Finds of instruments throughout the Roman Empire indicate that the art of surgery had progressed and proliferated. If any one of the branches of medicine had achieved true competence in the Empire, surgery is the most serviceable example. Surgery was important in the training of the conscientious physician, and both Galen and Celsus emphasize it although they came from divergent medical traditions (Celsus, prooemium VII; Galen, II, 272).

Technical competence in surgery became better as new shapes were devised for medical tools, and as new metals and alloys were found to provide sharper edges and cheaper equipment. Most instruments were made of bronze, or occasionally of silver. Iron was rarely used because, as in most ancient cultures, it was considered taboo by both the Greeks and Romans, and so was never used for surgical instruments on religious grounds. The design of many medical instruments remained unchanged and the quality of manufacture was seldom bettered until recent times. The full repertoire for Roman surgical equipment is far from completely known, and newly identified tools include a special forceps for applying caustics.

Bas Relief Fragment, 4th Century CE, Athens, National Museum This fragment shows a doctor performing an operation on a patient's head while Asclepius (identifiable by his superhuman size and the caduceus in his right hand) looks on.

Occasionally instruments not originally manufactured for surgical purposes were implemented. Galen and Celsus both mention that the strigil, a curved piece of metal with a handle used for scraping oil and sweat off the body after exercise, was often used to get into small openings. Galen says, “After having heated the fat of a squirrel in a strigil, insert it into the auditory canal” (Galen, XII, 623). Surgery was refined as long as the patient had courage and the doctor had good tools and experience. The patient’s chances increased if the head and abdomen were not involved. A cursory reading of Celsus’ summary of surgical techniques as they existed in the first century shows a sure knowledge of human anatomy.

Archaeological remains of what appear to be surgeon’s shops are common enough to indicate physicians specialized in surgery. Particularly famous is the so-called House of the Surgeon at Pompeii, where most of the surgical tools now housed in Naples were found. Philological evidence seems to support the idea that there was at least some distinction, even if not a rigid one, between general practitioner and surgeon. Medieval texts distinguish the two positions with different terms: medicus for a doctor, and magister for a surgeon.

Stele from Herculaneum, 1st Century BCE Surgeon excising an arrow from a wounded soldier Both men are depicted nude, suggesting that the episode stems from a mythic tale.

The Romans enlarged upon the variety of instruments available for surgery, and Galen wrote detailed instructions on their use. The makers of medical instruments are at best shadowy figures. The well-known relief pictured below is one of the few archaeological finds which helps clarify the situation. It suggests that some medical instruments were manufactured by specialist blade makers rather than by craftsmen who specialized in medical instruments. It seems improbable that there would have been sufficient demand for craftsmen dealing exclusively in medical instruments and there is as yet no known inscription naming such a specialist. In the larger cities of the Roman empire, physicians would probably have found craftsmen who could provide the broad range of medical equipment.