Medical instruments  Book III, Chapter 11, Section 1b
 



Levitor
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XX. He beareth in chief a Levitor with an Handle and in base a Volsella, or Puller. These are two Chirurgicall Instruments and of great use.
The Levitor, it is used to take up depressed Skulls, or to raise the Skull impressed. Imitateing Coopers, who are wont to reduce the boards of their wine vessels that are crushed in, with the like Instrument: it is called in Latine Elevator, or Elevatorium.


Tweezers
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The Volsella, or Puller, or Tweezers, it is an Instrument for manuall operation; it hath double teeth at the end of it, by which they take forth a peece of a bone which is corrupt and moueable; also Darts, Bullets, and the fragments of them: and all tents and hairs, with all other extraneous things of that kind, which are found in wounds: are by the toothed part of this Instrument taken forth. By this also women pull out hairs by the roots in their eye-brows, and from other parts of the body, if superfluous. The broader end of this will serve to spread Plasters on linnen cloth, or leather, for want of a Spatula. see numb 28 & chap 12 numb 10. It is also written Vulsella, which is the Chyrurgions Little Tongs, and are made of different shapes according to the diversity of their uses.


Dismembering knife
 XXI. He beareth a Dismembering Knife. and an Incision Knife, the Points Counterposed. The Dismembering Knife, is a crooked Blade, especially towards the point; it is to cut the flesh so far as the bone when a part is to be Sawed off: and is necessary before the amputation or the Leg or Arm. Some Chyrurgions have the blade of this kind of Knife almost of a Semicircle form, or Sickle like.


Incision knife
 The Incision Knife, the Latin name it scalpellum, it is a small Pen knife with a bending point, and some are streight pointed, slender, and narrow bladed, from whence they are termed Woodcocks bill knives With these Incision knives wounds are opened, and such as are two narrow are dilated. and also great Impostumations are cut, and Lanced.


Myrtle leaf pointed knife
 The third sort of knife is termed the Myrtle Leafe pointed knife, these are double knives, sharp on both sides, which at the end resemble the fashion of a Mirtle leafe, it is used to cut off Wens, and Womens breasts as are Cancerated.

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Dismembering chisel
 XXII. In this quarter are two other Instruments that belong to a Chyrurgion, The first is the Dismembering Chizell, which is used to cut off Toes and Fingers, and also the tops of the Arm, and of the Radius.


Probe
 The second is the Probe, the Latine from its office term it Uulnerum Exploratorium, which is a long slender Instrument round, with a kind of knob, or button at one end; an eye like to a Needle at the other. Yet in stid of an eye, some have a round flat end (a little turning) after the manner of a Spatula. Some make them bending at both ends, others have them streight all along. It is for that end generally made of Silver, that it may be bended upon necessary occasions; the round end is used to search out the state of wounds, and Fistula's; and also with Lint rowled about the end, to cleanse wounds from matter and corruption drawn out by Plasters. The broad end is called, the Probe towards you, and is used to apply powder, and plagets annointed with ointments, to wounds. see chap.12 numb. 12.


Dismembering saw
 XXIII. He beareth a Dismembering Saw. This is in forme and fashion like the Ioyners Tenant Saw, onely this hath the handle and the back all made of Iron worke: with this bones are Sawed asunder, when either a Legg, or Arme is to be taken off. By the benefite of a Screw, the Saw plate is made either strait, or more loose, in the iron frame.


Barber's chafer
 In the dexter chief is the Barbers Chaffer, (or as in our refined speech some call it a Chaffern, and a Caldafer, from the latine Calda ferens) wherein is carried hot water, for the triming and shaveing of such as desire to go according to the mode.


Forceps
 XXIV. He beareth a Chyrurgions Forceps. This is an Instrument like to Cizers, save the cuting part is flat, and fall one to an other, the backs being round; or to say more properly a paire of Pincers, which are used by the Thumb, and Fore or midle Finger, to take off a plaster; or used for severall other operations. They are of severall shaps and sizes as long, crooked, with teeth, with beaks, in fashion of an half moon, which according to their different shaps have different names.


Spatula
 XXV. In this Square you are presented with two sorts of Spatulas. The first hath only the simple name of a Spatula, whose use is to mix and temper Salves of several sorts upon the ball of the hand, to prepare the same for Tents to put in deep, and Lints (which are termed Plagets) to lay upon ebb wounds. As also to spread plasters either on cloth or leather. Some term them a Spatula, or Splatter. see numb.46.


Spatula linguae
 The Second is the Spatula Linguae, or a Tongue Spatula; it is principally used to hold down the tongue, when the mouth is to be looked into, in case of sores, or other distempers ariseing from inward causes. See an other kind of them in numb.44.


Speculum oris
 XXVI. He beareth a Speculum Oris in fesse between a Great or Strong Levitor, and a Uvular Spoon. but of them in perticulare.
The Speculum Oris, is an Instrument for the opening of the mouth when the teeth are so strongly set together, that noe ordinary meanes will open them. See cha. 10 numb.11. For distinction sake this may be termed the Pincer-like speculum Oris. There is an other kind of them in the next Square numb.27.


Great levitor
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The Great or Strong Levitor, It is an Instrument by which depressed Skulls are raised: and it doth its office with more force then that described numb.33. & chap 12 numb.3. because it hath not onely the firmness of it in the hand of him that raiseth it, but also in the head of the patient.


Uvula spoon
 The Uvula Spoon, is an Instrument made of Latine or Silver, and is applyed to the uvula that is fallen; being a small Spoon, whose handle is hollow, and about 8 or 9 inches long, and is joyned to the lower part of the Spoon; this Spoon being filled with pouders that are drying and digesting, and put under the uvular relaxed, the Surgion takes the lower end of the Pipe in his mouth, and by blowing, scatters the pouder all about upon the Uvula, and the Palate.


Spatulum oris
 XXVII. He beareth a Spatulum Oris with a Screw. This is another kind of Instrument to open the mouth wide with a Screw, when the Teeth are fastned and joined forcibly together, yet by the help hereof they are drawn asunder, that Meat or other Remedies may be applyed to Sick persons that they perish not. This is an Instrument highly commended by Amb. Parey, and others, for that use.


Syringe
 XXVIII. He beareth in this quarter two necessary Instruments used by Doctors and Chirurgions. The first is termed a Syringe, or Clyster Syringe; a Mouth or Ear Syringe; so called, because used chiefly about those parts: It is made of Pewter or Silver, and serveth to draw out any Liquid matter, or to squirt in any thing to the Organs of Hearing, or to the Larinx in the Throat, to cleanse and heal Swellings and Ulcers in those parts:


Twitcher
 The second Instrument is called a Twitcher, or Twitchers; by them Hair superfluously growing in any part is pulled up by the Roots, especially on the Eye-Brows, Eye-Lids, and the Nose; the other end serveth for a small Spatula; see numb.20.

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Draughts
 XXIX. These instruments are called Draughts, or Pincers for the Teeth; with them are drawn all sorts of Teeth, whether Dog, or Gum Teeth; but more particularly. The first is termed Draughts for the Teeth, or Teeth Pincers, which hold a Tooth fast between them, and by a sudden Wrench or Twitch, takes the Root and all together away with it. Some term this the Pacis or Forser, or Odontagra.


Forcer
 The next as lyeth under it, is termed a Forcer, or a Toothed Pincer, whose use is to pull out Teeth, which neither the Pellican or Common Draughts can draw forth. See another chap.9. numb.179.


Tooth Levitor
 The third is termed a Tooth Levitor; some have them with three Teeth, but most use them of two Teeth; with the help of this Instrument, the roots and pieces of Rotten Teeth are prised out of the Gums Some give these kinds of Instruments the name of Punchers or Forcers; see chap.12. numb.23.


Fleams
 XXX. Here are two sorts of Flegmes, which some term Fleams, or Tooth Rippers and Tooth-Pickers; with these the Gums are separated from the Teeth, that they may be pulled out with less danger and trouble. They are made after several fashions, and called by the Learned Phlebotomus, or Phelotomus, which is also a Blood Letter.


Dismembering pincers
 XXXI. In this Square is a Pair of Dismembering pincers, between two Flegmes. For the first, which is the Dismembering Nippers, as some term them, are things like Pincers with sharp edges at the closeing place; they are used for Amputation chiefly, and are appointed to the cutting off of the Fingers and Toes, as greater Instruments are used for the dismembering of the Armes and Leggs.


Fleams
  Image from published plate
In the chief and base, is set down two other forms of Flegmes for the riping of the Gums. the first haveing a flat edge at the contrary end, to cleanse the teeth from Scales. And the other hath a sharp point to pick the Teeth. Some draw the Flegmes with a plaine shank with out any work upon it; and so do the French & Germans.
And as these Flegmes are the vulgar, or common way of makein them; yet some have a sharp pointed hooke at one end, and flat at the other, for the scrapeing and cleansing of teeth from scales, and other hard substances which useth to fix themselves to the teeth. And others make the Phlegmes crooked at both ends. others one end crooked, and hook like; and the other flat, yet ending in a sharp point, after the form of a leafe: and are termed Gravers, or Flegmes with Gravers, which are for the same use as the flat end Flegmes. The crooked end being made sharp doth serve not only for tooth drawing, but also to Launch and cut the Gums, to let them blood, or to cut oftentymes the superfluous flesh away, which over groweth the teeth. From whence many call the Launcets, or Teeth Lancets.

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Ear picker
 XXXII. He beareth an Eare picker, or an Ear pick. The use of this Instrument is to cleanse eares from waxe, which often causeth a Deafness in the party: the other end is used to cleanse the teeth. see numb.46.


Terebellum
 XXXIII. He beareth a Terebellum, betw: a Scraping spatula, and a Lavitor. But of these severally. The Terebellum, or Terebellum with a Screw, is an hollow pipe, with a square shouldering and two handles like to the Forceps, through which Pipe goeth a long Piercer, with a most sharp Worm, or Screw at the end, which being conveyed into a wound made by a Gun-shot by the help of the Pipe in which it is hidden, when the Bullet is felt in the Wounds, then the Piercer is Screwed out of the Pipe into the Bullet, by which meanes it is drawn out, and the wound healed.


Scraping spatula
 The Scraping Spatula, so termed because the one end is made with a Scraping hook to cleanse wounds, and take of Splenters from Bones: and the other end haveing the forme of a Spatula, it is used for the spreading of Plasters, and takeing out of Unguents, to mix and temper them, and to put them on Lint. a Cyclisci, see numb.31.


Levator
 The Levator, or Levatorie, some write it Leviter, it is an Instrument by which a depressed or brused Scull is elevated or raised up. There are several forms of this Instrument, as numb.26 29 & cha. 12. num. 3 23. The lesser sorts are termed Levers.


Trepan
 XXXIV. There are two sorts of Trepans, or Head Saws, the one is the Male Trepan, the other the Female, now all the difference in them, is that one hath a Pin in the middle, the other hath not. They are fixed either in a Brace made of Iron fit for its use; or else in an Handle, or thing to turn it by after the maner of an Auger, or Carpenters Oger. So that this Trepan being thus furnished for use, is termed a Trepan fitted in its Brace: whose operation is to cut away a part of the Skull that is broken or brused down into the head, but it is seldome used, and the less the better, seeing other Instruments will perform it work with less danger, when there are fractures in the Cranium.


Lancet
 The Instrument under the Trepan is called a Lancet, it is a sharp pointed and slender blade made of Razor mettle, and sharp in both edges; fixt in a Tortoice case, or such like, to preserve it point, and keep it cleane. It use is to make an Orifice in a Vein for blood letting: as also to cut the Vessels, and open Impostumations in the Skin, and other incisions more in the flesh as need requireth. It is in latin Lanceta, and Scalprum Chyrurgicum.

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Male trepan and lentell
  XXXV. This is the other form of the Male trepan set in its Handle, or hold to turn it by. Of its use I have said some thing before, it being only to take up broken and brused Skulls, see chap.12 numb.4 5. Mr Woodall in his Surgeons Mate, called this a Trefine, a tribus finibus, from its three ends, the one performing the office of the Trepan, the Handle being at one end toothed serves for the Levitor; and the other smooth, for a Smooth Levitor. see cha.12 num.7.
The Instrument called a Lentell, or a Lenticular, in English a Cleanser, or Smoother: this is an other kinde of Trepan which is put into the Handle aforesaid when it is to be used; in which there is a square hole so made in it, by means whereof the end of the Trepan being wrapt about with Cotton, is easily put in, and taken out, as need requireth the chang of these round Saws. It is used to cleanse away all small shivers and rasping of bones, proceeding from the operation of excision; as also for the removeing of what wilbe offensive to the Dura Mater, or hinder the healing of the wound, as those very small erosions, Scrapings, dust, or Spills of bones are very apt to do.
[The second image (not on the plate) is drawn at the end of the chapter 9 medical images; it is clearly the trepan handle]


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