The institutes and practice of surgery: being the outlines of a course of lectures . tion of matter; andthat these consequences might have been prevented, per-haps, by a timely operation. But a great deal of judgmentwill be required to enable the surgeon to anticipate suchconsequences. The instruments that may be required for an operationon the skull, are two or three trephines, the largest aboutan inch in diameter, the second three quarters, and thethird half an inch; all of them provided with sharp teethwidely set, and with centre pins; Heyssaw, a lenticular,raspatory, trepan forceps, two el
The institutes and practice of surgery: being the outlines of a course of lectures . tion of matter; andthat these consequences might have been prevented, per-haps, by a timely operation. But a great deal of judgmentwill be required to enable the surgeon to anticipate suchconsequences. The instruments that may be required for an operationon the skull, are two or three trephines, the largest aboutan inch in diameter, the second three quarters, and thethird half an inch; all of them provided with sharp teethwidely set, and with centre pins; Heyssaw, a lenticular,raspatory, trepan forceps, two elevators, a brush forcleaning the trephine and saw, a tooth-pick or probe, tena-cula, sponges, crooked needles, ligatures, a scalpel, fyc. The object the surgeon has in view in applying the tre-phine, is either to make an opening for the removal ofcoagulated blood, or for the introduction of the elevatorbeneath a depressed bone. In the former case a large tre-phine should be employed, in the latter a small one. Veryfrequently, however, it happens, that there is a sufficient ; v. 2. Dream M Engd by /1> Compression of the Brain. 13 > space between the edges of the fragments of bone to insinu-ate the elevator, and with it restore the depressed portionto its natural level. Under such circumstances, the tre-phine need not always be employed. It is commonly re-commended to plant the crown of the trephine partly uponthe sound, and partly upon the depressed bone. When-ever the latter is sufficiently firm to bear the pressure ofthe instrument, I prefer resting it entirely upon it, in or-der to save the sound bone. If there is a wound of the scalp along with the fracture,it may be enlarged, if necessary, or so changed in shape,as to enable the surgeon to get at the bone, and effect hispurpose in the easiest way possible. If the integumentsremain entire, I would recommend the tripod incision—made in such a manner as to leave the angles of the woundobtuse instead of acute. The flaps
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