Woodblock illustration of surgical instruments/ instruments of external medicine from Waike xinfa zhenyan zhinan (Guide to Tried and True Methods at the Heart of External Medicine), published in 1887 (13th year of the Guangxu reign period of the Qing dynasty). The pointed cautery iron (jian lao), square/blunt cautery iron (fang lao), annular type (quan shi), depressor type (ya shi), hoe type (chu shi), iron spill (tienian), sickle type (lian shi) and depressor type (yashi) were all instruments employed in Chinese medicine for surgical or external treatment. The pointed cautery iron had a sharp tip. After being heated until red hot, it was used to pierce and cauterize septic boils and ulcers and bring them to a head, drawing the malignities and poisons (xiedu) together. The square/blunt cautery iron was similarly used to cauterize large boils, and served to dissipate the poisons. The annular type was used to isolate lesions during cauterization, to avoid damage to the surrounding tissue. In cases where medication could not easily be applied directly to a lesion, the depressor type offered an extremely convenient means of administering external treatment. Where decayed flesh could not easily be excised from a lesion, it could be gently removed using the hoe type. If the opening of a lesion was obstructed by tissue and purulent matter, the iron spill could be used to unblock it, allowing the pus to drain spontaneously. If the opening of a lesion was constantly oozing pus, it could be clamped together with tweezers, and then cut off using the sickle type. The depressor type was used chiefly to depress the tongue to allow access to the throat for examination, surgery, or the administration of drugs, by insufflation or otherwise.
