. On the theory and practice of midwifery . CRANIOTOMY. double, as .well as a pair of forceps for breaking up the skull. These are?well exhibited in the fourth edition of his work. These are a few of the principal instruments which have been employedin the operation of craniotomy. I have not given a detailed description,because most of them are discarded ; the instruments in general use beinga pair of scissors with shoulder-stops, as recommended by Smellie, buthaving a sharp edge on the outside (fig. 108), and a modification of Mes-nards simple crotchet (fig. 109). I have found it an advantage
. On the theory and practice of midwifery . CRANIOTOMY. double, as .well as a pair of forceps for breaking up the skull. These are?well exhibited in the fourth edition of his work. These are a few of the principal instruments which have been employedin the operation of craniotomy. I have not given a detailed description,because most of them are discarded ; the instruments in general use beinga pair of scissors with shoulder-stops, as recommended by Smellie, buthaving a sharp edge on the outside (fig. 108), and a modification of Mes-nards simple crotchet (fig. 109). I have found it an advantage to shortenthe points of the scissors above the stops, and also the hook of the crotchet;the latter of which should be slightly cleft. Mr. Holmes has modified thelatter, so that by closing the handles we open the blades (fig. 110). Fur-ther, I have added plates of a knife for cutting ofT the head or limbs ifnecessary (fig. Ill), a blunt hook (fig. 112), and Dr. Daviss bone forcepsfor breaking up the skull (fig. 113). Fig. 110. Fig. From tne inconveniences sometimes experienced with the crotchet, andto avoid the risk of injuring the mother, craniotomy forceps have beenemployed by different individuals. Among the moderns, M. Mesnard has the credit of first inventing andusing this instrument, and since his time it has undergone various modifi-cations. CRANIOTOMY. 345 Dr. Haighton used a pair resembling the lithotomy forceps ; and sincehis time Drs. Conquest and Davis, Mr. Holmes, and others, have inventedand described varieties of the instrument (fig. 114). The object of eachis the same, viz. to avoid the risk of tearing the soft parts of the mother;and the principle of seizing the skull between two blades, furnished withteeth, is also alike. Fig. 112. Fig. 113. Fig. 114. tf%
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