The Salt Lake herald. [volume] (Salt Lake City [Utah]) 1870-1909, 1906-10-28

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The wonders of modern surgery are
little realized by the Iaity,. or by those
who have not closely -watched. the de-
veiopment OF ehe- science in the last
two or three decades. It was not
long ago when a fracture of the skull
was considered, necessarily, fatal, and
the most daring disciple Of EsraIapius
would hesitate. for "a long 4tneIff the
suggestion were made to him that the
skull be opened and the brain treated
locally for any disorder.
But the advances that have been
made in this science in the last few
years, in the memory of even the
younger generation Of successful sur
Seons, have MADE the operation of re
moving a portion of the skull and even
portions of, the brain tissues, compare
lively simple. In view of the recent
discoveries that crime and mental de-
ficiency can be cured by means Of sur
gical operations on the skull. the in
terest in this branch of surgery has
extended from the ranks of the pro-
fession to the laity.
Description of Operation.
The technical details of an opera ton
of this character are of interest TO
the average thinking man or woma n,
and are given herewith
The head OF the patient is first cars
fully sterTliZed by being shaved and
washed with warm wafer. A wash of
~ulphuric ether is then USED, each sue
cessive drying being done with an as
Ceptic towel, Sterilized by heat. A
corrosive sub1imate gauze is then used
TO envelop the head dressing, which is
applied in a moistened condition. and
which is allowed TO remain until The
operation is begun
Iodine Is then used to mark off the
assures of SilviuS and Rolando. in the
region where the skull is usually
opened. The anaesthetic lis then ad-
Tninistered and three holes are pune
tured in the scalp with an awl or
gouge. These punetures reach to the
bone, so that when the scalp is laid
back the surgeon will be able to see
the building line After the administra-
ton of the anaeSthetic, the scalp is
again washed, first with soft soap and
hot water. then with sulphuric ether.
later with absolute alcohol and finally
with solution of corrosive sublimate
Hemmorhage Is Prevented.
-Four long needles are passed. through
the scalp at right angles to- each othe-.
In order that the pressure will check
the flow of blood from the many small
vessels which lead TO the place where
the cut IS TO be made. Hemorrhag,4
is thus prevented and the flow of
blood is so checked that the cut will
be left practically clean when the in
ciSiOnS- are made. Gel. .r. a. , r,7s- g. -
An incisiOn of horseshoe shape is then
made and the blood vessels are seized
with forceDs by an assistant, who has
placed compress. Of sterilized gauze
on the scalp. The skull is now bare
and 1T Is sc'aped to remove particles
or tissue. All rs now ready for the in
cision TO be made I'm the bOny shell.
For this the trephine is used. This
instrument looks something similar to-
an anger. An electric motor with a
rotary saw IS now much used, the.
work being done more quickly by this
instrument than By the. old style
trephine. Great care must be exercised
oy the surgeon in order that he does
not cut through the dura mater. or
hard covering encasing the brain The
button OF bone sawed through by he
trephlne or rotary saw is then re-
moved This may he replaced. though
OF late surgeons have eonclu6ed that
nature will fill the cavity. - A silver
plate IS sometimes, used to cover the
opening. -cs ~
Brain is Revealed.
Tee curved Iistpury, or a common
scalpel is used 10 divide the .dura. The
dura is seized with a fine fenaculum
and If is draVp< from the brain surface
\ curvcd. blunt scissors is Inserted into
the small 4incision and a cut is made
one-quarter # an inch from the edge
of the opening in the skull. The DUR
is then lifted with the greatest caution
from the brain This caution is nee
essary, because there might be. and
frequently are, loose adhesions which
cannot be torn without running |
great risk Of oRephgr one of the largel
veins that run TO, the. brain. When
arteries l~e found pressing ,1yer th,s
dura, they re liSatyred Ciea) beforel
the dura is divided The brain is now
exposed.
bad Spot" Removed.
The troublesone portion. which &c
called the bad spot" in the cases of |
depravity in man or child. is now ready
for the attention OF the surgeon Sco,-t
tissues. cystj, or tumors can then no
readily removed In the event of a |
hemorrhage developing, it can easily no
checked by the use Of aseptic guaze or
a thoroughly sterllized sponge The |
sauze is much preferred If the hem |
orrhage is d serious one IL can no /
checked by electric autery, or it may
be tied with = very fine catgut.
Brain May Be Cut.
1t is comparati lively easy matter 10 1
explore the brain with the hand. by
when unusual resistance may easily |
be detected. The fluctuations Of q. deem
seated cyst or the hardness of a solid
tumor is thus easily found IL neces-
sary probe or a hypodermic needle +
may be thrust into the brain without
great danger. The brain may even be +
cut where II IS found absolutely nee
essary, but az the speech and motor
areas arc in the cortex this Is avd:eed 1
o5ceDt IN extreme cases. /
Where q watery inflammation Of the I