Links

The surgical instruments from Stanway

Written by Ralph Jackson
(From The Colchester Archaeologist, No 11)

The importance of the medical kit from Stanway is already clear. Buried in the AD 50s, it is not only the earliest identifiable set of surgical instruments from Britain but also one of the earliest from anywhere in the ancient world. There is little doubt that the man buried with it had been a medical practitioner, and the location and form of his burial imply that his patients were members of the local tribal nobility. He, too, was more probably a native Briton than a Roman newcomer, and the surgical instruments shed a little light on his origins. Their overall similarity to contemporary sets of instruments from other parts of the Roman empire suggest contact with Roman medical personnel and, presumably, an acquaintance with the precepts of classical medicine. Indeed, one instrument - the slender bronze scoop probe or cyathiscomele - was probably a Roman import. All the rest, however, differ subtly from Roman types, and their rather idiosyncratic appearance may be explained in part by the fact that they were made in Britain, and in part, too, by their early date. It was only around the turn of the 1st century BC/1st century AD that Roman instruments began to acquire their relatively standardised form.

The instruments

It is notable that single-piece iron instruments predominate in the Stanway kit, which contrasts with the Roman preference for single- piece bronze instruments or composite bronze and iron instruments. Thus, the blade shapes of the two iron scal-pels mirror those of Roman examples, but their integral iron handles are exceptional. Similarly, the jaws of the bronze forceps are Roman in form but the terminal extension loop is not. Moreover, the outsplayed form of the double sharp hook (if that is what it is) is at present without parallel.

Nevertheless, the range of instruments is closely similar to that of the basic metal instrumentaria or core kits of the Roman world. This version of an instrumentarium comprises a complete set of the essential tools of ancient surgery: scalpels, sharp and blunt hooks, spring forceps, handled needles, a scoop probe, and a surgical saw. Whether treating battle wounds, accidental injuries or disease, these instruments would have enabled the Stanway healer to perform a very wide range of surgical interventions, for example, cutting and excising, retracting, seizing, extracting, dissecting, cauterizing as necessary. The operations could have included bone surgery, tonsillectomy (the removal of tonsils), the treatment of varicose veins, and fine eye operations, perhaps even the couching of a cataractous lens.

Like his Roman contemporaries, the Stanway healer would have had knowledge of medicinal plants. For surgical treatment of the tribal élite he may well have used herbal sedatives and pain-killers, such as those decocted from henbane, white mandrake and the opium poppy, all of which were known to the Romans. But these mild anaesthetics are unlikely to have been widely and generally available, and surgery was always a painful experience. It was also life endangering, for the importance of sterile instruments was not appreciated, and such antiseptic substances as were used, such as pitch, turpentine and red wine, lacked the strength of their modern counterparts. Post-operative infection was thus a major hazard and another real disincentive to surgery, especially internal operations, and it must often have been the cause of death or of limb amputations following gangrene. Nevertheless, although recovery must always have been jeopardised by the use of unsterile instruments, a sufficiently successful outcome to surgical treatment was evidently frequent enough to make it viable. In any case, while surgery might usually be regarded as a last resort, there would have been many occasions when there was no alternative, for example, with battle wounds. On the positive side, the Stanway kit, like Roman instrumentaria, comprises tools which are both care-fully designed and precisely manufactured. The level of craftmanship compares favourably with that of instruments of all later periods, so if surgery had to be undertaken then the Stanway healer could at least have had confidence in his equipment.

Ralph Jackson is an expert in ancient medical instruments and practice in the Department of Prehistoric and Romano-British Antiquities at the British Museum, and he is the author of Doctors and diseases in the Roman empire (first published in 1988 and re-printed in 1991).