Medical treatment in ancient Rome was both horrifically gruesome and, at times, highly effective. The Romans believed that diseases and natural catastrophes were ordained by the gods. So, the prescribed remedy was often a combination of prayers, sacrifices, and pagan rites. But still, some doctors performed extremely complex surgeries, saving many patients. Galen was by far the most famously skilled physician in the Roman world. He performed many surgeries that were not replicated for almost 2,000 years, including brain and eye surgery.

Roman surgeons employed many tools that bear a remarkable resemblance to some of our current-day instruments. Forceps, syringes, scalpels, and bone saws. These were made by specialist craftsmen that could achieve the fine details and sharpness required for the surgeon’s implements.

In a new study, researchers at the University of Exeter have shone new light on some of the medical instruments used by Roman surgeons more than 2,000 years ago in Britain. Employing state-of-the-art archaeological techniques and a CT scanner, they examined six implements, including a bronze scalpel handle, two surgical probes, a spoon, and two needles.

Tools of the trade

These tools, held by the Devon and Exeter Medical Heritage Trust (DEMHT), were originally unearthed 125 years ago at a site in the Walbrook River, London. The CT scanner, in particular, proved instrumental for the research, allowing the scientists to see beneath the corroded surfaces for all those years the tools were buried in dirt.

“New technologies allow us to investigate ancient objects in novel and exciting ways, revealing so much more about their design and manufacture, their capabilities and use,” said Professor Rebecca Flemming from the University of Exeter.

“In this case, you can see the attention devoted to crafting the socket where the iron scalpel blade was originally inserted into the bronze handle. The tiny scrolls are both beautiful and functional, making it easier to replace worn blades over the lifetime of the instrument. It is only the bronze that now survives, alongside Greek and Roman medical texts referring to these implements and describing the kinds of surgical interventions in which they were involved.”

Roman surgeons used these tools for various medical procedures. The scalpel was essential for operations and bloodletting. Probes enabled the doctors to examine the site of surgery before the operation, such as examining wounds and clearing earwax. The spoon likely mixed medicaments, while the needles could have been used to sew bandages.

However, a Roman surgeon’s toolkit was much more extensive. In 2023, archaeologists in Hungary found two wooden chests in a necropolis near Jászberény, some 35 miles from Budapest. The chests contained forceps, for pulling teeth and a curet, for mixing, measuring and applying medicaments. They also contained three copper-alloy scalpels fitted with detachable steel blades and inlaid with silver in a Roman style.

Advanced Roman surgery

Surgeries included many performed in the body’s orifices to treat polyps, inflamed tonsils, hemorrhoids, and fistulas. Besides trepanning, the more radical surgeries included mastectomy, amputation, hernia reduction, and cataract couching. Contrary to myth, cesarean sections did not enter medicine until long after Julius Caesar’s birth in 100 B.C.

The Romans did, however, practice embryotomy. In this surgery, a blade was used to cut the limbs from an infant while it was stuck in the birth canal. A hook was then used to withdraw the limbs, torso, and head from the birth canal. Although gruesome, the procedure could save the mother’s life.

The Romans may not have fully grasped the importance of sterilizing their surgical instruments. Still, they employed several techniques to eliminate germs that were only formally recognized much later. For example, they boiled their tools before use and ensured they were boiled again before using them on another patient.

Additionally, wounds were commonly cleansed with acetum, a highly effective antiseptic. In fact, it proved even more effective than the carbolic acid utilized by Joseph Lister over 1,500 years later. That’s remarkably effective considering the Romans were not aware that microbes existed — they just empirically knew that these procedures enhanced survivability and just rolled with it.

The new findings add to a body of knowledge, offering a clearer understanding of ancient medical practices and the sophisticated craftsmanship of Roman medical tools.