The frequency with which operations are now done upon the skull and brain has made apparent the need of improvement in our instruments for opening the skull. Seven years ago I published' an account of my experiments with the surgical engine, as a means of making openings in the skull; and I still believe it an excellent and safe means of effecting entrance to the cranial contents. The chief disadvantages are the expense of the engine and its liability in ordinary hands to get out of order. This latter objection held good at least in one hospital with which I have been associated.
The ordinary trephine, either cylindrical or conical, will probably be used much more frequently, therefore, than the surgical engine; hence, suggestions to improve its character are not inadmissible. The "segment trephine," described in the Operative Surgery of the Human Brain, is, I think, a valuable instrument with
ROBERTS JB. THE SEGMENT TREPHINE AND ANASEPTIC TREPHINE. Read before the Philadelphia County Medical Society, Feb. 27, 1889. JAMA. 1889;XII(12):407–409. doi:10.1001/jama.1889.02400890011001c
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