Craniotomy and cephalotripsy contrasted : with cases / by Alexander Milne.

  • Milne, Alexander.
Date:
1868
Catalogue details

Licence: Public Domain Mark

Credit: Craniotomy and cephalotripsy contrasted : with cases / by Alexander Milne. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    But? now, what are its merits ? Is it superior to other instru- ments, or is it not? Probably a longer probation is yet requisite before the question can be fully or fairly answered. At all events, now that it has been cleared of some of its more formidable points —made lighter in construction by Sir James Simpson, Braun, Dr Charles, Dr Kidd, Dr Kicks, and others—it is achieving unwonted success. It is now not much more bulky than a pair of long forceps. The principle of it is excellent; it has a twofold function; it both crushes and extracts; it is, so to speak, forceps and blunt- hook and crotchet in one. While you are crushing you are also seizing a bull-dog hold for the purpose of extraction—a hold of ten- fold security as compared with the craniotomy forceps, or any kind of hook under the sun. The advantage here is, that you may require only one introduction and one withdrawal, and thus liap- uly and mercifully escape the weary and painful seizing and losing mid, pulling and picking, and ceaseless twisting and tearing, until the exhaustion of the operator is nearly equal to that of the hapless and suffering patient. With it your work may be over, and done well too, in the course of a very few minutes—ten, fifteen, twenty. Moreover, its crushing power is great, and herein lies one of its most favourable features ; for it breaks down swiftly the cranial bones, including also the base, which latter is hardly reducible or assailable by the other instruments even after the expenditure of much time and skill and pains. Indeed, if you survey the crushed heads in the obstetric museums, you will find that, as a rule, the base has escaped all the assaults of the craniotomist, who, mayhap, has bestowed hours on the work of reduction. But a further advantage is that, by means of this instrument, you reduce the bones without much, if any, tearing of their cover- ings. The spicula then, if there are any, do not protrude, but are encased in the safe envelope of an almost unbroken scalp. Soft parts thus escape the chance of injury always dreaded under the other system from sharp edges of bone during the descent of the mangled head. Swiftness, in short, characterizes the cephalotribe in contradistinction to the interminable delay of the crotchet—a delay the evils of which are too well known to require repetition—and greater security and safety, directly and indirectly, so far as the mother is concerned. But in case these advantages should be deemed merely fanciful or theoretical, let us inquire a little into the practical working of the instrument. Theory and practice, it need hardly be said, do not necessarily comport; nay, they are often widely different, from unforeseen elements casting up, and coming into adverse play. But abroad, Baudelocque, Champion, Cazeaux, Scanzoni, Dubois, and others have employed it very successfully; and in this country, Simpson, Keiller, Kidd, and others, have also tested its value. The case I have detailed illustrates most strikingly the worth of