. Medical and surgical therapy . withwhich it is possible to make ahole in the skull half an inchin diameter without taking anyspecial precautions. UnfortunatelyDoyens perforator and brace andbit require to be ])erfectly sharpbefore use. T believe that myhand-perforator is but little known,and that there are only a fewspecimens in existence, so onehas often to be satisfied withthe old circular trephme suppliedby the medical service. This is a 27. .M artelslia 11(1 • perforator,with which it is to drill a holein the skull halfan inch in diameterwithout taking anyprecaution. TRU
. Medical and surgical therapy . withwhich it is possible to make ahole in the skull half an inchin diameter without taking anyspecial precautions. UnfortunatelyDoyens perforator and brace andbit require to be ])erfectly sharpbefore use. T believe that myhand-perforator is but little known,and that there are only a fewspecimens in existence, so onehas often to be satisfied withthe old circular trephme suppliedby the medical service. This is a 27. .M artelslia 11(1 • perforator,with which it is to drill a holein the skull halfan inch in diameterwithout taking anyprecaution. TRUE CHANIPJCTOMV HOI strong instrument which will always cut, even whenit is badly kept. Oiglis saw. Protection of the dura mater.—Marionsguide is used to pass Giglis saw from one trephinehole to the other. This instrument consists of aband of malleable metal with a groove in it (fig. 23),and is supposed to be used as follows : It ispushed through one of the trephine holes and madeto emerge from the other; then the saw is slid. Fig. 28.—The protector has been pushed from one trephine hole tothe other, and Giglis saw is in course of introduction between theprotector and the bone. along the groove between it and the bone, and thebridge of bone is sawn through after withdrawingthe guide (fig. 28). These are the instructions foruse which Marion gives in his excellent the guide may also serve as a protector, for whichpurpose it is left in place during the sawing. How-ever, whether the guide serves as a protector or not,its passage from one trephine liole to the other isoften very difficult. In fact, althouoh it may bemalleable it is rigid, and when an attempt is madeto push it from one trephine hole to the other, it willbe all right if the skull is not very thick and is onlyslightly convex, otherwise it raises a projection on 802 WOUNDS OF THE SKULL the dura mater, pushes up against it, and can onlyproceed by ploughing a furrow in the brain (fig. 29).Where there are
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgery, bookyear1918
