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THE NEW YORK JOURNAL OF MEDICINE. VOL. VIII........THIRD SERIES
NEW YORK: BAILLIÉRE BROTHERS, 440 BROADWAY. LONDON:-H. BAILLIÉRE 219 REGENT STREET. PAIRS:-J. B. BAILLIÉRE ET EILS, RUE HAUTEFEUILLE. MADRID:-c. BAILLY-BAILLIÉRE, CALLE DE PRINCIPE 1860.
426 Medical Retrospect. [May,
curved bistoury, guarded as before; each time the bleeding was very trifling. In a few minutes he was relieved, and swallowed some milk. Applied eight leeches over the seat of pain, and directed to encourage the hemorrhage with warm poultices. ~Evening~. Improving; the pain was very much relieved by the leeches, which bled freely. Upon examination, the swelling is found to be subsiding. R. Pulv. Doveri grs x.
Jan. 10th- Has slept none, but as had an easy night; has not been to bed but sat in his chair as he has done since the commencement of his attack. has only swallowed a few mouthfuls of water and thin arrow-root, but has had no difficulty in breathing, and no further sense of obstruction about the larynx. The edema has almost disappeared, but the the epiglottis has still somewhat curled on itself. Complains of some pain now on the right side of larynx; to apply a tobacco cataplasm. Patient convalesced slowly, but required no further treatment.
Cold Spring, April 10th, 1860.
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III.-- ~A new Trephine; being adapted to the free and rapid penetration of the Cranium, without danger of wounding the Membranes~. With an Illustration. By G. A. D. Galt, M.D., of Virginia.
The object of the trephine is to divide the cranial walls without danger of wounding the membranes or brain substance. The advantage which it possesses over the instrument now in use, will be apparent on examination of both. It consists of a truncate.
[illustration]
cone, with spiral peripheral teeth, and oblique crown teeth; when applied, the peripheral teeth act as cutting wedges so long as counteracting pressure exists on the crown teeth, upon removal, however, of that pressure, by the division of the cranial walls, its tendency is to act on the principle of a screw, but owing to its conical form, and the spiral direction of its peripheral teeth, its action ceases. When I first devised this instrument, it was my impression that the cone was an original idea of my own, but on examination of the Atlas of Blassins, I learned I learned that an instrument had been in use, of a conical shape, with longitudinal peripheral teeth. I found after experimenting with it, that the instrument possessed very little advantage over the old trephine now in use,
[next page] 1860] Operating Cases 427
inasmuch as it continues to cut after dividing the cranial walls, and consequently must wound the membranes and brain substance. I have operated on the dead subject twenty times, and have never succeeded in a single instance in wounding the membranes, though I endeavored to do so by applying additional force after having divided the cranial walls.
In the construction of the instrument it is important to preserve the precise relative shape of the cone given in the illustration, the ~number, and course of the peripheral teeth being the same~, whether the instrument be larger or smaller than that here represented. In attempting to realize my original idea, I was repeatedly foiled by my failure to obtain a proper shape of the cone, and direction of the peripheral teeth. Upon this condition alone will the complete success of the instrument depend. For the information of those who wish to obtain this trephine, I would add that Mr. Tieman, of New York, manufactures those with which I have experimented, and can now furnish them according to the model here given.
[This instrument was submitted to the members of the ~Surgical Section~ of the ~Academy of Medicine~,at a recent meeting, and on repeated trials, was found to fully answer the design of its inventor. In no instance were the coverings of the brain injured, and for this reason- the instant the crown teeth cut through the internal table, all action ceased, and the operator found it impossible to turn the crown. It was highly commended by the the surgeons present, and will, we believe, prove a valuable and most important invention. -Ed. N. Y. Jour. Med.]
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~A new and complete Case of Surgical Instruments~.-The practitioner of surgery not unfrequently has need of an operating case which, in a compact form, embraces the instruments necessary for any and all operations. To the country practitioner especially would a case of instruments thus selected be a valuable acquisition. Such an operating case has recently been prepared by W. F. Ford, 85 Fulton Street, New York, under the direction of Dr. James R. Wood, combining a single case of moderate dimensions, instruments, and apparatus adapted to every emergency which the surgeon can be placed.
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~American medical Association~.-The Thirteenth Annual Meeting of the American Medical Association will be held in New Haven, commencing on the first Tuesday of June next.
~The Quarantine and Sanitary Convention~.-Tho Fourth Annual Meeting of this Convention will be held in Boston on the 14th of June next.
(~italics)
