var. -
lat. modiolus
The term τρύπανον[1] designates a tool with multiple applications: it can indicate the tool used by the carpenter[2], commonly known as a drill, but also the war drill[3] and the surgical tool used to drill various parts of the body; in the medical field, it is mainly used in bone surgery.
[1] The term is treated more or less extensively by BLIQUEZ 1984: 198-203; BLIQUEZ 2015: 185-189; FISCHER 1989; JACKSON 1987: 417-422; JACKSON 1994: 190-197; JACKSON 2003; KRUG 1990: 101-103; MILNE 1907: 126-130: 257; SCHÖNE 1903: 283; TABANELLI 1958: 119-122. In particular, see Bertonazzi 2018 e 2019.
[2] As we read in Homer, Od. 9.384-386 ἐγὼ δ’ ἐφύπερθεν ἐρεισθεὶς | δίνεον, ὡς ὅτε τις τρυπᾷ δόρυ νήϊον ἀνὴρ τρυπάνῳ, οἱ δέ τ’ ἔνερθεν ὑποσσείουσιν ἱμάντι | ἁψάμενοι ἑκάτερθε, τὸ δὲ τρέχει ἐμμενὲς αἰεί. Thus in fact, the technical term for the drill according to Hesychius (τέρετρα τρύπανα, τ 515).
[3] Vd. Aen.Tact. 32.5 καὶ παρασκευάζεσθαι δὲ ὅπως λίθος ἁμαξοπληθὴς ἀφιέμενος ἐμπίπτῃ καὶ συντρίβῃ τὸ τρύπανον. For this meaning of the term τρύπανον and for the description of the war machine see LAMMERT in RE VII,A1, 714 s.v.
1.-2. Etymology- General linguistic commentary
Derived from the verb τρυπάω ('bore, pierce through' LSJ s.v.), very prolific in Greek[1], the noun has the suffix in –ανο-, "largement utilisé pour former des noms d'instruments quel que soit le degré vocalique de la racine" (CHAINTRAINE 1933: 199), although some consider it "morphologisch mehrdeutig" (FRISK 937, S.V. τρυπάω)[2].
The term appears in the list of instruments of Codex Parisinus Latinus 11219, fol. 36v r. 56.[3]
3. Abbreviation(s) in the papyri
No abbreviated form had appeared, as yet.
[1] From the same verb derive the nouns τρύπημα, the result of the transplantation operation, τρύπησις, the action of drilling, τρυπητής, the drill and τρυπητήρ, 'pierced vessel' (BEEKES 1513 s.v. τρυπάω), as well as τρύπανον, hence the variants τρυπάνιον, τρυπανώδης, τρυπανικός, τρυπανίζω, τρυπανισμός, the feminine τρυπάνη with the same meaning of drill or auger, and τρυπανία, belt for working with the drill. That the verb τρυπανίζω derives from the noun τρύπανον is also supported by the gloss of Hesychius: τρυπανίζεται· τρυπάνῳ πλήσσεται (τ 1563). A later formation is τρύπη ο τρῦπα, with the sense of 'hole'. Given the late certification of the latter noun, the verb 'can hardly be denominative. It is more likely to be an old iterative formation". (BEEKES 1513 s.v. τρυπάω), as also supported by CHANTRAINE (1140-1141 s.v. τρυπάω) and FRISK (937 s.v τρυπάω).
[2] In this regard, in DESTM (875, s.v.tràpano) we read: “la coesistenza del verbo e del sostantivo non dovrebbe far dubitare sulla derivazione, anche se qualcuno ritiene che è morfologicamente ambigua (mehrdeutig di Frisk)”. The Italian noun tràpano entered into current use around the 13th century, however a trèpano form is also documented, which appears as an alternative spelling in the medieval Latin trepanum, from which the semi-ducts terms of European languages probably derived. “In italiano la forma tràpano – con ulteriore alterazione vocalica nella prima sillaba – è attestata dal chirurgo della scuola salernitana Ruggero da Parma (ora chiamato Ruggero di Frugardo); si può considerare quasi certo che la -a- è intervenuta per l’influsso di altri vocaboli, spec. traforare e trapassare, semanticamente affini” (DESTM 875, s.v. tràpano).
[3] Vd. SCHONE 1903: 283 and FISCHER 1989: 31.
[1] τρύπανον
1. Hp. VC 18 [3.250.16-23 L.] – V-IV BCE
Ἀλλὰ χρὴ, ἢν ψιλωθῇ τῆς σαρκὸς τὸ ὀστέον, προσέχοντα τὸν νόον, πειρῆσθαι διαγινώσκειν ὅ τι μή ἐστι τοῖσιν ὀφθαλμοῖσιν ἰδεῖν, καὶ γνῶναι εἰ ἔρρωγε τὸ ὀστέον καὶ εἰ πέφλασται, ἢ μοῦνον πέφλασται, καὶ εἰ, ἕδρης γενομένης τοῦ βέλεος, πρόσεστι φλάσις, ἢ ῥωγμὴ, ἢ ἄμφω ταῦτα· καὶ ἤν τι τούτων πεπόνθῃ τὸ ὀστέον, ἀφεῖναι τοῦ αἵματος τρυπῶντα τὸ ὀστέον σμικρῷ τρυπάνῳ, φυλασσόμενον ἐπ’ ὀλίγον· λεπτότερον γὰρ τὸ ὀστέον, καὶ ἐπιπολαιότερον τῶν νέων ἢ τῶν πρεσβυτέρων
[Si l’os a été dénudé, il faut appliquer son intelligenee à essayer de discerner ce qui n’est pas apparent aux yeux, et à reconnaître si l’os est fracturé et contus, ou seulement contus, et si, l’instrument vulnérant ayant produit une hédra, il s’y joint contusion ou fracture, ou contusion et fracture à la fois. Dans le cas où l’os aura éprouvé quelqu’une de ces lésions, on donnera issue à du sang en perçant l’os avec un petit trépan perforatif; il y faut quelque précaution; car chez les jeunes sujets l’os est plus mince et plus superficiel que chez les sujets plus âgés (Littré 3.251)]
2. P. Strasb. inv. 1187, Fr. A, co. I, rr. 1-18 – II CE
] ̣ ̣ ̣ [ϲ]ι̣̣ν̣αρὰϲ τότε | ]ἐ̣φώρα̣ϲεν τρῆμα | ]νων εἶτα διὰ τῆϲ | τ]ῶν ἐκκοπέων δια | ]ἐ̣πιτέλει τὸν βαϲτα- |] ̣ τὰ μὲν τὰ ἐργα. | ]α̣θων· ἐπὶ δὲ τῶν | ]ν ο̣ὐχ ἀποδίδε̣ται μα- | π]ροσεπιτρέπει τῷ τρυ| [πάνῳ ] ̣ ̣ ̣ ἕωϲ κενεμβατεῖν ε- | τῶ[ν ϲμειλιο\ω/τῶν ἐκκοπέω(ν) | ] ̣ ̣ ̣ ι̣ν̣ δι’ ἑνὸϲ τῶν βα- | ] ̣ ̣ γ ̣ ̣ ̣ ̣ τω ̣ ε βαϲτα- | ].ν ϲιναρῶν τῶν ϲιναρῶν ὁ παθώ(ν) | [διαμό]τωϲιϲ ἐνκρείνεται καὶ ἡ̣ πυοποιὸϲ | [θεραπ]εία· ἐκεῖνο δὲ εἰδέναι δεῖ ὅτι ἐπὶ τοῦ | [ τῶ]ν ἀποστημ̣άτων μετὰ ὀλίγαϲ τα̣. |] ̣αἱφνίδιον ὁρᾶτ̣α̣ι τὸ βάθοϲ ἀνα-
[... lésés, alors ... il découvrit un trou ... ensuite, au moyen de la ... des exciseurs ... il accomplit (ou achève) ... les opérations d’une part
... d’autre part, pour les ... n’est pas évacué (ou restitué?) ... il permet au trépan... tomber dans le vide ... des exciseurs en forme de scalpels ... au moyen d’un des … des... lésés, le malade on adopte l’application de charpie e le traitement suppuratif; mai en ce domaine, il faut savoir que pour le ... des abcès après quelques ... soudain on voit la profondeur (Marganne 1998: 73)]
3. Gal. Meth. med. 6.150 (10.446.12-18 K.) – II CE
τῶν δ’ ἄχρι μήνιγγος διασχότων, εἰ μὲν εἴη μόνη ῥωγμὴ, τοῖς εἰρημένοις ξυστῆρσι χρηστέον· εἰ δὲ μετὰ θλάσεώς τινος, ἐκκόπτειν χρὴ τὸ τεθλασμένον, ἤτοι διὰ τρυπάνων ἐν κύκλῳ πρότερον κατατιτρῶντα, κᾄπειθ’ οὕτω χρώμενον τοῖς ἐκκοπεῦσιν, ἢ διὰ τῶν κυκλίσκων εὐθὺς ἐξ ἀρχῆς.
[Of those divisions that extend as far as the meninges, if it is a fracture alone, you must use the aforementioned raspatories. If it is combined with some crushing, it is necessary to excise what has been crushed either perforating first in a circle with trephines and then, in like manner, using the knives, or perforating with the cyclisci immediately from the outset (Johnston-Horsley 2011: 219)]
4. Gal. Meth.med. 6.151 (10.448.1-3 K.)
ἔνιοι δὲ τούτων, εἴτε δειλοτέρους χρὴ λέγειν, εἴτ’ ἀσφαλεστέρους, ταῖς καλουμέναις χοινικίσιν ἐχρήσαντο.
[Some doctors, whom we should call either too timid or too cautious, use the so-called ‘crown trephine’ (Jonhston-Horsley 2011: 221)]
5. Gal. De comp. med. sec. loc. 5.463 [12.821.17-18 – 12.821.1-2 K.] [Archigenes]
εἰ δὲ μηδ οὕτως ἀφυγιάζοιντο, διελὼν τὸν κανθὸν καὶ διαστήσας κατατίτρα λεπτῷ τρυπανίῳ συνεχεῖς κατατρήσεις, εἶτα τῇ κεφαλικῇ χρῶ, ἀποστήσονται γὰρ λεπίδες καὶ ὑγριασθήσονται.
[Se il metodo precedente non funziona, dopo aver diviso l’angolo dell’occhio e aver perforato l’apertura con un trapano leggero, continua a fare buchi successivi; poi usa un impiastro kephalikè, rimuovi i resti epiteliali e lascia guarire]
6. Gal. De comp. med. sec. loc. 5.477 [12.863.17-19 – 12.864.1 K.]
εἰ δὲ πρὸς μηδὲν τῶν προγεγραμμένων εἴκει, ἔγκειται δὲ ἰσχυρῶς ὁ πόνος, λεπτῷ τρυπάνῳ τρήσας τὸν ὀδόντα, χρῶ τοῖς εἰρημένοις βοηθήμασιν, εἴωθε γὰρ μᾶλλον οὕτως ὠφελεῖν
[Se non funziona nessun rimedio di quelli scritti prima e se il dolore persiste con violenza, dopo aver trapanato il dente con un trapano leggero, usare i rimedi precedentemente suggeriti, e così dovrebbe giovare di più di quelli consueti]
7. Heliod. ap. Orib. Coll.med. 44.8.2-6 [CMG 6.2.1, 122.29-38 – 123.1 Raeder] – IV CE
καὶ ἡ ἀκμὴ τοῦ τρυπάνου στηριζέσθω κατὰ τὸ ἐψιλωμένον μέρος τῆς πλευρᾶς πρὸς τοῖς κατὰ φύσιν σώμασι, καὶ γινέσθω ἡ ἐνέργεια. κἂν ὑποπέσῃ τῷ ἐνεργοῦντι κενεμβατῆσαι, τὸ ἔλασμα τῆς μήλης παραγαγέτω ὑπὸ τὸ τετρημένον μέρος. ὅλον δὲ δι’ ὅλου τὸ τῆς πλευρᾶς πάχος τιτράσθω, καὶ ἤτοι δύο τὰ πάντα διδόσθω τρήματα, ἓν καὶ ἕν, στενῆς οὔσης τῆς πλευρᾶς, ἢ δύο καὶ δύο, πλατυτέρας οὔσης. τὸν δὲ τρόπον τῆς τῶν τρημάτων δόσεως ἐκτίθεμεν ἐν τῷ περὶ τῶν τοῦ κρανίου λόγῳ, καθάπερ καὶ τὸν τρόπον τῆς ἐκκοπῆς. διακοπτέσθω δὲ τῆς πλευρᾶς καθ’ ἓν μέρος τὸ πλεῖον πάχος, καὶ λεπτὴ συνέχεια καταλειπέσθω, εἶτα τότε τὸ ἕτερον διὰ τῶν ἐκκοπέων διαιρείσθω ὅλον.
[Bisogna appoggiare la punta del trapano alla parte esposta della costola, vicino alle parti sane, e fare l’operazione. Se capita di raggiungere una cavità con forza, la parte piatta della sonda deve toccare sotto la zona trapanata. Tutta la densità della costola deve essere trapanata da parte a parte, e poi si devono fare due fori in tutto, uno per ciascuna costola nel caso in cui la costola sia stretta, oppure due per ciascuna costola se è larga. Dobbiamo far sì che la maniera della trepanazione dei fori corrisponda a quelli della testa, così come la maniera del taglio. Bisogna tagliare la parte più spessa della costola e lasciare una piccola aderenza; dopo questo, bisogna dividere l’altra costola da parte a parte con l’aiuto dello scalpello]
8. Heliod. ap. Orib. Coll. med. 44.20.12 [CMG 6.2.1, 135.35-38 – 136.1-3 Raeder] (τρυπάνη)
εἰ δέ τι τῶν μειζόνων ὀστέων, οἷον βραχίων ἢ μηρὸς ἢ πῆχυς ἢ κνήμη, πεπονθὸς ὑποπίπτοι, τρήσαντες τρυπάνῃ μέχρι σήραγγος, οὕτως τοῖς ἐκκοπεῦσιν ἀναβαλοῦμεν τὰ μέσα τῶν περιτρήσεων. εἰ δὲ μέχρι μυελοῦ συμβαίη πεπονθέναι τὸ ὀστοῦν, καὶ τὴν ἐκκοπὴν μέχρι μυελοῦ ποιησόμεθα, οὐκ αὐτὸ μόνον τὸ πεπονθὸς ἐκκόπτοντες, προσπεριλαμβάνοντες δὲ καί τι τοῦ ἀπαθοῦς εἰς τὸ ῥᾳδίαν τὴν μετὰ τοῦτο σάρκωσιν γενέσθαι.
[Se qualcuna delle ossa grandi, cioè del braccio, della coscia, dell’avambraccio o della tibia, è sofferente per qualche caduta, dopo aver praticato dei fori con un trapano fino alla cavità del midollo, con degli scalpelli, solleveremo le parti cave che sono risultate dalla trapanazione circolare. Se troviamo che l’osso è sofferente fino al midollo, e possiamo incidere fino al midollo, non solo dobbiamo incidere la parte sofferente, ma dobbiamo anche includere quella che non è danneggiata per far ricrescere facilmente la carne attorno alla parte malata]
9. Gal. ap. Orib. Coll. med. 46.11.11-13 [CMG 6.2.1, 220.22-33 Raeder]
ἔστω δὲ καὶ ἄλλη μηλωτρὶς ἔχουσα ἔριον περιειλημένον, ἵνα διὰ τοῦ ἐρίου τούτου ἐκ διαστημάτων ψυχρὸν ὕδωρ παραστάζηται τῷ τρυπάνῳ. ὅταν δὲ βαθύτερον γένηται τὸ τρῆμα, ὑπὲρ τὸ τῆς διπλόης πάχος τετρημένου τοῦ ὀστέου, τότε ἡ τοῦ τρυπάνου περιδίνησις ἀσφαλεστέρα γινέσθω, ἵνα μὴ ἀθρόως καταβιβασθέντος τοῦ τρυπάνου ἡ μῆνιγξ τρωθῇ. ὅταν δ’ ἤδη καταβιβασθῇ τὸ τρύπανον καὶ ἤτοι στοχασμῷ νοηθῇ, ὅτι ὅλον τὸ τοῦ ὀστέου πάχος τέτρηται, ἢ παρὰ μικρὸν λεπτῆς συνεχείας καταλελειμμένης, τότε ὁ ἐνεργῶν καταγευέσθω τοῦ βάθους, καθεὶς βελόνης λεπτῆς τὸ ἀμβλὺ μέρος, κἂν ἔτι λείπηται συνέχεια, ἐπικαθιέναι δεῖ τὴν ἀκμὴν τοῦ τρυπάνου εἰς τὸ βάθος καὶ τῇ ἠρεμαίᾳ στροφῇ τὸ καταλελειμμένον συνεχὲς ὀστέον τρῆσαι.
[Another ear probe is taken for inspection that has wool around the shaft, so that some cold water can be drawn down by the wool, from time to time, drop by drop, from the diastesis right down to the drill. When the hole is deep enough, and the bone has already been drilled, beyond the porous substance, then the drill is rotated more safety, so that the meninges is not damaged due to the sudden descent of the drill; when the drill has already gone down deep, and one assumes that the entire thickness of the bone had been drilled through, or that there is only a thin part left, then the surgeon must examine the depth of the hole, inserting the bevelled part of a thin needle; if there is an undrilled part still remaining, he has to put the drill bit down and then drill the remaining bone still attached by rotating it gently]
10. Heliod. ap. Orib. Coll.med. 46.29.8 [CMG 6.2.1, 239.27-31 Raeder] sulla crescita del callo osseo
ἐὰν μὲν οὖν χαύνη ᾖ ἢ σηραγγώδης ἡ ἐπίφυσις, αὐτόθεν τοῖς σμιλιωτοῖς ἐκκοπεῦσιν ἐκκοπτέσθω, ὅλη ἐκ τῆς βάσεως ἀναιρουμένη· ἐὰν δ ᾖ πυκνὴ ἢ ὀστώδης, πρότερον περιτιτράσθω ἡ τοῦ ὄγκου βάσις, τῆς τοῦ τρυπάνου ἀκμῆς πλαγίας προστιθεμένης, καὶ οὕτως ἡ ἐκκοπὴ γινέσθω.
[If therefore the excrescence is spongy or porous, the following must be removed immediately with chisels shaped like a scalpel, removing it completely from the base; if however it is compact and bony, first the base of the callus has to be drilled, applying the drill bit in a slightly oblique direction, and thus making the incision]
11. Paul.Aeg. 6.22.1 [CMG 9.2, 62.9.-14 Heiberg] – VII CE
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)]
12. Paul.Aeg. 6.88.5 [CMG 9.2, 132.18-22 Heiberg]
εἰ δὲ καὶ διὰ βάθους εἴη τοῦ ὀστέου πεπηγός (τοῦτο δὲ γινώσκομεν ἐκ τοῦ ἐνεστηριγμένον αὐτὸ μὴ σαλεύεσθαι βιαζομένων ἡμῶν), ἐκκοπεῦσι τὸ περικείμενον περιελόντες ὀστοῦν ἢ καὶ τρυπάνοις πρότερον περιτρυπήσαντες, εἰ πάχος ἔχοι, τὸ βέλος ἀπολύσωμεν.
[If it (scil. the weapon) be lodged deep in the bone (which we know by its being so firm that it cannot be shaken with a considerable force) we first remove the remaining part of the bone with a cutting instrument, or bore it with trephines if it has considerable thickness, and thus disengage the weapon (Adams 1846: 420)]
[2] τρύπανον ἀβάπτιστον
13. Gal. Meth.med. 6.150-151 [10.447.8-18 K.]
ἰσχυρῶν δὲ κατὰ τὰ πλεῖστα τῶν ὀστῶν ὑπαρχόντων κατατιτρῶνται τοῖς τρυπάνοις αὐτά. τινὲς δὲ ὑπὲρ τοῦ μηδέποτε ἁμαρτεῖν ἀβάπτιστα τρύπανα κατεσκευάσαντο. καλοῦσι δὲ οὕτως αὐτὰ διὰ τὸ μὴ βαπτίζεσθαι· περιθεῖ γὰρ ἐν κύκλῳ περιφερής τις ἴτυς; προὔχουσα μικρὸν ὑπεράνω τοῦ κατὰ τὸ τρύπανον ὀξέος πέρατος. εἶναι δὲ δήπου χρὴ πολλὰ καὶ ταῦτα πρὸς ἅπαν πάχος κρανίου παρεσκευασμένα· τοῖς μὲν γὰρ παχυτέροις τὸ μακρότερον ἁρμόσει τρύπανον· ὀνομάζω δὲ οὕτως ᾧ μεῖζόν ἐστι τὸ μεταξὺ τοῦ τ’ἄκρου πέρατος καὶ τῆς κυκλοτεροῦς ἴτυος· τοῖς δὲ λεπτομερέσι τὸ μικρότερον· ἔστι δὲ δήπου καὶ τούτῳ τὸ μετακὺ τοῦ πέρατός τε καὶ τῆς ἴτυος ἔλαττον.
[But when the bones are particularly strong, perforate them with the trephines. Some equip themselves with nonplunging trephines so they never make a mistake. They name them in this way because they don’t plunge in, there being an outer rim which runs around in a circle and is raised up slightly above the sharp edge of the trephine. Of course, there must also be many of these trephines prepared, to take into account every thickness of the skull. For those skulls that are thicker, the larger trephine is adequate. I term them thus based on how much more the distance is between the sharp edge [of the trephine] and the encircling [protective] rim. In those skulls that are thinner, the smaller [trephine] suffices. There is, of course, less space in these between the [sharp] edge and the [protective] rim (Johnston-Horsley 2011: 221)]
14. Paul.Aeg. 6.90.5 [CMG 9.2, 139.21-27 – 140.1-3 Heiberg]
εἰ δὲ ἰσχυρὸν εἴη τὸ ὀστοῦν, πρότερον τοῦτο περιτρυπήσαντες τοῖς ἀβαπτίστοις λεγομένοις (τοιαῦτα δὲ ἐστι τὰ ἔχοντα μικρὸν ἐσωτέρω τῆς ἀκμῆς ἐξοχὰς κωλυούσας αὐτὰ πρὸς τὴν μήνιγγα βαπτίζεσθαι) τότε διὰ τῶν ἐκκοπέων περιαιρέσει χρησάμενοι τὸ πεπονθὸς ὀστοῦν ἀφελώμεθα, μὴ ἀθρόως ἀλλὰ κατὰ μέρος, εἰ μὲν δυνατὸν τοῖς δακτύλοις, εἰ δὲ μὴ ὀδοντάγρᾳ ἢ ὀστάγρᾳ ἢ τριχολαβίδι ἢ τοιούτῳ τινί.
τὸ δὲ μεταξὺ τῶν τρημάτων χωρίον ἐχέτω διάστημα, ὅσον τὸ μῆκος πυρῆνος μεγίστου μήλης, τὸ δὲ βάθος, ἄχρις οὗ πλησίον γένηται τῆς ἔνδον ἐπιφανείας τοῦ ὀστέου, φυλαττομένων ἡμῶν ἅψασθαι τὸ τρύπανον τῆς μήνιγγος.
[If the bone be strong it is to be first perforated with that kind of perforators called abaptistae, which have certain eminences projecting a little above the point that prevent them from sinking down to the membrane, and then, by using the chisels, we remove the fractured bone not at once, but by pieces, if possible with the fingers, or otherwise with a tooth forceps, or bone forceps, or hair-nippers, or some such instrument. The space between the perforations should be as great as the breadth of the largest head of a specillum, and its depth should be until it is near the inner surface of the bone, taking care that the perforator (trepan?) do not touch the membrane (Adams 1846: 431-432)]
1. τρύπανον and its sources
In Graeco-Roman surgery there were two types of drill[1], suitable for surgical operations. The first model had to be a sharp, strong drill, also called pereterios or choinikis[2], and had a circular or crown shape[3]; it was used in the removal of fairly small portions of diseased bones, usually from the skull or chin. This operation was done by drilling several holes in a circle around the damaged parts, which were then joined with the help of a chisel or scraper, allowing the diseased bone section to be removed. The drilling of the skull, far from being the prerogative of Greek medical culture, was very common in many ancient populations, both for medical and magical-religious reasons; presumably, this type of operation was carried out with instruments that did not have to differ much from those of the Greco-Roman object of study.[4]
Although the surgical drill could also be activated manually it rotated slower and thus had an inferior penetration capacity. Nevertheless the drill included the use of a strap as well which, wrapped around the instrument shaft, would make it rotate when pulled; this technique was adopted by the medical profession from the technology developed in carpentry and perfected by craftsmen in order to work wood or metals[5]. A precise description of the three ways in which the strap could be used is given in a text of the VIDIUS of 1544 (see also MILNE 1907: 127).[6]
The second type of τρύπανον , called άβάπτιστον,[7] was used in bone surgery of some magnitude, which however, required special attention in order not to go too deeply into the bone when drilling, as in operations on the flat bones of the cranial cavity; the abaptiston drill, thanks to a sort of ‘stop collar’ at a certain length of the rod, would prevent [the drill] accidentally damaging the brain.[8]
As presented above among the testimonia, P.Strasb. inv. 1187 illustrates a bone surgery operation performed with the combined use of τρύπανον and έκκοπεύς,[9] so it is refers to the remark of the papyrus in the reference section of the term έκκοπεύς. In addition, the term τρύπανον has been given as a misspelling and amendment of τρυπινον in P.Oxy. 14.1674 by Jones, in his new edition of the papyrus after Grenfell and Hunt’s editio princeps (who read τρυcινον ), in a totally non-medical context.[10]
2. τρύπανον word and object
Archaeological evidence does not seem to have brought to light examples of hand-held drills, nor models of arc drills, probably because the iron components have been corroded over time.[11]
1) In addition to being operated manually, the drill could be rotated by means of straps attached to the shaft[12]. The three main ways in which the abaptiston surgical drill was operated are described in the Surgery of VIDIUS and reported in MILNE 1907: 127. The first method consisted simply in wrapping a strap around the drill shaft and then pulling the head free to rotate the instrument. The second involves a bow with a string of a bow wound once round the shaft “of a bow with the string of the bow wound once round the shaft”. The third makes use of a piece of metal placed transversally to the drill with a hole in the centre through which the shaft can be passed, with straps running from the end of the crossbar to the tip of the shaft.
2) The tomb of the doctor of Bingen has yielded two specimens of χοινικίς and/or πρίων and, according to Como, they could be the first specimens found at the beginning of the 19th century[13]; the description is then looked into further by KUNZL (1983: 20-21 and 84 fig. 59 nn. 1-5) and by BLIQUEZ (2015: 189): "[a] pair of copper alloy crown strands came to light in the instrumentation of the surgeon of Bingen (Fig. 47). They are equipped with the removable centering pins mentioned by Celsus. One is slightly larger than the other and the number of teeth is different on each of them. The perforations through which the bow strap/thong has been passed are preserved, but neither is equipped with the chuck to be gripped by the operator. This suggests that the chucks may have been made of perishable material, most likely wood. Preserved along with these crown drills is the bow or aris that drove them”.
3) Some specimens of instruments used in bone surgery, about forty, were found in the excavations of the "Surgeon's House" in Rimini[14]: among them, although fused in a metal cluster, a folding handle of a bow drill is distinguishable.[15]
4) To conclude the presentation of the realia of the various types of drills, a brief mention must be made of an exceptional find from Fidene. In a rare example of a coming together between written evidence, realia and paleopathological evidence, in the cemetery near Rome, the skull of a child dating back to the second century AD was brought to light, in which were evident traces of a surgical operation on the skull, probably performed with the support of a τρύπανον (probably άβάπτιστον) or, as suggested by MARIANI COSTANTINI/CATALANO/DI GENNARO/DI TOTA/ANGELETTI (2000: 306), with "a blunt-edged surgical instrument, possibly a chisel" (ἐκκοπεύς in Greek). As pointed out by JACKSON (2003: 319) “[i]t has been possible to determine that the child had suffered from an intra-cranial expanding (hydrocephalus)”, had been quite intensively cared for over a prolonged period, and probably, as a last resort, had undergone an operation (cranial trepanation) to open the skull despite which the child died, probably quite soon afterwards".[16] Presumably the operation which the child had undergone, as Jackson hypothesizes, is the one presented by Galen (Gal. Meth. med. 6.150 [10.446.12-18K.]. vd. among the evidence is the case [13]), in which the use of the drill is an alternative and contextual to that of the simple ἐκκοπύς and κυκλίσκος; if so, the type of 'gouge' used in this operation could be of the same type as those found in Rimini.[17]
[1] Vd. BLIQUEZ 1984: 203; 1984: 185-189; JACKSON 1987: 417ss.; KRUG 1990: 101-103; MILNE 1907:126-130. In his most recent paper, Bliquez translates 'trephine' as the cylindrical or crown drill and 'trepan' as the τρύπανον άβάπτιστον, 'for the sake of convenience', specifying in note, however, that '[t]he term trepan is sometimes applied to both types as in the Oxford English Dictionary and Dorland's Illustrated Medical Dictionary (28th ed., 1994)'. (BLIQUEZ 2015: 186). The history of the two terms is particularly interesting: the 'trephine' was invented by John Woodall of St. Bartholomew's Hospital between 1630 and 1636; the particular feature of this instrument was that it was rotated more by the action of the wrist than the whole hand, and the drill tip was slightly conical, to avoid sinking too much into the flesh. The name derives from a characteristic of the handle, which had "two ends shaped so that they could be used as bone levers to elevate fragments. This gave the instrument its name, 'tres fines', Latin for ' three points', referring to the two ends of the handle and the removable centre pin [...]. Its spelling was soon 'Greeked' to trephine, because Greek was very prestigious, even if most surgeons of the time were literate tradesmen who knew little Latin and less Greek" (MARTIN 1995:261-262). The two terms, however, were destined to overlap a little later: "[s]oon after Woodall invented his improved instrument, the word trepan fell into disrepute. There was a slang word 'trepan' current at the time that meant to trick or deceive. Suggesting that a trepan was needed did not inspire patients, so within 70 years 'trephine' and 'trepan' were hopelessly confused, and have stayed that way in English ever since".
[2] Gal. Ling. s. dict. exolet. expl. 19.129.15 περητηρίῳ: τρυπάνῳ τῷ εὐθεῖ καὶ ὀξεῖ· ἔστι γὰρ καὶ ἕτερον ἡ χοινικίς.
[3] The different types of drill (whose generic name is terebrum) are precisely described, as well as in Greek medical literature, also in Cels. 8.3.1 [CML 1, 374.23-28 - 375.1-3 Marx]: exciditur verso os duobus modis: si parvulum est. quod laesum est, modiolo, quam χοινεικιδα graeci vocant; si spatiosius, terebris. Utriusque rationem proponam. Modiolus ferramentum concavum, teres est, imis oris serratum, per quod medium clavus ipse quoque interiore orbe cinctus demittitor. Terebrarum autem duo genera sunt: alterum simile ei. quo fabri utuntur, altermm capituli longioris; quod ab acuto mucrone incipit. dein subito latius fit. atque iterum ab alio principio paulo minus quam aequaliter sursum procedit. For the use of instruments in bone surgery in Celsus see JACKSON 1994: 190-195.
[4] Vd. BLIQUEZ 2015: 187. Some perforated skulls of Celtic origin, found in several Austrian sites (Durrnberg, Katzelsdorf, Guntramsdorf), dated to the 3rd-2nd century B.C., might have been operated with Roman type crown drills; for more details see KUNZL 1995: 222-223 and BREITWIESER 2003: 149.
[5] According to BLIQUEZ (2015: 187 and n. 448), a red-figure attic vase found in Chiusi, dated between the last quarter of the sixth and the first half of the fifth century BC. (number CAVI 201642) would have as subject a carpenter in the act of using a belt drill. The vase is visible at the following link in Beazley's database: http://www.beazley.ox.ac.uk/xdb/ASP/browse.asp?tableName=qryData&newwindow=&BrowseSes
sion=1&companyPage=Contacts&newwindowsearchclosefrombrowse=
[6] About Guido Guidi see PAZZINI (1948: 83): “Surgeon and anatomist. Translated and commented Greek treatises. Called Vidius Vidi in Latin. Born in Florence at the beginning of the XVI century. At age of 35 years was introduced to court of Francis I, gaining in Paris an excellent reputation. He then went to Tuscany (1547) where he held the professorship in Pisa, the appointment as doctor of Cosimo I and several ecclesiastical benefits. He was a renowned surgeon and anatomist. His surgical work includes the translation of some Hippocratic books (De ulceribus fistulis et vulneribus capitis, De fracturis, articulis et Medici officina), with the commentaries of Galen (the Galenic book De fasciis and that of Oribasio De laqueis et de machinamentis). Guido died in 1569".
[7] The adjective, although well attested, as reliable, in late and Christian writings, is not very frequent in medical writings; it appears only in the passages of Galen and Paul of Aegina reported among the testimonia. In Latin, the τρύπανον ἀβάβτιστον is called terebra by Celsus, who recommends it in more invasive operations than those carried out with the modiolus alone: (8.3.3-4 [CML 1, 375.13-21 Marx]) at si latius vitium est quam ut illo comprebendatur, terebra res agenda est. Ea foramen fit in ipso fine vitiosi ossis atque integri; deinde alterum non ita longe, tertiumque, donec totus is locus qui excidendus est his cavis cinctus sit. Atque ibi quoque, quaternus terebra agenda sit, scobis significat. Tum excisorius scalper ab altero foramine ad alterum malleolo adactus id quod inter utrumque medium est excidit; ac sic ambitus similis et fit qui in angustiorem orbem modiolo imprimitur. The term appears also in the Byzantine writers of medicine, so see BLIQUEZ 1984: 198.
[8] The type of drill ἀβάπτιστον is explained in the lexicon of Hesychius (a 69) as, τρυπάνου εΐδος ἰατρικοΰ, so that it is clearly distinguished from that of handicraft use; moreover the terebella abaptista is also placed as lemma in the Lexicon Medicum of CASTELLI (1 s.v.): "Abaptista, Terebella est, qua in fracturis capitis (quae usque ad cerebri membranam pervenerunt, quando id quod contusum est. excidi debet) utimur. Cui Terebella (ne dum Medici eam audiacius tractantes duram membranam, quae ossi substernitur, violent) supra eius acutam cuspidem, parum extans efformant, quam Terebella quod mergi non possit, ab argumento Abaptistam vocant, ex α et βαπτίζω (Gal 6. Meth. cap. 6)”.
[9] The integration at ll. 9-10 τῷ τρυ|[πάνῳ] has been proposed by FAUSTI 1989, from paralleling with some surgical operations made with both drill and chiesel as in Gal. Meth. med. 6.150 [10.446.12-18 K.] (see [2] among the evidence of έκκοπεύς); in the editio princeps of LEWIS 1936, in fact, reads τώ τρυ | [ ].
[10] JONES 2012 proposed the τρυπανον reading as a regularisation of the erroneous reading τρυπινον, correction from τρυcινον after an autoptic analysis of the papyrus: the context is that of a letter of Theon writing instructions to his son Apollonius to cut an acacia and throw the wood in a τρυcινον (r. 5, reading GRENFELL/HUNT 1920: 132-133). The reading τρυπανον indicates the term as "a synonym for πυρεΐον, which although more commonly meaning 'fire sticks' can denote 'earthen pan for coals' (LSJ 1556b) - a vessel in which something is burned" (JONES 2012: 271). According to Jones, in this context, τρύπανον could indicate the small drill which was pierced with sticks to make a fire, or a vessel to burn fuel in, especially given the indication to throw acacia wood into something (rr. 4-5 τήν ὕλην αὐτῆς βάλε εἰς τὸ̣ν̣ | τ̣ρ̣υ̣π̣ινον).
[11] “As to material survivals, no example of a hand-operated modiolus/trephine can be authenticated, though Meyer Steineg made a claim for a piece in his collection. This accords with the lack of testimony to its use in the literature. The same is true of bow driven trepan bits, as not one has been recovered in a surgical context. The reason may be that bits of this kind were of iron and, like other tools of this material, have rusted away” (BLIQUEZ 2015: 188).
[12] “Trephines and trepans could be rotated by hand; or they could be spun more rapidly by wrapping them with a strap or thong that could then be drawn by the free hand. Details in the sources on these maneuvers are scarce; but clearly the most efficient method of operating, and probably the one generally preferred, was to insert the drills into chucks, wrap them with a thong and then work the strap back and forth with a bow, exactly as the drills employed by wood and metal workers, from whom this method must have been borrowed” (BLIQUEZ 2015: 187-188).
[13] “Zwei Knochenbohrer, auch ‘Krontrepan’ genannt (gr. χοινικίς u. πρίων, lat. modiolus); der untere Rand des Zylinders ist scharf gezahnt; im Zylinder von 1 befinden sich zwei kreuzweise eingefügte Plättchen mit einem Dorn in der Mitte; am Ende des Bohrers 1 sind zwei gegenüberliegende Ösen, in denen eine fiedelbogenartige Drille saß oder ein Holzgriff befestigt war. […] Wohl wird er in der antiken Medizin genannt, aber bisher scheint er noch nirgends gefunden worden zu sein; im Nationalmuseum zu Neapel fehlt er bei den medizinischen Instrumenten auch” (COMO 1925: 160-161).
[14] Vd. JACKSON 2003: 316 (fig. 2)-317.
[15] Other minor examples could be found in Colophon instrumentarium (CATON 1914: 116, Fig. 46), in Marcianopoli’ House (MINCHEV 1983: 146; KIROVA 2002: 81 e 86), at the British Museum (CATON 1914: 117) and in the Berlin Antikenmuseum (JACKSON 2005: 105, unprovenienced).
[16] ANGELETTI/GAZZANIGA 2008: 38-40 e MARIANI-COSTANTINI/CATALANO/DI GENNARO/DI TOTA/ANGELETTI 2000: 305-307.
[17] “A latex mould of the cranial surface in the region of the trepanation demonstrated a close match between the dimensions and profile of the grooved channel and those of the cutting edge of the slenderest Rimini gouge. There can be little doubt that this was the type of instrument used by healer operating on the Fidenae child” (JACKSON 2003: 319).
P.Strasb. inv. 1187
Editions: LEWIS 1936: 90-92, n. 8; FAUSTI 1989; MARGANNE 1998: 67-84;
Studies: KÖRTE 1938: 128, n. 915; ANDORLINI 1993: 495, n. 54; GHIRETTI 2010: 159-162.
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.
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.
Angeletti, L.R. / Gazzaniga, V. (2008), Alla ricerca dell’eccellenza: la professione medica a Roma, in Atti del Convegno internazionale ‘Medici e pazienti nell’antica Roma’ (Rimini, 12 giugno 2008), «Bollettino dell’Ordine dei Medici Chirurghi e degli Odontoiatri della Provincia di Rimini» 9, 1-2, 25-43.
Beekes, R., EDG, Etymological Dictionary of Greek, I-II, Leiden-Boston, 2010.
Bertonazzi, F. (2018), “La trapanazione cranica nell’Antichità: alcuni casi nella letteratura medica e (forse) in un papiro greco”, in “Parlare la medicina. Fra lingue e culture nello spazio e nel tempo”, Atti del convegno internazionale, Università di Parma, 5-7 settembre 2016, a cura di N. Reggiani e F. Bertonazzi, Milano, pp. 89-112.
Bertonazzi F. (2019), “Digital edition of P.Strasb. inv. 1187: between the papyrus and the indirect tradition”, Proceedings of 28th International Congress of Papyrology, Barcelona 2016, Universitat Pompeu Fabra, 2019, pp. 857-871.
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.
Breitwieser, R. (2003), Celtic Trepanation in Austria, in Trepanation: History, Discovery, Theory, eds. R. Arnott, S. Finger, C.U.M. Smith, Lisse, The Netherlands, 147-153.
Castelli, B. (1665), Lexicon Medicum Græco-Latinum, a Batholomæo Castello Messanense inchoatum. Nunc vero in commodum publicum Opera et Studio Adriani Ravesteini, Art. Med. Doct., ex Hippocr. Galen. Avicenn. atque aliorum Celeberrimorum Medicorum Monumentis, Roterodami, 1665.
Caton, R. (1914), Notes on a Group of Medical and Surgical Instruments found near Kolophon, «Journal of Hellenic Studies» 34, 114-118.
Chantraine, P., DELG, Dictionnaire étymologique de la langue grecque, I-II, Paris, 1968-1980.
Chantraine, P. (1933), La formation des noms en grec ancien, Paris.
Como, J. (1925), Das Grab eines römischen Arztes in Bingen, «Germania» 9, 152-162.
Daremberg, C. (1851-1876), OEuvres d’Oribase. Texte grec en grande partie inédit collationné sur les manuscrits, traduit pour la première fois en français par les Drs Bussemaker et Daremberg, Paris.
De Benedittis, G. (1995), Molise, repertorio delle iscrizioni latine, vol. I Bovianum, Campobasso.
Di Benedetto, V. (1986), Il medico e la malattia. La scienza di Ippocrate, Torino.
DESTM, Dizionario etimologico storico dei termini medici, a c. di E. Marcovecchio, Impruneta, 1993.
DESLI, Dizionario etimologico-semantico della lingua italiana. Come nascono le parole, a c. di M. Alinei e F. Benozzo, Bologna, 2015.
DISC, Dizionario italiano Sabatini Coletti, Firenze, 2008 [http://dizionari.corriere.it/dizionario_italiano/].
Fausti, D. (1989), P.Strasb. inv. gr. 1187: testo chirurgico (Eliodoro?), in Annali della Facoltà di Lettere e Filosofia, Firenze 10, 157-169.
Fischer, K.-D. (1989), ‘Universorum ferramentorum nomina’. Frühmittelalterliche Listen chirurgischer Instrumente und ihr griechisches Vorbild, in Mittellateinisches Jahrbuch, Internationale Zeitschrift für Mediävistik 22, eds. W. Berschin, P. Dronke, P. Von Moos, J. Stolhmann, J. Szövérffy, Stuttgart, 28-44.
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].
Grenfell, B.P. / Hunt, A.S. (1920), Letter to Theon to his Son Apollonius, P.Oxy. XIV 1674, Oxyrhynchus Papyri, part XIV, 132-133.
Jackson, R. (1986), A Set of Roman Medical Instruments from Italy, «Britannia» 17, 119-167.
Jackson, R. (1987), A Set of Surgical Instruments from Roman Italy, in Archéologie et Médecine, VIIéme Rencontres Internationales d’Archéologie et d’Histoire d’Antibes (23-25 octobre 1986), Juan-les-Pins, 413-428.
Jackson, R. (1994), The surgical instruments, appliances and equipment in Celsus’ De medicina, in La médicine de Celse. Aspects historiques, scientifiques et littéraires, Centre Jean-Palerne, Mémoires XIII, eds. G. Sabbah, Ph. Mudry, Saint-Étienne, 167-209.
Jackson, R. (2003), The Domus ‘del chirurgo’ at Rimini: an Interim Account of the Medical Assemblage, «Journal of Roman Archaeology» 16, 1, 312-321.
Jackson, R. (2005), Holding on to Health? Bone Surgery and instrumentation in the Roman Empire, in Health in Antiquity, ed. H. King, London-New York, 97-119.
Johnston, I. / Horsley, G.R.H. (2011), Galen, Method of medicine. Edited and translated by Ian Johnston and G.H.R. Horsley, Cambridge-London.
Jones, B.C. (2012), What is a τρυϲινον? A fresh look at P.Oxy. XIV 1674, «Archiv für Papyrusforschung» 58/2, 269-272.
Kirova, N. (2002), Specialized Medical Instruments from Bulgaria in the Context of Finds from Other Roman Provinces (I–IV C ad), «Archaeologia Bulgarica» 6, 1, 73-94.
Körte, A. (1938), n. 915, «Archiv für Papyrusforschung»13, 128.
Körte, A. (1941), nn. 1014 e 1017, «Archiv für Papyrusforschung»14, 145.
Krug, A. (1990), Medicina nel mondo classico, Firenze.
Künzl, E. (1983), Medizinische Instrumente aus Sepulkralfunden der römischen Kaiserzeit, Bonn.
Künzl, E. (1996), Forschungsbericht zu den antiken medizinischen Instrumenten, in Aufstieg und Niedergang der römischen Welt , Part. II: Principat, Vol. 37,3, eds. W. Haase, H. Temporini, Berlin-New York, 2434-2639.
Lewis, N. (1936), Études de papyrologie, III, Le Caire.
LM, Lexicon Medicum Anglicum, Russicum, Gallicum, Germanicum, Latinum, Polonum, pod redakcja Doc. Dra Med. Boleslawa Zlotnickiego, Warsawa, 1971.
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. (1994), La réduction des luxations de l’épaule dans le De medicina de Celse, in La médicine de Celse. Aspects historiques, scientifiques et littéraires, Centre Jean-Palerne, Mémoires XIII, eds. G. Sabbah, Ph. Mudry, Saint-Étienne, 123-133.
Marganne, M.-H. (1998), La chirurgie dans l'Égypte gréco-romaine d'après les papyrus littéraires grecs, Leiden-Boston-Köln.
Mariani-Costantini, R. / Catalano, P. / di Gennaro, F. / di Tota, G. / Angeletti, L.R. (2000), New light on cranial surgery in ancient Rome, «Lancet» 355, 305-307.
Martin, G. (1995), Trepanation in the South Pacific, «Journal of Clinical Neuroscience» 2, 3, 257-264.
Milne, H.J. (1907), Surgical Instruments in Greek and Roman Times, Oxford.
Minchev, A. (1982), Roman Medicine in Marcianopolis, in Concilium Eirene XVI. Proceedings of the 16th International Eirene Conference, Prague 31.8.–4.9.1982, Prague, vol. 2, 143-148.
Pazzini, A. (1948), Bio-bibliografia di storia della chirurgia, Roma.
Pokorny, J. Indogermanisches etymologisches Wörterbuch, Tübingen-Berne-Munich, 1957-1969 (prima ed.), 2005 (5° ed.).
Roberts, C.H. (1938), Catalogue of the Greek and Latin Papyri in the John Rylands Library of Manchester, III, Manchester.
Schöne, H. (1903), Zwei Listen chirurgischer Instrumente, «Hermes» 38, 280-284.
Tabanelli, M. (1958), Lo strumento chirurgico e la sua storia, Forlì.
Turner, E.G. (1975), Early Papyrus Codices of Large Size, in Proceedings of the XIV International Congress of Papyrologists, London, 309-312.
Turner, E.G. (1977), The Typology of Early Codex, Philadelphia.
Vidius, V. (1544), Chirurgia e Græco in Latinum conversa, Vido Vidio Florentino interprete, cum nonnullis eiusdem Vidij comentaijs. Cum privilegijs Rom. Pontificis, Galliarum Regis et Ducis Ferrariæ, quorum exemplum indici librorum subiecimus, Paris.
Vulpes, B. (1847), Illustrazione di Tutti gli Strumenti chirurgici Scavati in Ercolano e in Pompei, etc., Napoli.
Francesca Bertonazzi