18 's. HOLTH. M.-N. KI. 
From fig. 5 will be seen the great resemblance between our number 
23 and the lowest picture in fig. 4 from the Arabian MS. in Oxford. This 
fact makes me agree with Mr. Hirschberg that the sawtoothed outlines of 
the latter are only an unsuccesful drawing of the decoration of the hand'e. 
The same is the case with the reproduction of the stem of the instruments 
in the two lower pictures in fig. 4 as a thin line; even made of steel they 
would have been too slender. Made of bronze the stem ought like ours, 
be 2 mm. The ancient authors say expressely that the cataract couching 
needle (always bronze) must be strong; for this reason the puncture with 
the cataract needle itself through the membranes of the eye was often 
difficult, and therefore performed by the Arabs with a scalpel point as the 
Mohammedan cataract couchers still do in India today (R. H Elliot). 
3) One end of the handle is provided with a knob of 2 mm diameter, 
and seems likely to be made for a preparatorv act in the depression such 
as it is described by Antyllos, by Paullos Aiginetes and by many Arabian 
surgeons. Local anæsthetics were not known, the operation was painful, 
the eye made an escaping movement upwards by which the surgeon might 
risk making a wrong puncture. In order to prevent this accident, both 
Greek and Arabian authors advised the operator first fo make with the 
knob of the handle a dent in the surface of the eye where the puncture 
was to be made; then turn the instrument and make the puncture exactly 
in the dent. According to Hirschberg, Salah Ad-Din advised first to dip 
the knob into an antimonial paint by which the dent became a black spot. 
According to Mr. Sudhoff similar end knobs as those seen in fig. 4 
and fig. 5 may be found as decorations on pictures of Arabic tooth instru- 
ments in the Latin incunabel editions; but none of those drawn in his 
work, have »sawtoothed« outlines and in the only one which could be 
considered (Sudhoff fig. 32) only the handle is of bronze in which a steel 
instrument is placed. Our instrument, like all ancient cataract couching 
needles, is wholly of bronze. 
Arabic surgical instruments do not seem to exist in European museums. 
At any rate no special journal of the history of medicine contains any- 
thing about this; and illustrated accounts of medical history contain only 
diagrams from the above mentioned Mediæval manuscripts. It is possible 
that the very durable old bronze instruments are handed down to the next 
generations and are used to this very day. At any rate medical textbooks 
from the middle ages (in printed copies) are still in use by such Arabian 
physicians as have not acquired modern medical education from the French 
in Algiers and Beirut and from the English in Cairo. Of the Arabian 
instruments in PI. III, I believe r1 and 23 to be the rarest. 
