Moments in Surgical History |

On Scalpels and Bistouries

Ira M. Rutkow, MD, MPH, DrPH
Arch Surg. 2000;135(3):360. doi:10.1001/archsurg.135.3.360.
Text Size: A A A
Published online


SCALPEL, AS DEFINED IN Stedman's Medical Dictionary is: "A pointed knife with convex edge." Amongst the oldest known instruments in a surgeon's armamentarium, early representations of scalpels are found on a sculptured ex-voto stone tablet located on the site of the temple of Aesculapius at Athens' Acropolis, dating from about 300 BC. Since Greece had passed into the Iron Age, it is probable that their cutting instruments were made of steel and often double ended, containing a blade and spatula. Moving ahead several centuries, Roman scalpels were mostly bronze and, although the actual blade sometimes had double cutting edges, whenever possible, the combination of 2 instruments in 1 was also used. Thus, knives frequently had a spoon or even a raspatory at its opposite end. Known to Romans as "scalpellus," in more technologically advanced forms the metal of the blade could be found continuing down between 2 metal plates that were screwed on either side of it to form a holder. These rudimentary forms of handles in certain Roman scalpels were often finely worked and not uncommonly embellished or gilded with silver.

Figures in this Article

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption

For scalpels and bistouries, 19th-century surgical etiquette strictly dictated the manner in which they should be held. In this plate from Joseph Pancoast's (1805-1882) A Treatise on Operative Surgery (1844), the "positions of the bistoury and scissors" are demonstrated. In making a science out of "hand-positions," 19th-century surgeons varied in regard to the total number of these positions but, at least, one surgeon described 8 of them, ranging from holding the instrument as a " knife . . . writing pen . . . and like the bow of a violin."

Graphic Jump Location




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics