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ABSTRACT: Bladder stones, one of the scourges of the past, have been recorded as far back as 6,500 BC. Lithotomy was famously proscribed in the Hippocratic Oath, but it was certainly being undertaken in Hellenistic Alexandria by the 3rd century BC. However, the earliest surviving description of the operation is that of Celsus in the early 1st century AD, while identifiable instrumentation currently dates between the 2nd and early 5th century AD. Finds from Rimini, Marcianopolis, Ephesus and Cyrene illustrate how widespread the operation was at the time of the Roman Empire, but the majority of lithotomy instruments, of which those in the Museo Nazionale Romano are an important part, have been discovered in Rome itself doubtless a reflection of the size of the city's medical 'market'.Medicina nei secoli 01/2010; 22(1-3):393-418.