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LXXIV. Theoretical Suggestions for the Improvement of 

 Practical Surgery. By A Correspondent. 



1st. In that part of the operation of amputation when the 

 hone is to be sawed through, it appears to me that a steady- 

 support to the bone would materially facilitate and secure 

 the correct action of the saw : In the present mode, when 

 the only means of steadying the bone and resistance to the 

 action of the saw is made by the grasp and manual force of 

 frequently agitated assistants, the difficulty of dividing the 

 bone, without splintering and ruggedness, is very consider- 

 able. Might not a perpendicular prop from the floor, with 

 a semicircular hollow to receive the bone, be of great effect 

 in rendering it steady ? When a retractor is used, might 

 not such prop form part of that instrument? Carpenters, 

 when they saw timber, always take care to make it steady 

 previous to the application of the saw ; Why should not 

 the same mode be u*ed when sawing the bones of the arm 

 or leg? The soft parts could not be injured by such a me- 

 thod ; as by the present mode of amputation, by double in- 

 cision, a considerable length of bone is bared before the saw 

 is used, and why might not the proposed support be applied 

 to that part ? 



2d. In the operation of trepaning the skull, when the 

 scalp is sufficiently removed, it is essential to remove just 

 so much of the pericranium and no more, as the head of 

 the trephine will include; because the cranium, when de- 

 nuded of its pericranium, will, like other bones denuded of 

 their periosteum, grow carious. This part of the operation 

 is now generally performed by an instrument called a 

 raspatory, or by scraping the skull with a small scalpel. 

 Would not this be performed much more complete bv 

 having a head adjusted to the trephine handle, precisely the 

 dimensions of the serrated head, and which head would 

 have a circular cutting edge, with a species of concave plane 

 or scraper within it? One turn of such an instrument as I 

 can imagine, and as any person could easily contrive, but 

 which I find difficult to describe bywords, would completely 

 remove the exact portion of pericranium and no more*. 



3d. Were surgeons to make themselves acquainted with 

 tin implements ur ; ed in different mechanical professions, it 

 is possible some valuable additions might be made to the 



have reason to believe that there is such an instrument as the one 

 above .Alluded to. It was said to h^ve been the invention of Mr. Henry 

 Cline, juoii 



Vol. 30. No. 152. Dec, 1810. 2 C present 



