p=26-28}} Blades were secured to the handles using simply sockets or key-hole shaped sockets using an alloy known as solder. The scalpel had great flexibility and performed a wide variety of functions, such as tearing away muscle and tissue during amputation,{{Cite book |last1=Naseem |first1=Mohammad |title=International Medical Law |last2=Naseem |first2=Saman |date=2019-02-08 |publisher=Kluwer Law International B.V. |isbn=978-94-035-0795-8 |language=en}}{{Cite book |last=Arindam |first=Bit |title=Design and Development of Affordable Healthcare Technologies |date=2018-06-22 |publisher=IGI Global |isbn=978-1-5225-4970-3 |pages=28 |language=en}} severing the umbilical cord, removing nasal polyps, mastectomies, making incisions, cutting through bone, and hernia repair.{{Cite book |last=DK |url=https://books.google.com/books?id=dicCDQAAQBAJ&dq=Bone+levers+ancient+rome&pg=PA42 |title=Medicine: The Definitive Illustrated History |date=2016-10-11 |publisher=Penguin |isbn=978-1-4654-5893-3 |pages=42 |language=en}}

File:Roman rectal speculum. Wellcome L0007298.jpg

The rectal speculum also called the catopter was a dual-bladed surgical instrument in ancient Rome.{{cite web |date=2007 |title=Surgical Instruments from Ancient Rome |url=http://exhibits.hsl.virginia.edu/romansurgical/ |access-date=16 September 2014 |publisher=University of Virginia Claude Moore Health Services Library}}{{Cite book |last1=Matsiota |first1=Eugenia |title=Laparoscopic Colon Surgery: Milestones, Education, & Best Practice |last2=Kouraklis |first2=Gregory |publisher=Springer International Publishing |year=2020 |isbn=978-303-056-728-6 |pages=4}}{{Cite book |last1=Schollmeyer |first1=Thoralf |url=https://books.google.com/books?id=pA0FrBYqDo4C&dq=Rectal+speculum+ancient+Rome&pg=PA3 |title=Practical Manual for Laparoscopic & Hysteroscopic Gynecological Surgery |last2=Mettler |first2=Liselotte |last3=Ruther |first3=Dawn |last4=Alkatout |first4=Ibrahim |date=2013-02-28 |publisher=JP Medical Ltd |isbn=978-93-5090-283-7 |pages=3 |language=en}} Feminine specula were used to dilate vaginas. These specula were sized according to the age of the patient, and it was ensured that it was not larger than the urethra. To open the vagina, an assistant would turn a screw, expanding the blades, and therefore the vagina. Rectal specula were used to examine the bowels and its damaged parts.{{Cite book |last=Montasir |first=Magda |title=Evolving Medicine: How to Make the Art of Healing Healthy Again |date=2015-04-27 |publisher=Archway Publishing |isbn=978-1-4808-1770-8 |language=en}} In the Republic these tools were made of copper and tin, by the Empire these tools began to be made of silver, as this material was less brittle. Specula also had rounded mirrors with handles. The surgeon, or another person, usually a slave would hold these mirrors.

{{Main|Spoon of Diocles}}

File:Roman catheters.jpg

The Spoon of Diocles also called the Dioclean kyathiskos was an ancient medical tool allegedly designed by Diocles of Carystus for removing arrowheads.{{Cite book |last=Van Der Erik |first=P.J. |title=Diocles of Carystus. Volume 2, Commentary: A Collection of the Fragments with Translation and Commentary |publisher=Brill |year=2018 |isbn=978-900-437-750-9 |pages=306}}{{Cite book |last=Magill |first=Frank N. |title=The Ancient World: Dictionary of World Biography |date=2003-12-16 |publisher=Routledge |isbn=978-1-135-45740-2 |pages=349 |language=en}} It was a long bronze or iron tool with two hooks ending a curved scoop with a hole and a perforation. This tool would be pushed under and then between the arrow and the flesh.Book Review: [https://muse.jhu.edu/article/4707 The Treatment of War Wounds in Graeco-Roman Antiquity] by Christine Salazar, reviewed by Lawrence J. Bliquez; in Bulletin of the History of Medicine, Volume 75, Number 3, Fall 2001 (pages 49, 557-558); 10.1353/bhm.2001.0108;{{Cite book |last=Longrigg |first=James |url=https://books.google.com/books?id=hTaBAAAAQBAJ |title=Greek Medicine: From the Heroic to the Hellenistic Age A Source Book |date=2013-08-21 |publisher=Routledge |isbn=978-1-136-78219-0 |pages=186 |language=en}} The head of the arrow would be caught in the hole, and the scoops would cover the barbs. Thus, when the arrow was dragged out the flesh would not be pierced.{{Cite book |last=Rance |first=Caroline |title=The History of Medicine in 100 Facts |date=2015-12-15 |publisher=Amberley Publishing Limited |isbn=978-1-4456-5004-3 |language=en}} This instrument may have not existed.[https://www.ucl.ac.uk/~ucgajpd/medicina%20antiqua/sa_ArchaeologicalRemains.pdf Archaeological Remains as a Source of Evidence for Roman Medicine], by Patricia A. Baker, in Medicina Antiqua, published 2009{{Cite book |last1=Campbell |first1=Brian |url=https://books.google.com/books?id=5QNREAAAQBAJ |title=The Oxford Handbook of Warfare in the Classical World |last2=Tritle |first2=Lawrence A. |date=2017 |publisher=Oxford University Press |isbn=978-0-19-049913-6 |pages=303 |language=en}} It is only mentioned by Celsus, who was a Roman physician, and no other writers.{{Sfn|Celsus||p=321}}

Catheters were also inserted into the bladder to treat urinary tract infections, ureteral stones, prostate cancer, bladder stones, sexually transmitted infections,{{Cite journal |last=Güner |first=Ekrem |date=September 1, 2019 |title=Understanding the genital diseases of Ancient Anatolia in the light of the inscribed male genital offerings presented to gods |url=https://www.turkishjournalofurology.com/Content/files/sayilar/184/384-388.pdf |journal=Turkish Journal of Urology |volume=45 |issue=5 |page=386 |doi=10.5152/tud.2019.47527 |pmc=6739084 |pmid=31509512 |via=Europe PMC}} painful urination, and difficulty urinating.{{Cite book |last1=Yamauchi |first1=Edwin M. |title=Dictionary of Daily Life in Biblical & Post-Biblical Antiquity: Medicine & Physicians |last2=Wilson |first2=Marvin R. |date=2022-05-17 |publisher=Hendrickson Publishers |isbn=978-1-61970-936-2 |language=en}} The size and shape of the catheters depended on the gender and size of the individual. Bladders were drained through the urethra using an S-shaped catheter.{{Cite journal |last1=Güner |first1=Ekrem |last2=Güner |first2=Şebnem |last3=Özdemir |first3=Osman |date=June 2019 |title=A Unique Representation of Female Urinary Catheter in Ancient Roman Art |url=https://doaj.org/article/d149a5b5faa54793ac489b159d11f776 |format=PDF |journal=Journal of Urological Surgery |publisher=Galenos Yayinevi Tic. Ltd |publication-place=Turkey |volume=6 |issue=2 |pages=172–173 |doi=10.4274/jus.galenos.2019.2697 |s2cid=194370172 |issn=2148-9580 |via=The Directory of Open Access Journals|doi-access=free }} Another procedure involved injecting a piece of thread with wool wrapped around it into the pipe of the tool. Then it was dipped in oil and used to make an incision into the perineum.{{Sfn|Milne|1907|p=143}}

File:Strigil MET DP9106.jpg

{{Main|Strigil}}

This tool was used for scraping off dirt, perspiration, and oil to cleanse the body. The strigil was most commonly used by male athletes, although in other cultures such as the Etruscans it was used by a wider variety of people.{{cite journal |last1=De Puma |first1=Richard |title=A Third-Century B.C.E. Etruscan Tomb Group from Bolsena in the Metropolitan Museum of Art. |journal=American Journal of Archaeology |pages=429–40}} They could also be used as burial goods and these tools are commonly depicted on works of art.Fossey, John M. "The Ritual Breaking of Objects in Greek Funerary Contexts: A Note". Folklore: 21–23.Padgett, J. Michael (2002). Objects of Desire: Greek Vases from the John B. Elliot Collection. Record of the Art Museum, Princeton University. pp. 36–48. It generally consisted of a curved metal blade, and a metal handle.{{cite book |last1=Padgett |first1=J. Michael |title=Objects of Desire: Greek Vases from the John B. Elliot Collection. |date=2002 |publisher=Record of the Art Museum, Princeton University. |pages=36–48}} Other materials that could be used included bronze, iron, and reeds.Boardman, John. "Sickles and Strigils". The Journal of Hellenic Studies: 136–137.

File:Bronze knife.jpg

Another kind of knife, known as the polypus knife, was sharply pointed and shaped like a myrtle leaf. The knife was used to cut around tumors. To make an incision between the anus and the testicles a knife known as the lithotomy knife was used.{{Sfn|Milne|1907|p=39-40}} The uvula knife was designed to perform operations on the throat and the uvula. There is little information on its shape and characteristics.{{Sfn|Milne|1907|p=46-47}} Tonsil knives were used to remove the tonsil from mouths.{{Sfn|Milne|1907|p=47}} To treat pterygium it was raised with a sharp hook, then a needle with a flaxen thread and horsehair was passed under it. The horsehair was used to saw off the pterygium and a scalpel was used to sever the base of it. Alternatively, the pterygium knife was a kind of knife used to cure pterygium. It was used to separate the adhesion to the sclerotic. This tool was narrow and sharply pointed.{{Sfn|Milne|1907|p=44-46}}

File:Ärztliche Instrumenten (RGM) 1.JPG

Obstetrical hooks may have existed in ancient Rome.{{Cite book |last=Duffin |first=Jacalyn |title=History of Medicine, Third Edition: A Scandalously Short Introduction, Third Edition |date=2021-06-28 |publisher=University of Toronto Press |isbn=978-1-4875-0917-0 |pages=291 |language=en}} These hooks were smooth and had short points, which were inserted into the ears, eyes, mouths, and forehead to extract children.{{Cite book |last=Hibbard |first=Bryan M. |title=The Obstetrician's Armamentarium: Historical Obstetric Instruments and Their Inventors |date=2000 |publisher=Norman Publishing |isbn=978-0-930405-80-9 |pages=1 |language=en}} Sharp hooks were used to hold open incisions, removing tissue, fixing and retracting wounds, raising blood vessels, removing tonsils, transfixing the pterygium, and for dissection. Blunt hooks were used to stretch adhesions near the eye and to pierce lips.{{Sfn|Milne|1907|p=86-87}} Traction hooks were used to remove the fetus during especially tough labor. These hooks were smooth and round, with a short point. Once the head presented itself, the hook was inserted into the area and then used to extract the child. This procedure needed to execute carefully and gently. If it was not then there was an increased risk of death. It was common practice to use two hooks at once in these procedures. Another kind of hook, known as a decapitator, was used to decapitate the fetus during an abortion.{{Sfn|Milne|1907|p=152-154}}

File:Bronze cauterizing probe, Roman, 199 BCE-500 CE Wellcome L0057393.jpg

In ancient Rome saws could be used to amputate limbs for surgical purposes.{{Cite book |last=Maynard |first=Charles W. |title=The Technology of Ancient Rome |date=2006-01-15 |publisher=The Rosen Publishing Group, Inc |isbn=978-1-4042-0556-7 |pages=36, 51 |language=en}}{{Cite book |last1=Synovitz |first1=Linda Baily |title=Consumer Health & Integrative Medicine |last2=Larson |first2=Karl L. |date=2018-09-28 |publisher=Jones & Bartlett Learning |isbn=978-1-284-14412-3 |pages=84 |language=en}} Osteotomes were used to cut away at bone and remove membranes. Thigh tourniquets would stop bleeding and prevent the venom from spreading.{{Cite book |last1=Santoni-Rugiu |first1=Paolo |url=https://books.google.com/books?id=KYv0A2QuRLkC&dq=cosmetic+surgery+ancient+Rome&pg=PA300 |title=A History of Plastic Surgery |last2=Sykes |first2=Philip J. |date=2007-08-10 |publisher=Springer Science & Business Media |isbn=978-3-540-46241-5 |pages=46 |language=en}} Another common tool was bronze or iron cross-bladed scissors.{{Cite book |last=Tschen-Emmons |first=James B. |title=Artifacts from Ancient Rome |date=2014-09-30 |publisher=ABC-CLIO |isbn=978-1-61069-620-3 |pages=267 |language=en}}{{Cite book |last=Challoner |first=Jack |title=1001 Inventions That Changed the World |date=2022-04-12 |publisher=Simon and Schuster |isbn=978-1-6672-0005-7 |language=en}}{{Cite book |author=Deborah Dolan Hunt |title=Fast Facts About the Nursing Profession: Historical Perspectives in a Nutshell |date=2017-05-28 |publisher=Springer Publishing Company |isbn=978-0-8261-3139-3 |pages=24 |language=en}} During surgeries spatulas could also be used. Although they were primarily used to produce and apply medicine.{{Cite book |last=Hetherington |first=Laura |title=The Illustrated Histories of Everyday Inventions: Discover the True Stories Behind the World's 64 Most Overlooked Innovations |date=2019-11-26 |publisher=Simon and Schuster |isbn=978-1-7325126-4-1 |pages=24 |language=en}}{{Cite book |last=Rayborn |first=Tim |title=Who Made That?: The Fascinating True Stories Behind the World's Greatest Inventions |date=2022-04-05 |publisher=Simon and Schuster |isbn=978-1-64643-215-8 |pages=15 |language=en}} Ancient Roman surgical tools called phlebotomes were used in operations known as phlebotomies. This tool is one of the most commonly mentioned tools in Ancient Roman medical literature. Despite this, there are no detailed descriptions of the phlebotome. This likely stems from the commonality of the instrument. Due to its popularity, doctors and writers assumed all readers would already be familiar with its appearance and usage.{{Sfn|Milne|1907|p=34-35}} Hemispathions were used to divide the fistula.{{Sfn|Milne|1907|p=38-39}} Syringes in ancient Rome had a variety of uses. Nasal syringes were made of two bronze or horn pipes that were used to inject liquids into the nostrils. Ear syringes were also common tools. They were used to remove unhealthy substances from the ears, and clean the ears, the bladder, the vagina, and the foreskin. Cannulae were used to heal ascites and empyema. This was done by using the bronze cannulae to make an incision into the abdomen and the peritoneum.{{Sfn|Milne|1907|p=110-114}} Cauteries were common ancient surgical tools with a variety of types. Cautery knives were used to remove cancers such as malignant polyps as well as hydroceles. Cauteries could also remove eschars in the spleen, and hernias. It was also used to treat hemorrhoids, diseases of the liver, and trichiasis.{{Sfn|Milne|1907|p=116-120}} The lithotomy scoop was a long and slender semicircular tool used to extract calculi.{{Sfn|Milne|1907|p=146-147}} Enemas were usually made of long silver tubes with perforations attached to a pig's bladder. This bladder was filled with horse milk and closed with a cord.{{Sfn|Milne|1907|p=105}} To treat dysentery, enemas were injected into the body's orifices, such as vaginas, bladders, or uteruses. In this operation, cannulae were inserted into the body. These cannulae had circles of small holes to prevent ascariasis, a disease caused by a parasitic roundworm.{{cite journal | last1=Dold | first1=Christina | last2=Holland | first2=Celia V. | title=Ascaris and ascariasis | journal=Microbes and Infection | publisher=Elsevier BV | volume=13 | issue=7 | year=2011 | issn=1286-4579 | doi=10.1016/j.micinf.2010.09.012 | pages=632–637| pmid=20934531 | hdl=2262/53278 | hdl-access=free }}{{Sfn|Milne|1907|p=107-108}}

File:Greco-Roman instruments. Replicas of instruments Wellcome M0000361.jpg

There were surgical procedures for abortion in ancient Rome, but they were rarely used, and most abortions were conducted using herbs or other drugs.{{Cite book |last=Smith |first=Bonnie G. |url=https://books.google.com/books?id=EFI7tr9XK6EC&dq=Abortion+surgery+ancient+Rome&pg=PA5 |title=The Oxford Encyclopedia of Women in World History |date=2008 |publisher=Oxford University Press |isbn=978-0-19-514890-9 |pages=5 |language=en}} When surgery was used, it involved the use of surgical instruments to penetrate the mother. Usually this procedure ended in the death of both the fetus and the mother.{{Cite book |last=Ermatinger |first=James W. |url=https://books.google.com/books?id=9rI6CgAAQBAJ&dq=Abortion+surgery+ancient+Rome&pg=PA221 |title=The World of Ancient Rome: A Daily Life Encyclopedia [2 volumes]: A Daily Life Encyclopedia |date=2015-08-11 |publisher=ABC-CLIO |isbn=978-1-4408-2908-6 |pages=221 |language=en}} Soranus of Ephesus wrote that purging, carrying heavy weights, and the injection of olive oil into the vagina or uterus, were all procedures used to carry out abortions.{{Cite book |last1=Bullough |first1=Vern L. |url=https://books.google.com/books?id=UHymAgAAQBAJ&dq=Abortion+surgery+ancient+Rome&pg=PA4 |title=Human Sexuality: An Encyclopedia |last2=Bullough |first2=Bonnie |date=2014-01-14 |publisher=Routledge |isbn=978-1-135-82509-6 |pages=3 |language=en}}{{Cite book |last=Salisbury |first=Joyce E. |url=https://books.google.com/books?id=HF0m3spOebcC&dq=Abortion+surgery+ancient+Rome&pg=PA1 |title=Encyclopedia of Women in the Ancient World |date=2001 |publisher=ABC-CLIO |isbn=978-1-57607-092-5 |pages=1 |language=en}}

File:Bronze lancet, found at Ephesus Wellcome L0057115.jpg]]Amputations were used to treat gangrene.{{Cite book |last1=Gabriel |first1=Richard A. |url=https://books.google.com/books?id=6sAftYT6dsIC&dq=Amputation+in+Ancient+Rome&pg=PA94 |title=From Sumer to Rome: The Military Capabilities of Ancient Armies |last2=Metz |first2=Karen S. |date=1991 |publisher=ABC-CLIO |isbn=978-0-313-27645-3 |pages=98 |language=en}} Ancient Roman surgeons utilized tools known as "blunt dissectors" to expose "vessels." Blunt dissectors were also involved in another procedure designed to treat headaches and ophthalmia. This operation began by shaving the patient's hair off. Then, a warm headband or fomentation was placed around their neck. Following this, ink was used to map the "vessels." The surgeon would then proceed to use their fingers to stretch the skin, and then an assistant would make an incision. To finish the procedure, hooks and dissectors were used to expose the "vessels." Blunt dissectors were usually leaf-shaped, and possibly with hexagonal handles.{{Sfn|Milne|1907|p=84-85}} Another kind of dissector was curved dissectors. They were used to dissect lips that had been incised with a hook. One of these dissectors, which was stored in the National Archaeological Museum in France, was made of an ornamented handle with a small hook at one end. On the other was a leaf-shaped dissector.{{Sfn|Milne|1907|p=85}}

Bloodletting or a phlebotomy was a common practice in ancient Rome. It was common for surgeons to use a tool known as the phlebotome or the katias to make an incision into another point, which would cause the wound to bleed at another point.{{Sfn|Milne|1907|p=34}}{{Sfn|Milne|1907|p=32-37}} Another process involved putting a burning piece of cloth into the patient's mouth to draw out blood. Alternatively, leeches could be used. Ear scoops would be pressed on the proximal end of the vein. This would obstruct the blood flow, which would allow the phlebotome to be used to discharge blood.{{Sfn|Milne|1907|p=65}}File:Woodcut of the Birth of Julius Caesar.jpg, who Suetonius, a Roman historian says was born through a Caesarean section.]]

During a Roman Caesarean section the doctors would make an incision into the abdomen and uterus of the mother.{{Cite book |last1=Rice |first1=Martin |url=https://books.google.com/books?id=AasJAAAAQBAJ&dq=intestine+surgery+ancient+Rome&pg=RA1-PR2 |title=Clinical Research in Occupational Therapy |last2=Cutler |first2=Susan K. |date=2012-02-15 |publisher=Cengage Learning |isbn=978-1-133-71017-2 |pages=22–23 |language=en}} Following this, the baby was removed.{{Cite book |last1=Woods |first1=Michael |url=https://books.google.com/books?id=tFY5TkSgSmsC&dq=eye+surgery+surgery+ancient+Rome&pg=PA67 |title=Ancient Medical Technology: From Herbs to Scalpels |last2=Woods |first2=Mary B. |date=2011-01-01 |publisher=Twenty-First Century Books |isbn=978-0-7613-6522-8 |pages=67–69 |language=en}} This practice could also be conducted on dead mothers to remove the babies from their corpses.{{Cite web |date=2013-10-25 |title=The Truth About Julius Caesar and "Caesarean" Sections |url=http://www.todayifoundout.com/index.php/2013/10/caesarean-sections-named-emperor-julius-caesar/ |access-date=2022-05-18 |website=Today I Found Out |language=en-US}} It was rare for doctors to perform this operation, as it bore a high mortality rate. According to Roman religion the god Asclepius was born by a Caesarian section.{{Cite book |last=Douglass |first=Carl |url=https://books.google.com/books?id=nUBZEAAAQBAJ&dq=Caesarean+Section+Ancient+Rome&pg=PT24 |title=The Dutch Century: Domination of the Spice Trade at Any Cost |date=2021-12-01 |publisher=Publication Consultants |isbn=978-1-63747-036-7 |language=en}} Roman historians Suetonius and Pliny the Elder also record Julius Caesar as being born through a Caesarian section.{{Cite book |last1=Jauniaux |first1=Eric |url=https://books.google.com/books?id=iUNuEAAAQBAJ&dq=Caesarean+Section+Ancient+Rome&pg=PT36 |title=Textbook of Caesarean Section |last2=Grobman |first2=William |date=2016-04-28 |publisher=Oxford University Press |isbn=978-0-19-107631-2 |language=en}} The veracity of these claims is debated.{{Cite news |date=2013-10-25 |title=The Truth About Julius Caesar and "Caesarean" Sections |url=http://www.todayifoundout.com/index.php/2013/10/caesarean-sections-named-emperor-julius-caesar/ |access-date=2022-06-02 |website=Today I Found Out |language=en-US}}

Cataract surgery is a surgery in which cataracts are removed. This kind of surgery has been practiced since 29 CE in Ancient Rome.{{Cite book |last1=Midyett |first1=F. Allan |url=https://books.google.com/books?id=SXCPBQAAQBAJ&dq=eye+surgery+surgery+ancient+Rome&pg=PA154 |title=Orbital Imaging E-Book |last2=Mukherji |first2=Suresh Kumar |date=2014-11-18 |publisher=Elsevier Health Sciences |isbn=978-0-323-35427-1 |pages=154 |language=en}}{{Cite book |last=Gualdi |first=Federica |url=https://books.google.com/books?id=SPTTAgAAQBAJ&dq=eye+surgery+surgery+ancient+Rome&pg=PA1 |title=Femtolaser Cataract Surgery |date=2014-01-30 |publisher=JP Medical Ltd |isbn=978-93-5090-989-8 |pages=1 |language=en}} According to Celsus' description of cataract surgery, surgeons would use their right hand to perform on the left eye, and vice versa. During the procedure a needle was inserted between the pupil and the temple until it "meets resistance." Then, the surgeon would rotate the needle until the cataract had been pushed beneath the pupil.{{Cite book |last=Ellis |first=Harold |url=https://books.google.com/books?id=OsZWFyUYtDQC&dq=general+surgery+ancient+Rome&pg=PA24 |title=A History of Surgery |date=2002 |publisher=Cambridge University Press |isbn=978-1-84110-181-1 |pages=24–25 |language=en}} Following the cataract surgery, the patient would be treated with "soothing Medicants" and wool soaked in the white of the egg. The patient would also exclusively drink water and abstain from solid food until they no longer had an inflammation, which was a side effect of the surgery.{{Cite book |last=Irby |first=Georgia L. |url=https://books.google.com/books?id=P6W-DwAAQBAJ&dq=Obstetrical+hooks+surgery+ancient+rome&pg=PA381 |title=A Companion to Science, Technology, and Medicine in Ancient Greece and Rome, 2 Volume Set |date=2019-12-05 |publisher=John Wiley & Sons |isbn=978-1-119-10070-6 |pages=379, 381 |language=en}}{{Sfn|Celsus||p=351-353}}

File:Roman instruments, needles, hair ornaments etc. Wellcome M0000871.jpg

Modern cosmetic surgery has origins in the ancient Greco-Roman world.{{Cite book |last=Panfilov |first=Dimitrije |title=Cosmetic Surgery Today |date=2011-01-01 |publisher=Thieme |isbn=978-3-13-162861-9 |language=en}} Roman surgeons were capable of repairing damaged ears, noses, and lips.{{cite book | last1=Vogel | first1=Wolfgang H. | last2=Berke | first2=Andreas | title=Brief history of vision and ocular medicine | publisher=Kugler/Wayenborgh | publication-place=Amsterdam | date=2009 | isbn=978-90-6299-220-1 | oclc=758684735}}{{Cite book |last=Fisher |first=Maryanne |url=https://books.google.com/books?id=I40tDwAAQBAJ&dq=skin+grafting+ancient+Rome&pg=PA598 |title=The Oxford Handbook of Women and Competition |date=2017 |publisher=Oxford University Press |isbn=978-0-19-937637-7 |pages=598 |language=en}} Celsus discussed rhinoplasty techniques in his De Medicina.{{Cite book |last1=Latham |first1=Melanie |title=The Regulation of Cosmetic Procedures: Legal, Ethical and Practical Challenges |last2=McHale |first2=Jean V. |date=2020-04-30 |publisher=Routledge |isbn=978-0-429-48969-3 |language=en}} Ancient rhinoplasty involved the grafting of a new nose onto the old one.{{Cite book |last=Eamon |first=William |url=https://books.google.com/books?id=6i7zyhRx64MC&dq=rhinoplasty+ancient+Rome&pg=PA100 |title=The Professor of Secrets: Mystery, Medicine, and Alchemy in Renaissance Italy |date=2010 |publisher=National Geographic Books |isbn=978-1-4262-0650-4 |pages=100 |language=en}}{{Cite book |last=Craddock |first=Paul |url=https://books.google.com/books?id=ZrE9EAAAQBAJ&dq=skin+grafting+ancient+Rome&pg=PT15 |title=Spare Parts: The Story of Medicine Through the History of Transplant Surgery |date=2022-05-10 |publisher=St. Martin's Publishing Group |isbn=978-1-250-28033-6 |language=en}} Burns were treated using vinegar, ashes, cork, bran, or honey.{{Cite book |last1=Spitz |first1=Lewis |url=https://books.google.com/books?id=YcwgCAAAQBAJ&dq=skin+grafting+ancient+Rome&pg=PA957 |title=Operative Pediatric Surgery 6Ed |last2=Davenport |first2=Mark |last3=Coran |first3=Arnold |date=2006-11-24 |publisher=CRC Press |isbn=978-1-4441-1360-0 |pages=957 |language=en}} To treat both, skin grafting was used.{{Cite book |last=Hannam |first=James |url=https://books.google.com/books?id=XUVAHkwxfpsC&dq=rhinoplasty+ancient+Rome&pg=PA251 |title=The Genesis of Science: How the Christian Middle Ages Launched the Scientific Revolution |date=2011-03-22 |publisher=Simon and Schuster |isbn=978-1-59698-205-5 |pages=251 |language=en}}{{Cite book |last=Parsons |first=Paul |url=https://books.google.com/books?id=EN0lDwAAQBAJ&dq=rhinoplasty+ancient+Rome&pg=PT390 |title=Science 1001: Absolutely everything that matters in science |date=2013-02-14 |publisher=Quercus Publishing |isbn=978-1-84916-872-4 |language=en}} Galen, alongside Celsus, described the use of cheek reconstruction to heal facial injuries.{{Cite book |last1=Brodell |first1=Robert T. |url=https://books.google.com/books?id=8LXZDwAAQBAJ&dq=skin+grafting+ancient+Rome&pg=PA125 |title=Office Procedural Tips & Tricks in Dermatology |last2=Jackson |first2=Jeremy D. |last3=Helms |first3=Stephen E. |last4=Cosulich |first4=Michael |date=2019-09-30 |publisher=Jaypee Brothers Medical Publishers |isbn=978-93-86107-04-6 |pages=125 |language=en}}

Hernia repair was done using trusses and bandages. Roman surgeons would conduct an operation designed to treat hernia. Usually, it was only used to treat small hernias belonging to young patients. It consisted of an incision into the scrotum. A tool known as the crow bill or the corvus was used to open the scrotum and cure the hernia.{{Sfn|Milne|1907|p=43-44}} Another process involved using two blocks of wood to clamp the hemiscrotum, causing the sac to be inflamed, thus reducing its size. It also could be treated by removing the testicles and ligating the scrotum.{{Cite book |last1=LeBlanc |first1=Karl A. |url=https://books.google.com/books?id=4NlVDwAAQBAJ&dq=stomach+surgery+ancient+Rome&pg=PA5 |title=Management of Abdominal Hernias |last2=Kingsnorth |first2=Andrew |last3=Sanders |first3=David L. |date=2018-04-16 |publisher=Springer |isbn=978-3-319-63251-3 |pages=4 |language=en}} Ligatures could also be used during these operations to avoid bleeding. The ancient Romans had treatments for umbilical hernia, a medical condition in which the abdominal wall behind the navel is damaged.{{cite book | last1=Lissauer | first1=Tom | last2=Clayden | first2=Graham | title=Illustrated textbook of paediatrics | publisher=Mosby/Elsevier | publication-place=Edinburgh | date=2007 | isbn=978-0-7234-3397-2 | oclc=70663705}} Before this procedure, the patient was laid on their back to cause the hernia to fall back into the abdomen. Afterwards the navel was placed between two rods with their ends tied together, then a needle was placed inside of the protrusion.{{Cite journal |last1=Köckerling |first1=F. |last2=Köckerling |first2=D. |last3=Lomas |first3=C. |date=December 12, 2012 |title=Cornelius Celsus—ancient encyclopedist, surgeon–scientist, or master of surgery? |journal=Langenbeck's Archives of Surgery |volume=398 |issue=4 |pages=609–616 |doi=10.1007/s00423-013-1050-0 |pmc=3627856 |pmid=23344725}}

The ancient Romans practiced lithotomy, a surgical procedure to remove calculi.{{Cite web |date=November 10, 2010 |title=Lithotomy |url=https://brunelleschi.imss.fi.it/catalogo/genappr.asp?appl=SIM&xsl=approfondimento&lingua=ENG&chiave=100209 |url-status=dead |archive-url=https://web.archive.org/web/20101110061647/http://brunelleschi.imss.fi.it/museum/esim.asp?c=100209 |archive-date=November 10, 2010 |access-date=May 20, 2022 |website=Museo Galileo}} Usually, they were only conducted on individuals younger than 14. This was because the more developed prostate of older people enhanced the difficulty of the operation. One way this procedure could be practiced is by cutting through the bladder until the surgeon reached the perineum. An assistant held the patient in a lithotomy position, exposing their perineum. Two fingers were placed into the patient's rectum and against the perineum.{{Cite journal |last=Herr |first=Harry |date=November 15, 2007 |title='Cutting for the stone': the ancient art of lithotomy |url=https://pubmed.ncbi.nlm.nih.gov/18284407/ |journal=BJU International |volume=101 |issue=10 |pages=1214–1216 |doi=10.1111/j.1464-410X.2008.07510.x |pmid=18284407 |via=PubMed |s2cid=27163679}} Another procedure involved the usage of a scoop at the end of a probe to remove objects such as stones or beans and kidney stones.{{Cite book |last1=Wein |first1=Alan J. |url=https://books.google.com/books?id=fu3BBwAAQBAJ&dq=urology+Ancient+Rome&pg=PA2521 |title=Campbell-Walsh Urology: Expert Consult Premium Edition: Enhanced Online Features and Print, 4-Volume Set |last2=Kavoussi |first2=Louis R. |last3=Novick |first3=Andrew C. |last4=Partin |first4=Alan W. |last5=Peters |first5=Craig A. |date=2011-08-25 |publisher=Elsevier Health Sciences |isbn=978-1-4160-6911-9 |pages=2521 |language=en}}{{Cite book |last=DK |url=https://books.google.com/books?id=nbWBBAAAQBAJ&dq=kidney+stones+Ancient+Rome&pg=PA82 |title=History of the World in 1,000 Objects |date=2014-10-01 |publisher=Penguin |isbn=978-1-4654-3663-4 |pages=82 |language=en}}{{Cite book |last=Prioreschi |first=Plinio |url=https://books.google.com/books?id=H3ZaIYAaOSQC&dq=kidney+stones+Ancient+Rome&pg=PA262 |title=A History of Medicine: Roman medicine |date=1996 |publisher=Horatius Press |isbn=978-1-888456-03-5 |pages=262 |language=en}}

Ancient Roman doctors were capable of performing neurosurgery on depressed skull fractures.{{Cite book |last1=Desai |first1=Tejal |url=https://books.google.com/books?id=Edk-AAAAQBAJ&dq=neurosurgery+surgery+ancient+Rome&pg=PA97 |title=BioMEMS and Biomedical Nanotechnology: Volume III: Therapeutic Micro/Nanotechnology |last2=Bhatia |first2=Sangeeta N. |date=2007-05-26 |publisher=Springer Science & Business Media |isbn=978-0-387-25844-7 |pages=97 |language=en}}{{Cite book |last=Gillard |first=Arthur |url=https://books.google.com/books?id=WIFmDwAAQBAJ&dq=brain+surgery+ancient+Rome&pg=PA142 |title=Traumatic Brain Injury |date=2012-10-19 |publisher=Greenhaven Publishing LLC |isbn=978-0-7377-7312-5 |pages=142 |language=es}} Celsus believed that this surgery should be conducted with as little bone removed as possible. Galen disagreed, he wrote that doctors should elevate the bones and the bone fragments using forceps.{{Cite book |last=Ganz |first=Jeremy C. |title=James Hill, a Dumfries Neurosurgeon: His Background, Achievements, and Contributions |date=2021-11-08 |publisher=Cambridge Scholars Publishing |isbn=978-1-5275-7707-7 |pages=119 |language=en}} During this operation a hole was drilled into the skull. Roman doctors believed this would cure headaches and relieve pressure. Flat chisels were used to cut away at overlying edges, and trepans were used to carve holes into interlocking bones.{{Cite journal |last1=Ganz |first1=Jeremy |last2=Arndy |first2=Jurgen |date=April 14, 2014 |title=To reap a rich harvest: experiencing agricultural labor in ancient Greece |url=https://pubmed.ncbi.nlm.nih.gov/24731159/#:~:text=A%20history%20of%20depressed%20skull%20fractures%20from%20ancient,first%20to%20describe%20sensible%20management%20for%20depressed%20fractures. |journal=Journal of the Histories of Neuroscience |volume=23 |issue=3 |page=234 |doi=10.1080/0964704X.2013.823267 |pmid=24731159 |via=PubMed |s2cid=11905716}}File:IcoonAgatha.jpg holding her severed breasts|219x219px]]

Celsus describes the ligature technique for treating hemorrhoids. He also mentions that after the surgery patients suffered from urinary retention, which is the inability to fully empty the bladder.{{Cite book |last1=Khubchandani |first1=Indru T. |url=https://books.google.com/books?id=ymSswOZ-vbMC&dq=Colorectal+surgery+ancient+Rome&pg=PA2 |title=Surgical Treatment of Haemorrhoids |last2=Paonessa |first2=Nina |date=2002-01-11 |publisher=Springer Science & Business Media |isbn=978-1-85233-496-3 |pages=2 |language=en}} Galen believed that surgeons should choose to amputate, instead of sawing into healthy bones. He also wrote that to stop bleeding, pressure should be used instead of ligatures.{{Cite book |last=Watson |first=Beriah André |url=https://books.google.com/books?id=Op6rkQ2BwM0C&dq=Amputation+in+Ancient+Rome&pg=PA5 |title=A Treatise on amputations of the extremities and their complications |date=1885 |publisher=P. Blakiston |pages=5 |language=en}} Surgical techniques like tracheal intubation and tracheotomy date back to Ancient Rome.{{Cite book |last=Coventry |first=Brendon J. |url=https://books.google.com/books?id=FL28BAAAQBAJ&dq=esophagus+surgery+ancient+Rome&pg=PA180 |title=General Surgery Risk Reduction |date=2014-01-13 |publisher=Springer Science & Business Media |isbn=978-1-4471-5391-7 |pages=180 |language=en}} The ancient Roman writer Aulus Gellius described a technique that functioned similarly to bariatric surgery. Which is conducted to reduce the weight of obese individuals. In this technique the surgeon would forcefully contract the stomach, thus limiting the passage of food.{{Cite book |last=Matz |first=David |url=https://books.google.com/books?id=FkuS2l5rqTgC&dq=stomach+surgery+ancient+Rome&pg=PA83 |title=Voices of Ancient Greece and Rome: Contemporary Accounts of Daily Life |date=2012 |publisher=ABC-CLIO |isbn=978-0-313-38738-8 |pages=83 |language=en}} Catgut sutures were used by the ancient Romans as early as the 2nd century CE.{{cite book |last=Nutton |first=Dr Vivian |author-link=Vivian Nutton |url=https://books.google.com/books?id=PREr9_rojrQC |title=Ancient Medicine |date=2005-07-30 |publisher=Taylor & Francis US |isbn=9780415368483 |access-date=21 November 2012}}{{Cite book |last1=Tang |first1=Peifu |url=https://books.google.com/books?id=gPUyEAAAQBAJ&dq=Orthopedic+surgery+Ancient+Rome&pg=PA7 |title=Tutorials in Suturing Techniques for Orthopedics |last2=Wu |first2=Kejian |last3=Fu |first3=Zhongguo |last4=Chen |first4=Hua |last5=Zhang |first5=Yixin |date=2021-06-10 |publisher=Springer Nature |isbn=978-981-336-330-4 |pages=7 |language=en}}{{Cite book |last=Engs |first=Ruth Clifford |url=https://books.google.com/books?id=CapVEAAAQBAJ&dq=Sutures+ancient+Rome&pg=PA288 |title=Bizarre Medicine: Unusual Treatments and Practices through the Ages |date=2022-01-11 |publisher=ABC-CLIO |isbn=978-1-4408-7125-2 |pages=288 |language=en}} They also used sutures with metallic hooks. Celsus discusses other kinds of suturing techniques in his medical literature. He wrote that the wounds were to be stitched up. Roman doctors used linen, wool, silk, hair, and clips to seal wounds.{{Cite book |last=Rooney |first=Anne |author-link=Anne Rooney|url=https://books.google.com/books?id=29gV_kCmZrIC&dq=intestine+surgery+ancient+Rome&pg=PA153 |title=The History of Medicine |date=2012-07-15 |publisher=The Rosen Publishing Group, Inc |isbn=978-1-4488-7370-8 |pages=153 |language=en}}{{Cite book |last=Qin |first=Yimin |url=https://books.google.com/books?id=wsPlBwAAQBAJ&dq=Sutures+ancient+Rome&pg=PA124 |title=Medical Textile Materials |date=2015-11-21 |publisher=Woodhead Publishing |isbn=978-0-08-100624-5 |pages=124 |language=en}}{{Cite book |last=Rooney |first=Anne |url=https://books.google.com/books?id=jBMEAwAAQBAJ&dq=Sutures+ancient+Rome&pg=PT183 |title=The Story of Medicine |date=2009-01-08 |publisher=Arcturus Publishing |isbn=978-1-84858-039-8 |language=en}}

The ancient Romans practiced tonsillectomies.{{Cite book |last1=Atchity |first1=Kenneth John |url=https://books.google.com/books?id=W0KI0lU2FoIC&dq=Tonsillectomies+ancient+Rome&pg=PA184 |title=The Classical Roman Reader: New Encounters with Ancient Rome |last2=McKenna |first2=Rosemary |date=1998 |publisher=Oxford University Press |isbn=978-0-19-512740-9 |pages=184 |language=en}}{{Cite book |last=Millenson |first=Michael L. |url=https://books.google.com/books?id=lC2GDwAAQBAJ&dq=Tonsillectomies+ancient+Rome&pg=PA40 |title=Demanding Medical Excellence: Doctors and Accountability in the Information Age |date=2018-06-01 |publisher=University of Chicago Press |isbn=978-0-226-16196-9 |pages=40 |language=en}}{{Cite book |last1=Miner |first1=Gary D. |url=https://books.google.com/books?id=NXyCDwAAQBAJ&dq=Tonsillectomies+ancient+Rome&pg=PT43 |title=HEALTHCARE's OUT SICK - PREDICTING A CURE - Solutions that WORK !!!!: Predictive Analytic Modeling, Decision Making, INNOVATIONS and Precision Medicine Necessary to Correct the Broken Healthcare Delivery System |last2=Miner |first2=Linda |last3=Dean |first3=Darrell L. |date=2019-01-04 |publisher=CRC Press |isbn=978-0-429-01580-9 |language=en}} Roman surgeons would use their fingers or a blunt hook to separate the tissue by the tonsils. Vinger mouthwash was used to induce hematopoiesis, or the stable production of blood cells.{{Cite book |last1=Pang |first1=Kenny P. |url=https://books.google.com/books?id=odkzBwAAQBAJ&dq=Tonsillectomies+ancient+Rome&pg=PA123 |title=Advanced Surgical Techniques in Snoring and Obstructive Sleep Apnea |last2=Rotenberg |first2=Brian W. |last3=Woodson |first3=B. Tucker |date=2013-05-01 |publisher=Plural Publishing |isbn=978-1-59756-632-2 |pages=123 |language=en}} Following the surgery, the tonsils were cut out. It was common for patients to profusely bleed following the procedure. Roman surgeons usually would also remove the vulva. To treat breast cancer, the Romans had an operation similar to a mastectomy. It would remove the pectoral muscles of the sufferer. Galen wrote that doctors should cut through healthy tissue around the infected tissue, ensuring that all cancerous material was removed.{{Cite book |last1=Bland |first1=Kirby I. |url=https://books.google.com/books?id=1u4x_iGiHNEC&dq=breast+surgery+ancient+Rome&pg=PA717 |title=The Breast E-Book: Comprehensive Management of Benign and Malignant Diseases |last2=Copeland |first2=Edward M. |last3=Klimberg |first3=V. Suzanne |date=2009-09-09 |publisher=Elsevier Health Sciences |isbn=978-1-4377-1121-9 |pages=717 |language=en}} This operation could also be used as a punishment. For example, Agatha of Sicily was a Christian saint who had her breasts cut off.{{Cite book |last1=Ray |first1=Colette |url=https://books.google.com/books?id=ncklBAAAQBAJ&dq=breast+surgery+ancient+Rome&pg=PA1 |title=Psychological Aspects of Early Breast Cancer |last2=Baum |first2=Michael |date=2013-03-07 |publisher=Springer Science & Business Media |isbn=978-1-4613-8563-9 |pages=1–2 |language=en}}

File:Roman dental forceps found 1894 Wellcome M0013704.jpg

It is unclear which Roman profession or professions would have performed dentistry. There may have been medical specialists trained to perform dental procedures, it is also possible that dentistry was practiced as a subset of other professions, such as barbery. Tooth extraction is an oral surgical procedure conducted to remove teeth. In ancient Rome, it may have been practiced by specialists who were not associated with any other medical professionals in ancient Rome. This practice required teeth to be extracted softly to avert the danger involved.{{Cite book |last1=Ferneini |first1=Elie M. |title=The History of Maxillofacial Surgery: An Evidence Based Journey |last2=Goupil |first2=Michael T. |last3=Halepas |first3=Steven |date=2022 |publisher=Springer Nature |isbn=978-3-030-89563-1 |pages=112 |language=en}} This danger also resulted in the practice becoming rare. Ancient literature describes another process dedicated to extracting teeth. In this process, the tooth would be grabbed and rocked until it could be removed with hands. Another practice involved cutting the gum and bone surrounding a tooth and then extracting it. Celsus recommended that physicians should also extract the bone near the teeth and that they should refuse to extract children's teeth unless they were preventing adult teeth from growing.{{Cite book |last1=Becker |first1=Marshall J. |url=https://books.google.com/books?id=XjklDwAAQBAJ&dq=Oral+surgery+ancient+Rome&pg=PA18 |title=The Etruscans and the History of Dentistry: The Golden Smile through the Ages |last2=Turfa |first2=Jean MacIntosh |date=2017-02-17 |publisher=Taylor & Francis |isbn=978-1-317-19465-1 |language=en}}{{Cite book |last=Ciment |first=James |url=https://books.google.com/books?id=8zkVCwAAQBAJ&dq=tooth+extraction+ancient+Rome&pg=PA181 |title=How They Lived: An Annotated Tour of Daily Life through History in Primary Sources [2 volumes]: An Annotated Tour of Daily Life through History in Primary Sources |date=2015-12-14 |publisher=ABC-CLIO |isbn=978-1-61069-896-2 |pages=181 |language=en}}

The ancient surgeon Dioscorides used Mandragora offcinarum as a painkiller during surgery. Other substances were used, such as opium, henbane, wine, belladonna, and alcohol.{{Cite book |last1=II |first1=Edmond I. Eger |url=https://books.google.com/books?id=H--3BAAAQBAJ&dq=eye+surgery+surgery+ancient+Rome&pg=PA4 |title=The Wondrous Story of Anesthesia |last2=Saidman |first2=Lawrence J. |last3=Westhorpe |first3=Rod N. |date=2013-09-14 |publisher=Springer Science & Business Media |isbn=978-1-4614-8441-7 |pages=4 |language=en}}{{Cite book |last=Stolberg |first=Victor B. |url=https://books.google.com/books?id=plWaCwAAQBAJ&dq=Painkillers+in+ancient+Rome&pg=PA31 |title=Painkillers: History, Science, and Issues |date=2016-03-14 |publisher=ABC-CLIO |isbn=978-1-4408-3532-2 |pages=31–32 |language=en}}{{Cite journal |last=Perk |first=Halûk |date=April 1, 2007 |title=Medical Equipment of the Antiquity from the Halûk Perk Collection. |journal= |pages=1–15}} Anal fistula were treated by passing probes through the anus, then once it was drawn out, a linen thread was placed into it. Following this the ends of the linen were tied to grip the skin by the fistula. To treat stab wounds in which the intestines fell out of the body, the surgeon would first examine the injuries to the intestines and their color. The large intestine was sutured, and if either intestine was pallid, black, or livid the patient was laid on their back with their hips raised. If the wound was too narrow to allow for an easy replacement of the intestines, the surgeon would cut it until it was "sufficiently wide." If the intestines were too dry, they were coated in water. Following this, an assistant would use their hands or hooks to separate the margins of the wound. Then the skin would be stitched with two rows of stitches. Projectiles were removed by enlarging the wound area with a scalpel, then using a forceps to drag the projectile out. To treat abscesses a scalpel or a spathion was used to make linear incisions. Afterwards, all the skin covering the pus was cut off. Following the surgery, the area was disinfected with honey. Another procedure involved using tongue depressors or spathomeles to depress the tongues of adult patients. Following this, the abscess was opened with a probe or a needle knife.{{Sfn|Milne|1907|p=79}}

• {{Cite book |last=Milne |first=John |url=https://books.google.com/books?id=fHYuAAAAIAAJ |title=Surgical Instruments in Greek and Roman times |date=1907 |publisher=At the Clarendon Press |isbn=978-859-100-771-4 |location=Oxford}}
• {{Cite book |last=Celsus |first=Aulus|url=https://penelope.uchicago.edu/Thayer/E/Roman/Texts/Celsus/home.html|title=De Medicina}}

{{Commons category|Ancient Roman medical tools|Surgery in ancient Rome}}

• [http://exhibits.hsl.virginia.edu/romansurgical/ Surgical Instruments from Ancient Rome]

{{Ancient Roman medicine}}

Category:History of medicine

Category:History of anatomy

Category:Surgery theory

Category:Surgical instruments

Category:History of surgery

Category:Ancient Roman medicine