A major step in human evolution was taken when the hunter-gatherers captured and bred the animals that had been their prey. They became livestock farmers and had to learn how to herd, handle and care for animals; domestication commenced. This required equipment ad surgical instruments that enabled restraint when it was necessary to handle, treat wounds or attempt surgery on their livestock.
The dawn of veterinary surgery
One of the main objectives of domestication is obtaining control of breeding to ensure a supply of new stock and to select for desirable characteristics. The farmers recognised sex difference and its use in livestock management. Sterilisation of males was found to be desirable to control behaviour and encourage fattening; from this, castration, the first veterinary surgical procedure, evolved. Sterilisation was used on males in all domesticated livestock species, and on female cattle and pigs.
Surgery began with the treatment of wounds and abscesses, invariably with the same methods used on humans. Animal-specific handling equipment developed but only became of real value once metals had been discovered. There is little information on these until descriptions begin to appear in the early Greek and Roman literature. Apart from castration, surgery was limited as there was little knowledge of anatomy. Fracture repair was the exception, with the early development of splinting methods used, in some cases, on animals.
Apart from castration, surgery was limited as there was little knowledge of anatomy. Fracture repair was the exception, with the early development of splinting methods
Basic surgical instruments were well developed in Roman times: excavations have revealed scalpels, hooks, sounds, probes, tongs, extraction forceps, lithotomes, trephines and the Dioclean cyanthiscus spoon – a V-shaped instrument that could be inserted into a wound and opened to extract arrowheads – that was invented by Diocles of Carystus in the fourth century BC. This was an invaluable and safe way to extract arrowheads and foreign bodies from humans and animals. Innovation produced instruments, mostly made of copper and some brass, while forged iron was used for cutting and cautery instruments.
Surgical instruments in early equine veterinary practice
Equine veterinary practice was recognised in Greek and Roman societies, but in the Greek world, the specialists were termed Hippiatroi.
Several of their gravestones show knives and gelding irons. Aristotle in his treatise (circa 350 BC) mentions the castration of cattle and ovariotomy of pigs, camels and cockerels. Other literature indicates that castration, bleeding, cauterisation and trepanation (a circular opening in the skull) were all recognised veterinary procedures.
The Scythians in central Asia and eastern Europe were competent horsemen and possibly the first to castrate horses around 450 BC.
The evolution of surgical tools for castration
The most important animal was the horse, and the most important surgical procedure was castration as a means of controlling equine behaviour. The Romans had a surgical rule, cito, tuto et jacunde (quickly, safely, agreeably), and animals always had to be well secured.
The castration operation appears to have evolved from bistournage, a manual manipulation of the testicle and spermatic cord until the artery becomes thrombosed and atrophies (mainly used in France). This was followed by crushing the testicle and cord with a hammer and applying clamps, but this procedure was seen as cruel. Next was a procedure called mortelage, which involved crushing the spermatic cord with a heated gelding iron, which severed the scrotum and also cauterised the wound. Then wooden clamps became widely used, sometimes left on to cause atrophy but more commonly with the clamp placed to crush the total upper scrotum and a cut below.
By the middle 1800s, instrument technology had advanced, and the veterinary surgeon could choose between the ecraseur with toothed wire, several types of emasculator or wooden clamps left on for 24 hours. Specially designed claw forceps were in use, as was the thermo-cautery, an “improved” gelding iron. This operation was a central feature of equine practice up until the early 1900s. Every veterinary surgeon had a set of hobbles to cast the horse or would use the standing position – for the latter, surgeons had to be fast and efficient.
The open cut was used on pigs and initially on calves and lambs until the Burdizzo emasculator was introduced (now banned in many countries). When placed correctly at the top of the scrotum, the Burdizzo will crush the blood vessels and spermatic cords, resulting in atrophy; however, poor placing often leads to a high failure rate. It is mostly used on calves and lambs.
The march of progress
Technology progressed slowly with the end of the Roman Empire until the 15th and 16th centuries when there were significant advances in the care of horses and other livestock.
Martin Bohme (1550–1636) designed and produced a range of 30 surgical instruments, working in Augsburg, Bavaria, which was then a centre for metalwork. An obvious necessity was a restraint method to immobilise the animal while the procedure was undertaken, as there was no anaesthesia.
Technology progressed slowly with the end of the Roman Empire until the 15th and 16th centuries when there were significant advances in the care of horses and other livestock
Methods of restraint
The equine mouth cramp or twitch was developed to use on the lip and, sometimes, the tongue. To operate on horses a variety of hobbles were invented for use on the lower legs; the hobbles were pulled together to cast the animal, preferably on to a bed of straw or hay. Many had a quick release method.
For cattle, a bulldog clamp with rope was fitted on the cow’s nose, and to restrain bulls, a nose punch was used to clip out a disc of nasal cartilage and fix a hinged copper ring, tightened with a screw. With a bull pole attached, good control was achieved. For more aggressive bulls, a metal or leather bull-blind was fastened across the forehead, but this was difficult to use. Pigs were difficult to restrain except by a rope noose around the upper jaw.
To prevent animals from nibbling or licking wounds or operation sites, a wooden neck cradle was devised for horses, and for sheep, a metal wire collar. The Elizabethan collar was introduced for cats and dogs, first made from leather with holes for fastening laces, and for dog muzzling, a bandage or cloth was looped over the nose with a simple clove hitch.
More effective livestock mouth gags were developed in wood and then metal to keep jaws apart for delivering liquid drenches. The probang, a flexible tube instrument to clear oesophageal obstructions, was developed, together with a metal gag with a central cross bar with a ring for the probang. In the late 19th century, various end pieces were developed to either thrust the obstruction into the rumen or grasp and remove orally; leather straps were fastened around the horns to hold the probang gag in place.
Bloodletting and more
From very early days it was known that rapid relief from bloat (hoven, tympanites) in cattle and sheep could be obtained by plunging a knife into the rumen and releasing the gases. This was replaced by the trochar and cannula: the spike-ended trochar was inserted and then removed, leaving the cannula in place to allow effective dispersal of the gases.
An ancient practice in animal surgery was making a hole in the skull to remove hydatids from the brain or necrosed bone from the sinuses. The trephine (or trepan) was developed to cut a circular piece of cranium bone with accuracy.
An ancient practice in animal surgery was making a hole in the skull to remove hydatids from the brain or necrosed bone from the sinuses
Well recognised in Greek and Roman veterinary texts, the bleeding of animals to balance the four “humours” (blood, phlegm, black bile, yellow bile) was believed to cure almost every disease. Initially, lancets were used to pierce the vein but were replaced by fleams and a bloodstick. The fleam resembled a pocketknife with two or three blades, each with a sharpened, triangular razor end on one side only. The vein, usually the jugular, was raised by a finger or a loop of cord or cloth around the neck. The fleam was placed on the raised vein and struck with a bloodstick of solid, often weighted, wood. Blood was collected and the wound closed with a pin and horsehair tie. Bleeding was, in general, used as a treatment up to the late 18th century before losing favour as knowledge expanded.
Tail docking
Tail docking in horses and sheep (now banned) became widespread. The tools were either a hand-operated guillotine, similar to shears, or a heated cauterising tail-docking iron, which was hit with a weighted hammer. For sheep, heated irons were used with block and pressure on the iron to sever and cauterise. At this time much use was made of cauterising irons, and the “firing” of horses was commonly used to treat inflammatory lesions.
The farrier at this time (18th century) had become the major provider of veterinary services and had developed a range of tools, such as hoof picks, searchers and paring knives, for shoeing and hoof disorder treatments.
The development of surgical instruments for pregnancy, dentistry and beyond
Many instruments and devices began to appear, with either a novel idea or an improvement on previous models, such as Clyster pumps for easy enema administration (mainly for horses); a “parturition instrument”, which had a series of attachments to be used with a master crutch to enable extraction of a foetus; an innovative flexible tracheotomy tube and trochar; and specific dental instruments.
By the 1800s, a variety of devices or instruments were introduced. Horse riders usually carried a hoof pick, which began as a curved short iron rod with a wooden handle to become a hinged tool with a pick on one end and a small hammer on the other to knock loose shoe nails.
Shepherds carried a short saw to trim curved horns to prevent growth into the eyes or skull. They also always carried a salve box, either strapped to the waist or an arm, to provide easy treatment to any wounds or sheep scab lesions – the salve was a complex homemade mix.
Shepherds carried a short saw to trim curved horns to prevent growth into the eyes or skull. They also always carried a salve box […] to provide easy treatment to any wounds or sheep scab lesions
For hunting dogs, a brutal “instrument” was used to trim the ear flaps to reduce the likelihood of damage by thorny undergrowth during the chase. This was achieved by a “rounding iron” with a semicircular blade; with the restrained dog’s ear on a block, the iron on the ear was given a sharp blow. This cruel procedure was also used for fighting dogs, while fighting cocks had their wattles and combs dubbed with scissors.
Cattle owners in known black quarter areas used a seton needle to insert a blistering tape in the dewlap as a preventive measure. Within living memory, this was replaced by a loop of wire in the dewlap. In fact, this procedure appears to have been a reasonable but unreliable preventive “vaccination” against the clostridial bacterial cause of black quarter.
The advent of anaesthesia in veterinary practice
By the end of the 1800s the first anaesthetics had been introduced. From then, surgery rapidly advanced and suddenly the variety of instruments increased dramatically. Many of the basic instruments – scalpels, syringes, forceps and needles – were those used in human surgery, but the veterinary range grew enormously.
The Arnold and Sons 1893 veterinary instrument catalogue is a hardback book of 216 pages with an entry listing of 896 instruments and equipment (of varying sizes)! In the instrument listings, many are prefaced by the innovator or designer’s name. One name had 17 different instruments – T W Gowing, MRCVS. He was in practice in Camden Town. Innovation in veterinary surgical instruments had created the basis for modern surgery.
