καυτήρ

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Var. καυστήρ; dim. καυτήριον, καυστήριον

Lat. cauter, cauterium, ferrum (candens), ferramentum (candens)

GENERAL DEFINITION

The καυτήρ (‘cautery’) is a heavy-duty surgical instrument normally used for burning injured tissues and arresting haemorrhage. It was frequently composed of iron thanks to its heat resistance, but some items were made in copper alloy and also in silver and gold. 

A. LANGUAGE BETWEEN TEXT AND CONTEXT

1-2. Etymology and general linguistic commentary

 

The derivation of καυτήρ from the verb καίω (‘to burn’) is generally admitted by modern etymological dictionaries[1]; however the etymology of the verb has been discussed by many scholars: Pokorny[2] suggests that it came from the Indo-European root k̂ēu-2, k̂ǝu-, k̂ū- (‘to shine’), linked to the semantics of light and/or burning, like Armenian šukh (‘radiance, splendour, fame’) and the Old Indian śumbhati (‘it shines’).

The related semantic field comprehends words from different technical languages, in particular from artistic and medical ones. In art, terms like ἔγκαυμα, ἔγκαυσις, ἐγκαυστικός, ἔγκαυστος refer to the technique of encaustic painting. In surgery, we find καυτηρίδιον (‘very small cautery’) and the denominative verb καυτηριάζω (‘brûler, cautériser’)[3].

 

 

3. Abbreviations in the papyri:

No abbreviated form had appeared, as yet; however we find the diminutive forms

καυτήριον in P. BGU II 469 as well as in P.Lond.Lit. 166 and P. Ross. Georg. I 20.

καυστήριον in P.Lond. 2.391.8 (Lsj9 932)



[1] Chantraine 481, Beekes 618, Boisacq 393-4, Frisk 756-7 s.v. καίω

[2] Pokorny 595 s.v. k̂ēu-2, k̂ǝu-, k̂ū-.

[3] Chantraine 481 s.v. καίω

B. TESTIMONIA - A selection of representative sources

1. Hp. Int. 25 [VII 230, 16-21 L.] (V-IV BCE)

κἢν μὲν ἀπὸ τουτέων καθίστηται, ἅλις ἢν δὲ μὴ, ὁκόταν μέγιστος ᾖ ὁ σλὴν καὶ οἰδέῃ μάλιστα, καῦσαι μύκησι, τὰς κεφαλὰς ἀπολαβὼν, ἢ σιδηρίοισι, μετὰ φυλακῆς πολλῆς καὶ τηρήσιος, ὅκως μὴ πέρην διακαύσῃς.

Si ces moyens ôtent le mal, c’est bien; sinon, quand la rate a le plus de volume et est le plus gonflée, on fera, avec des champignons ou le fer, des cautérisations qui comprendront les extrémités de la rate; on aura le plus grand soin à ce que la cautérisation ne transperce pas (VII 231, 19-24 L.)

 

2. IG II2 1534, fr. A, r. 61[1] (274-273 BCE)

ἐγκαυστήριον κοῖλον ὃ ἀνέθηεκεν Καλλίμαχος Θυμαιτύπος

A hollow cauterizing instrument which Kallimachos Thymaitades dedicated (Aleshire 1989: 200)

 

3. O. Berenike II 131, r. 6 (50-75 CE)

καυτήρια δύο

Two cauteries

 

4. BGU II 469, r. 7 (159-160 CE)

ἐν τῷ στήθι (lege στήθει) καυτή[ρ]ιον

(A brand made by a) cautery on the breastbone

 

5. SB  XXIV 16171, r. 11 (= P.Euphr. 10, 26 May 250)

ἔχου|σαν σημ⟨ε⟩ῖον καυτῆρος ἐπὶ μηρῷ δεξιῷ

Having a brand made by a cautery on the right-hand leg

 

6. P.Oxy. XLIII 3144,  r. 8 (23 July 313)

ἔχοντα τὸν δεξιὸν πόδα τὸ ς ψυτ̣ρακαυτῆρας (lege ψυχροκαυτῆρας)

Having a cold brand in s-shape on the right-hand foot

 

7. P.Lond.Lit. 166, col. II, rr. 12-39 – col. III, rr. 1-5 (II CE)[2]

Tῶν | [μέ]ντοι γε ὀργανικῶν οἱ διαϲημό|τ̣[ε]ροι παραιτηϲάμενοι τοὺϲ ἀϲτρα|[γ]αλίϲκουϲ καὶ τὸν μελίκηρον διὰ | [τ]οῦ καυτηρίου τὴν̣ γένυν κ̣αταρτί|[ζ]ειν ἠθέληϲαν· παρήγγειλαν |[γ]ὰ̣ρ ὕπτιο̣ν̣ μὲν ϲχηματίζειν τὸν | [π]άϲχοντα κατά τινοϲ ὁμαλοῦ κα|[τ]αϲκευάϲματοϲ ὥϲπερ βάθρου καὶ | [ἐ]πικεχ[ηνό]τι τῶι ϲτόματι π̣λάγιον | [π]αρεντιθέν̣αι καυτ[ή]ριο[ν], τ̣οῖϲ δ̣[ὲ] | [ἐ]κκειμ̣[έν]ο[ι]ϲ τ[οῦ] κ[αυ]τ[η]ρίου ἄκροι[ϲ] | [δύ]ο διπλῶ[ν κηριῶν] μ[ε]ϲότητα | π[ε]ρ̣[ιτι]θ[έναι, τὰϲ δ]ὲ ἀ̣ρχὰϲ τούτων | κ̣ά̣τῶι φέρει[ν] κ̣[αὶ περ]ιάπτ[ει]ν ὑπε|ρ̣[ο]ειδε`ῖ´ ξ̣ύ̣λ̣ω̣ι, τ[ρ]ίτη[ν δ]ὲ κη[ρία]ν | προϲλαμβάνειν διπλῆν καὶ ταύτηϲ | [τὴ]ν μεϲότητα τάϲϲειν ὑπὸ τὸ γέ|[νει]ο̣ν̣, [τ]ὰϲ δὲ ἀρχὰϲ διὰ μήλων ἀ|[ναφέρ]ε̣ι̣ν̣ ὑπ[ὲ]ρ [κεφ]αλῆϲ τοῦ πάϲχον|[τοϲ] κ̣[αὶ πά]λιν ὑπε̣[ρο]ει[δεῖ ξ]ύλωι πε-|ριάπ[τ]ειν, ἵνα τ̣ῶ̣[ν ξ]ύλων ἀνακλω|μένω̣ν [ἡ τά]ϲ̣ι[ϲ προχ]ω̣ρήϲῃ· ὑπὸ | [γὰ]ρ τῆϲ τρ[ίτ]ηϲ [κηρία]ϲ κάτωθε[ν ἄ]|[νω] ἡ γένυϲ ἀν̣[άγεται], ὑ[π]ὸ δὲ τοῦ | [κα]υτηρίου ὀ̣[  ̣  ̣  ̣  ̣  ̣  ̣  ̣  ̣  ̣  ̣  ̣  ̣]α̣[  ̣]α | [  ̣  ̣]ϲμ̣ον εἴϲω̣[  ̣]α̣[  ̣  ̣  ̣  ̣  ̣ καὶ οὗτ]οϲ̣ | [δ]ὲ ὁ καταρτιϲμὸϲ ο[ὐκ ἐλεύθεροϲ] |[μο]μφῆϲ· τὸ γ̣ὰ̣ρ̣ κ̣[αυ]τήριον ἔμ|π̣[υ]ρ̣ον τυγχάνο[ν] φώ̣κει τοὺϲ ὀ|δόνταϲ μετὰ τοῦ εἰδέναι ὅτι πάν|τωϲ ἀπ[ο]πείπτε̣ι̣ ἀνα[β]ρεχόμε|νον ὑπ[ὸ τ]ῶν χαλ̣εινῶν.

Cependant, parmi les instrumentistes, les plus éminents, qui avaient rejeté les petits astragales et la cire, voulurent réduire la mâchoire au moyen d’un cautère. En effet, ils prescrivirent  d’allonger le patient sur le dos sur un appareil plat comme un banc, d’introduire un cautère en  travers de la bouche béante, de placer autour des deux extrémités saillantes du cautère le milieu de cordons  doubles, de porter leurs bouts vers le bas et de les attacher autour d’un bâton en forme de pilon, de fixer un troisième cordon double et de placer son milieu sous le menton, d’en relever les bouts, à travers les pommettes, au-dessus de la tête du patient et de les attacher de nouveau autour d’un bâton en forme de pilon, afin que, quand les bâtons seront renversés en arrière, l’extension progresse. En effet, c’est sous l’effet du troisième  cordon que la mâchoire est soulevée de vas en haut, et c’est sous l’effet du cautère que … à l’intérieur … et cette réduction n’est pas exempte de reproche. En effet, la cautère, qui se trouve être brûlant, grille les dents lorsqu’on sait que, mouillé de nouveau, il tombe tout à fait au vas des commissures (Marganne 1998: 44)

 

8. P.Ross.Georg. I 20, col. III, rr. 118-123 (II CE)[3]

χρωνείων ὄντων ἔκλε-|ψειϲ τῶν κ̣[ατ]ὰ τὴν ἐπιφ[ά]-|[ν]ειαν ἀγγείων καὶ διὰ [π]υ[ρη]-|νοειδῶν καυτηρεί[ω]ν κ[αῦ]-|[ϲ]ειϲ. Ἐνίοτε δὲ καὶ ἀπόϲφ[ιγ]- [ξ]ειϲ καὶ ἐκτομή. |

Quand les écoulements d’humeurs sont chroniques, dégagement des vaisseaux superficiels et cautérisation au moyen de cautères à bouton. Parfois aussi, ligature et incision (Marganne 1994: 121)

 

9. Ps.-Gal. Introd. s. medic. 339 [XIV 797, 8-15 K.] (II CE)

ὁμοίως δὲ καὶ τὰ ὑπὸ τῶν ἰοβόλων ἤδη προκατειλημμένα. ἔπειτα καυτῆρσιν ἄγαν πεπυρωμένοις ἱστῶμεν τὴν νομήν. Μετὰ δὲ τοὺς καυτῆρας πράσῳ τῷ χλωρῷ καταπλάσσομεν μεθ’ἀλῶν, εἶτα ὅταν καθαρθῶσιν αἱ ἐσχάραι, ὡς ἕλκη θεραπεύομεν. τὰ δὲ τῶν ἰοβόλων δήγματα οὐδὲ ταχὺ ἐπουλοῦσθαι βουλόμεθα, ἀλλ’ὡς ἐπὶ τὸ πλεῖστον ῥευματίζεσθαι τὰ ἕλκη σπουδάζομεν.

The same thing with those who have been bitten by poisonous animals. After taking red-hot cauteries, we have to put them on the wound. After cauterization, put a plaster made of green leek with salt, until the eschars are purified and the wound is healed. We do not want that the bite of a poisonous animal scars over too fast, but we pay attention that the wounds flow.

                                               

10. Ps.-Gal. Introd. s. medic. 388 (XIV 782, 2-9 K.)

καύσει δὲ τῇ διὰ καυτήρων χρώμεθα, ἰδίως μὲν ἐπὶ τῶν νεμομένων ἤδη πάντων καὶ ἐπὶ τῶν ῥευματιζομένων ὀφθαλμῶν, ἰσχίων, ἢ καὶ τῶν ἐντός. καὶ γὰρ ἐπὶ φθισικῶν παραλαμβάνονται καυστῆρες καὶ ἐπὶ σπληνικῶν καὶ ἐπὶ τῶν εἰς μασχάλην μελετησάντων ἐκπίπτειν βραχιόνων καὶ ἐπὶ αἰγίλωπος καὶ ἐπὶ τῶν μελαινομένων ἢ πριζομένων διὰ τὰ ἀναστομούμενα ἀγγεῖα καὶ ἐπὶ τῶν ἄλλως αἱμορῥαγούντων

We burn with cauteries, especially for all ulcerations, rheumy eyes, sciatica or even internal conditions. For example, they are applied for wasting and splenetic diseases, for shoulder dislocations, for lacrimal fistula (aegilops), for gangrene, or for blood vessels that are being opened during amputation and for other hemorrhagic situations (Bliquez 2015: 157)

 

11. Gal. Meth. med. 301-302 [X 896, 6-18 K.] (II CE)

ἡ τοίνυν μέθοδος, ὑπὲρ ἧς ἐν τῇδε τῇ πραγματείᾳ πρόκειται λέγειν, ἐπὶ ταῖς ὀδύναις ἁπάσαις, ὅσαι διὰ θηρίων ἢ φαρμάκων γίνονται, διττὸν ἔχει τὸν σκοπὸν, κένωσιν τε καὶ ἀλλοίωσιν τοῦ τὴν ὀδύνην ἐργαζομένου. […] τινὲς δὲ καὶ δι’αὐτοῦ τοῦ στόματος ἕλκουσι τὸν ἰὸν, αὐτοὶ προσπίπτοντες τῷ πεπονθότι μορίῳ καὶ περιλαμβάνοντες αὐτὸ τοῖς χείλεσιν. ἔχεταί γε μὴν καὶ τοῦ προειρημένου σκοποῦ τὸ καυτήριον, ὅσα τε φάρμακα παραπλησίως τοῖς καυτηρὶοις ἐσχάραν ἐργάζεται.

So the method I started talking about in this treatise has the double purpose to heal every kind of suffering, caused either by poisonous animals or by drugs, namely the evacuation and alteration of what causes the pain. […] Some instruments drag the poison out through the mouth, by reaching the injured area and surrounding it with the edges. The cautery has this specific feature, as well as drugs very similar to cautery that heal eschars

 

12. Leon. ap. Aët. XVI 44, 13 [LXI 16, 62-5 Zervos] (VI CE)

ἐγὼ μὲν οὖν ἐπὶ τῶν μὴ συμπεφυκότων τῷ θώρακι καρκινωμάτων, εἴωθα χρῆσθαι τῇ χειρουργίᾳ· ἔστι δὲ ὁ τρόπος τοιοῦτος· τῆς πασχούσης ὑπτίας ἐσχηματισμένης, ὑπὲρ τὸ καρκίνωμα διαιρῶ τὸ μέρος τοῦ μαστοῦ τὸ ὑγιές, καὶ τὸ διῃρημένον ὑποκαίω καυστηρίοις, ἕως ὅτου ἐσχαρωθέντων τῶν σωμάτων ἐπισχεθῇ ἡ αἱμορραγία· εἶτα πάλιν τέμνω, περιχαράσσων ἅμα καὶ βαθυτομῶν τὸν μαστόν, καὶ πάλιν τὰ τετμημένα καίω· καὶ πλειστάκις τοῦτο ποιῶ τέμνων καὶ μετὰ ταῦτα καίων πρὸς ἐποχὴν τῆς αἱμορραγίας, καὶ ἔστιν κίνδυνος ἡ αἱμορραγία αὕτη. μετὰ δὲ τὴν τελείαν ἀποκοπὴν πάλιν ἐπικαίω τὰ μέρη τὰ ὅλα ἕως ἀναξηρασμοῦ, τὸ μὲν γὰρ πρῶτον καὶ δεύτερον πρὸς τὴν τῆς αἱμορραγίας ἐποχήν, ἔσχατον δὲ μετὰ τὴν τελείαν ἀποκοπὴν τὰ καυτήρια προσάγειν πρὸς τὴν τοῦ πάθους ὅλου ἀνασκευήν· εἴωθα δέ ποτε καὶ χωρὶς καύσεως ἐνεργεῖν, ὅταν ὄγκος γένηται περὶ τὸν μαστὸν χοιρώδης, μελετῶν τὴν τοῦ καρκινώματος γένεσιν. τοιούτου τοίνυν ὄντος τοῦ πάθους, ἔξεστιν ἀρκεσθῆναι τῇ ἀπὸ τῶν ὑγιῶν μερῶν ἐκτομῇ τοῦ μαστοῦ, οὐδὲ γὰρ σφοδρὰ γίνεται ἐπὶ τῶν τοιούτων αἱμορραγία.

I usually operate in cases where the tumors do not extend into the chest. The procedure is as follows. When the patient has been placed on her back, I incise the healthy area of the breast above the tumor and then cauterize the incision until scabs form and the bleeding is stanched. Then I incise again, marking out the area as I cut deeply into the breast, and again I cauterize. I do this quite often, incising and then cauterizing to stanch the bleeding. This way the bleeding is not dangerous. After the excision is complete I again cauterize the entire area until it is desiccated. I apply the cauteries the first and second time to check the bleeding, but the last time, after the tumor has been excised, for the complete cure of the disease. Sometimes it is my practice even to operate without cauterization when a breast tumor is not scrofulous, as I treat the source of the tumor. So when such a condition exists, one can cure it with excision [of the tumor] from the healthy parts of the breast; for the bleeding is not at all excessive in such cases (Bliquez 2015: 160)

 

13. Paul.Aeg. VI 57, 1 [CMG IX 2, 97, 6-15 Heiberg] (VII CE)

Οὐ περὶ τῶν διὰ σέβας ἐθνικὸν περιτεμνομένων νῦν ὁ λόγος ἡμῖν, ἀλλὰ περὶ τούτων, οἷς διαθέσεως αἰδοιικῆς γενομένης ἡ πόσθη μελαίνεται. χρὴ τοίνυν ἐπ’ αὐτῶν τὸ μεμελασμένον ἅπαν διαιρεῖν κατὰ κύκλον, καὶ μετὰ τοῦτο λεπίδι σὺν μέλιτι χρηστέον ἢ καὶ σιδίῳ καὶ ὀρόβῳ δίκην ἐμμότου. εἰ δὲ αἱμορραγήσοι ποτέ, τοῖς μηνοειδέσι καυτηρίοις χρηστέον πρὸς ἀμφότερα συμβαλλομένοις, αὐτήν τέ φημι τὴν αἱμορραγίαν καὶ τὴν νομὴν τοῦ τραύματος. εἰ δὲ ὅλη ποτὲ δαπανηθείη ἡ βάλανος, σωληνάριον μολιβοῦν ἐνθέντες τῷ πόρῳ δι’ αὐτοῦ κελεύσομεν ἀπουρεῖν τοὺς κάμνοντας.

[We do not treat at present of those who are circumcised in conformity to a heathen rite, but of those in whom the prepuce has become black from some affection of the privy part. In such cases, it becomes necessary to cut off the blackened portion all around; and afterwards we must have recourse to the squama aeris with honey, or to pomegranate-rind and tare, in the form of those applications which are made upon a pledget. And if there be a haemorrhage, we must use lunated cauteries, which contribute to two good purposes: I mean the stoppage of the bleeding and of the spreading sore. But if the whole glans be consumed, having introduced a leaden tube into the urethra, we direct the patients to make water through it (Adams 1846: 349-350)].

 

14. Paul.Aeg. VI 2, 1 [CMG IX 2, 45, 10-5 Heiberg]

Ἐπὶ μὲν ὀφθαλμῶν ἄνωθεν ἐπιρρεομένων ἐπί τε δυσπνοϊκῶν τῶν διὰ περιττωματικῆς ὑγρότητος περιουσίαν πεμπομένης ἐκ τῆς κεφαλῆς κάτω πρὸς θώρακα καὶ λυπούσης τῇ συνεχείᾳ τὰ τῇδε μόρια καίουσι κατὰ τὸ μέσον τῆς κεφαλῆς ὧδέ πως· προξυρήσαντες τὰ περὶ τὴν κορυφὴν μέρη καυτῆρας πυρηνοειδεῖς ἐμβάλλουσι καίοντες ἕως ὀστέου τὸ δέρμα, ξέοντες δὲ μετὰ τὴν ἔκπτωσιν τῆς ἐσχάρας τὸ ὀστοῦν.[4]

 In ophtalmia, occasioned by a defluxion from above, and in dyspnœa, produced by a redundance of a recrementitious humour which is sent from the head down to the chest, and by lodging there proves in injourious to the parts contained in it, they burn the middle of the head in this manner. Having first shaven the parts about the vertex, they apply cauteries shaped like olive-kernels and burn the skin down to the bone, seraping the bone after the falling off of the eschar (Adams 1846: 248)

 

15. Paul.Aeg. VI 22, 1 [CMG IX 2, 62, 9-14 Heiberg]

τινὲς δὲ μετὰ τὴν ἐκτομὴν τῶν σαρκῶν τρυπάνῳ χρησάμενοι τὸ ὑγρὸν ἢ τὸ πῦον εἰς τὴν ῥῖνα μετήγαγον· ἡμεῖς δὲ τῇ καύσει μόνον ἠρκέσθημεν ἐπὶ τοσοῦτον καίοντες τοῖς αἰγιλωπικοῖς καυτηρίοις, ὥστε λεπίδα ἀποστῆναι, καὶ μετὰ τὴν καῦσιν τῷ φακομέλιτι ἢ τῷ σιδιωτῷ καὶ τοῖς λοιποῖς ξηραίνουσι τῶν βοηθημάτων χρησόμεθα.

Some, after the excision of the flesh, use a perforator, and make a passage for the fluid or matter to the nose; but we are contented with burning alone, using the cauteries for ægilops, and burning down until a lamina of bone drop off; and after the burning we have recourse to lentils and honey, or to the application consisting of pomegranate-rind with honey, and other such desiccative remedies (Adams 1846: 284)[5]

 

16. Paul.Aeg. VI 48, 1 [CMG IX 2, 87, 19-24 Heiberg]

Ἀγκίστροις ἀνατείναντες τὸ δέρμα τὸ ἐπικείμενον τῷ σπληνὶ μακρῷ καυτηρίῳ πεπυρακτωμένῳ διαμπὰξ αὐτὸ καύσομεν, ὥστε τῇ μιᾷ προσβολῇ δύο γενέσθαι ἐσχάρας, καὶ τοῦτο πράξομεν τριχῶς, ὥστε τὰς πάσας ϛ ἐσχάρας γενέσθαι. ὁ δὲ Μάρκελλος τῇ λεγομένῃ τριαίνῃ ἢ τριαινοειδεῖ καυτηρίῳ χρώμενος τῇ μιᾷ προσβολῇ τὰς ἐσχάρας εἰργάζετο.

Some pick up the skin with hooks and push through it a long cautery, and repeat this three times so that there are six eschars. Marcellus, however, by using the instrument called a trident or trident-shaped cautery, formed six eschars at one application (Milne 1907: 117)

 

17. Paul.Aeg. V 3, 3 [CMG IX 2, 10, 3-4 Heiberg] ξηρίον ἐσχαρωτικὸν τῶν λυσσοδήκτων

ἀπονίζειν δὲ τὸ ἕλκος ἑψοντας ἐν ὕδατι χαμαίμηλον καὶ τὴν τοῦ ἀγρίου λαπάθου ῥίζαν. τινὲς δὲ καὶ καυτηρίοις σιδηροῖς τὸ ἕλκος καίουσιν.

Wash the sore with a decoetion of camomile in water, and the root of the wild dock. But some burn the sore with heated irons. (Adams 1846: 164)



[1] R. 84 in Aleshire’s edition. For the complete text, translation and a line-by-line commentary see Aleshire 1989: 177-248; for the identification of ἐγκαυστήριον κοῖλον  with a surgical instrument see Aleshire (1989: 235): “[t]he ἐγκαυστήριον is here almost certainly a cauterizing instrument […] although the compound noun is apparently not otherwise attested in this sense (cf. καυστήρ, καυτήρ in this sense at Hp. Haem. 6, Gal. 19.111, Hippiatr. 26). τὰ ἐγκαυστήρια at IG XI (2) 287A.44 probably refers to instruments used in encaustic painting”.

[2] The content deals with four different methods to reduce the dislocation of the jaw; the first three mechanical treatments are rejected by the author because of their inefficacy. The first one (I-II,12) uses the “small astragalos” and wax; the second (II, 13-III, 8) is the Alexandrine method (see also P.Ryl. II 529); the third one (III, 9-IV, 6) is suitable in case of unilateral dislocation or bilateral disarticulation of the jaw and uses two bands crossed around the neck. In the last section (IV, 7-V, 37) the author describes his own method, based on the use of two bands crossed next to the ears and fixed one above the head and the other one on the ground. The text is attributed with uncertainty to Heliodorus.

[3] The text belongs to the genre of medical catechism with didactic purpose and deals with some eye diseases. It is composed in the form of ἐρωταπόκρισις (question and answer) and the nine ἐρωτήματα, all marked with eistheseis, deal with γλαύκωμα (‘cataract’, l. 57), σταφύλωμα (‘defect in the eye inside the cornea’, ll. 68 and 73), types (l. 80) and surgery of σταφύλωμα (l. 84), πτερύγιον (disease of the inner corner of the eye, ll. 94 and 98), types (l. 105) and surgery of πτερύγιον (l. 110). The third column contains a question and answer about ῥευματισμός (‘flood’, l. 116) and a question about ὑποσπαθισμός (kind of operation for eye-affection, l. 124), both marked with eistheseis.

 

[4] The same instrument is used by Paul also for the surgery called periskyphismos (VI 7 [CMG IX 2, 50, 1-24 Heiberg]), for healing migraine. The surgeon has to burning the tissue around the painful area, so as to create a thick eschar and to act on the blood vessels. This kind of surgery can be done also with scalpel, hooks (ἄγκιστρα) and needle (βελόνη), though an olivary cautery (πυρηνοειδὴ καυτήριον) avoids the risk of haemorrhage in such a sensitive area.

[5] This particular kind of καυτήρ recurs in several medical texts of Byzantine age (see  Bliquez 1984: 198).

C. COMMENTARY

1. καυτήρ and its medical sources

Although the use of the καυτήρ was very common and this instrument was employed in a variety of surgical operations, it is possible to categorize four main functions[1] based on Greek medical literature: “ (a) to staunch bleeding, (b) to eliminate diseased tissue, (c) to open the way to other parts of the body, and (d) to produce counter irritation”.[2] The great variety of operations performed by the cautery is also shown by the pseudo-Galenic Introductio sive medicus [10].

The primary use of cautery allowed to stop an haemorrhage (see [13] and Orib. Coll.med. 50.7.1 [CMG 6.2.2, 59.11-23 Raeder]) caused by  an operation (see [12], in the spelling variant καυστήρ) or an accidental wound. In some cases, burning a small area could be useful to remove diseased tissues, as in the surgery of the eyes (see [8][14][15]). Because of its power of cauterizing the inner layers of the skin, the καυτήρ could be used to open the way to other parts of the body, as in case of the surgery of the liver (as in [1] and [16]). When the injury is caused by a bit of a poisonous animal, the recourse to cautery could be resolved, as in the cases [9][11][17].

In a papyrus dated to the II century CE, (see [7]) the καυτήρ is employed in an unexpected way, though in a medical context again. The text deals with four different methods to reduce the dislocation of the jaw; in one of them (called ‘Alexandrine method’, used by οἱ ὀργανικοί surgeons), the unknown author affirms that the doctor has to put a red-hot cautery across the mouth and then, with some surgical ropes, make the extension of the jaw. This method is rejected by the author because the ἔμπυρον καυτήριον burns the teeth, being therefore unsafe for the patient.

In some cases, the word καυτήρ does not indicate the instrument itself, but the brand it leaves on animals, as attested in two documentary papyri from Roman Egypt (see [4][5]), which deal with sales of working animals.

In addition to the literary sources, the use of καυτήρ is attested also in a Greek inscription, dated to 274-273 BCE (see [2]), in which the καυτήρ is listed in an inventory of objects dedicated to the Athenian Asklepieion. A similar occurrence of the term in a list of objects is attested in a documentary papyrus dated to I century CE (see [3]).

 

 

2. καυτήρ word and object

 

Just like many other surgical instruments, the καυτήρ could have been made of several materials: the most common examples were made of iron, thanks to its heat resistance (for this reason σιδήριον is found more frequently than καυτήρ in the Corpus Hippocraticum, see [1], and also [17]) but in some particular cases they were made of copper alloy (χάλκεον), silver or gold.

Moreover, a great variety of sizes and temperature of use is attested: the cauteries are said to be λεπτός (‘fine’), μικρός (‘small’), μακρός (‘big’, as in [16]), παχύς (‘thick’), μαχαιρωτός (‘sword-shaped’), σφηνίσκους (‘wedge-shaped’), ψυχρός (‘cold’, as in [6]) or, more frequently, ἔμπυρος (‘red-hot’, as in [7]) or πεπυρωμένος (as in [9]).

 

From the IV century onwards, several new shapes are attested in medical literature by means of new modifying adjectives, probably as a result of technological innovations. So we can find a μηνοειδής καυτήριον, (‘lunated cautery’), in Orib. Coll.med. 50.7.1 [CMG 6.2.2, 59.11-23 Raeder] and in [13] only; this kind of instrument was recognised by Bliquez (1981: 219–220) as the same type found in a tomb in Bingen, Germany:

 

 

(Fig. 1: lunated cautery, μηνοειδής, from  Bingen. Bliquez 2015: 403, fig. 36; for the picture see Künzl 1983: 84 fig. 58 n. 14)

 

Furthermore, in case of eye surgery (or operation in critical areas), the doctor could use a not very common kind of cautery called πυρηνοειδής, or olivary: thanks to his fine edge, it could reach every portion of tissue with ease and precision; the term is attested in two testimonia only, by P.Ross.Georg. I 20 [8] and by Paulus of Aegina [14]. There was also a more specialized instrument, suitable for healing the fistula lachrymalis, namely the αἰγιλωπικὸς καυτήριον (attested in the diminutive form and in Paulus only, see [15]). A sample of the πυρηνοειδής has been excavated in Reims, “a particularly attractive candidate is the puren equipped needle (presumably) handle excavated at Reims in the instrumentarium of the ophthalmologist G. Firmius Severus” (Bliquez 2015: 172), whom floruit was between the end of II and the beginning of III century CE.

 

 

(Fig. 2: olivary cautery πυρηνοειδής, see Bliquez 2015: 401, fig. 32)

 

 

(Fig. 3: Künzl 1983: 65, fig. 36, n. 31)

 

 

The same kind of cautery, the τριαινοειδὲς καυτήριον mentioned by Paulus of Aegina (see [16]), was recognized by Vulpes (1847: 74) among the instruments excavated in the archaeological sites of Pompei and Herculaneum (see fig. 4), but more recently Bliquez called into question that identification[3], because of its (probably) non-medical nature.

 

 

 

(Fig. 4: trident cautery τριαινοειδὴς. Vulpes 1847: tav. V, fig. XIII)

 

 

In some cases, the iron cautery bears another instrument on its opposite side, like the καυτήρ found in Asia Minor, now preserved at the Römisch-Germanisches Zentralmuseum of Mainz (see fig. 5).

 

 

(Fig. 5: Künzl 1983: 47 fig. 15, n. 12)



[1] Cautery was not the only instrument that could be used to perform a cauterization: doctors could rely on different therapies, e.g. kinds of funguses or even dung (see the paragraph ‘Natural Substances used in Cauterization’, Bliquez 2015: 172-173).

[2] Bliquez 2015: 160.

[3] “Also, Vulpes saw in a three-pronged item of copper alloy in the surgical collection of the Naples Museum a specimen of the triaine. My own investigation reveals that this piece has nothing to do with Pompeii or Herculaneum, having come into the Museum via the Borgia collection […]. It therefore has no medical provenience and is surely only a hairpin or a small fork” (Bliquez 2015: 169, n. 383). The same opinion was expressed in Bliquez/Jackson 1994: 45.

D. BIBLIOGRAPHY

P.Ross.Georg. I 20

Editions: BÄCKSTRÖM  1909: 449-481; ZERETELI /KRUEGER  1925: 137-145; MARGANNE  1994: 112-132;

Studies: KAPPUS  1912: 266-267; KIND  1919: 68-69; OLIVIERI  1928: 235-249; MARGANNE  1978: 313-320; ANDORLINI  1993: 511, n. 95; GHIRETTI  2010: 176-181.

 

P.Lond.Lit. 166

Editions: KALBFLEISCH  1902: 3-8; MARGANNE  1998: 35-66;

Descriptions: HAEBERLIN  1897: 398, n. 134; KENYON  1989: XIV; OLDFATHER  1923: 43, n. 813; MILNE  1927: 133 n. 166.

Studies: CRÖNERT  1903: 375-376 e 475-82; KIND  1912: 193, n. 164; MARGANNE  1985: 105-108; MARGANNE  1988: 107-111; ANDORLINI  1993: 496, n. 57; MARGANNE  1995; GHIRETTI  2010: 187-195.

  

General Bibliography

 

Adams, F. (1846), The Seven Books of Paulus Ægineta, translated from the Greek with a Commentary embracing a complete view of the Knowledge possessed by the Greeks, Romans and Arabics on all subjects connected with Medicine and Surgey, by Francis Adams, in three volumes, London.

Aleshire, S.B. (1989), The Athenian Asklepieion: the people, their dedications, and the inventories, Amsterdam.

Andorlini, I. (1993), L’apporto dei papiri alla conoscenza della scienza medica antica, A.N.R.W. II 37.1 Berlin-New York, 458-562.

Beekes, R., EDG, Etymological Dictionary of Greek, I-II, Leiden-Boston, 2010.

Bliquez, L.J. (1984), Two Lists of Greek Surgical Instruments and the State of Surgery in Byzantine Times, «Dumbarton Oaks Papers» 36, 187-204.

Bliquez, L.J. (2015), The tools of Asclepius. Surgical Instruments in Greek and Roman Times, Leiden-Boston.

Bliquez, L.J. / Jackson, R. (1994), Roman Surgical Instruments and Minor Objects in the National Archaeological Museum of Naples, with a Catalogue of the Surgical Instruments in the Antiquarium at Pompeii by Ralph Jackson, Mainz.

Boisacq, É., DELG, Dictionnaire étymologique de la langue grecque, étudiée dans ses rapports avec les autres langues indo-européennes, Heidelberg-Paris, 19161.

Chantraine, P., DELG, Dictionnaire étymologique de la langue grecque, I-II, Paris, 1968-1980.

Como, J. (1925), Das Grab eines römischen Arztes in Bingen, «Germania» 9, 152-162.

Crönert, W. (1903), Sprachliches zu griechische Ärzten, eine Untersuchung über den Verfasser des griechischen Papyrus Lond. Nr. 155, «Archiv für Papyrusforschung», 2, 375-376 e 476-482.

Frisk, H., GEW, Griechisches etymologisches Wörterbuch, I-III, Heidelberg, 1954-1979.

Ghiretti, G. (2010), Luoghi e strumenti della professione medica antica. La testimonianza dei

papiri greci d’Egitto, «Papyrotheke» 1 [http://dspace-unipr.cineca.it/handle/1889/1493].

Haeberlin, C. (1897), Griechische Papyri: Volumina Herculanensia, «Centralblatt für Bibliothekswesen» 14, 389-396.

Kalbfleisch, K. (1902), Papyri Graecae Musei Britannini et Musei Berolinensis, Rostock.

Kenyon, F.J. (1898), Greek Papyri in the British Museum, II, London (repr. Milano, 1973).

Kind, F.E. (1912), sine titulo, «JAW» 158, 168-171 e 192.

Künzl, E. (1983), Medizinische Instrumente aus Sepulkralfunden der römischen Kaiserzeit, Bonn.

Marganne, M.-H. (1985), De l’utilisation du ‘scalp’ comme remède aux affections oculaires, «Revue médicale de Liège», 40, 17, 600-603.

Marganne, M.-H. (1987), Les instruments chirurgicaux de l’Égypte gréco-romaine, in Archéologie et Médecine, VIIéme Rencontres Internationales d’Archéologie et d’Histoire d’Antibes (23-25 octobre 1986), Juan-les-Pins, 403-412.

Marganne, M.-H. (1988), Le chirurgien Héliodore: tradition directe et indirecte, in Études de médicine romaine, Centre Jean-Palerne, Mémoires VIII, ed. G. Sabbah, Saint’Étienne, 107-111.

Marganne, M.-H. (1994), L’ophtalmologie dans l’Égypte gréco-romaine d’après les papyrus littéraires grecs, Leiden-Boston-Köln.

Marganne, M.-H. (1995), De la réduction des luxations de la mâchoire: précédents antiques à la manoeuvre de Nélaton, «Revue médicale de Liège», 40, 3, 105-108.

Marganne, M.-H. (1998), La chirurgie dans l'Égypte gréco-romaine d'après les papyrus littéraires grecs, Leiden-Boston-Köln.

Milne, H.J. (1907), Surgical Instruments in Greek and Roman Times, Oxford.

Milne, H.J. (1927), Catalogue of the Literary Papyri in the British Museum, London.

Oldfather, C.H. (1923), The Greek Literary Texts from Graeco-Roman Egypt, Madison.

Pokorny, J. Indogermanisches etymologisches Wörterbuch, Tübingen-Berne-Munich, 1957- 1969 (prima ed.), 2005 (5° ed.).

Tabanelli, M. (1958), Lo strumento chirurgico e la sua storia, Forlì.

Vulpes, B. (1847), Illustrazione di Tutti gli Strumenti chirurgici Scavati in Ercolano e in Pompei, etc., Napoli.

E. CPGM reference(s)

O.Berenike II 131, r. 6 (50-75 CE)

BGU II 469, r. 7 (159-160 CE)

SB XXIV 16171, r. 11 (= P.Euphr. 10, 26 may 250)

P.Oxy. XLIII 3144,  r. 8 (23 july 313)

P.Lond.Lit. 166, col. III, rr. 1-2 (II CE)

P.Ross.Georg. I 20, col. III, rr. 120-121 (II CE)

P.Lond. II 391, r. 8 (VII CE)

AUTHOR

Francesca Bertonazzi

καυτήρ
Accepted term: 24-Oct-2016