[ 133 ] 
In the hands of a judicious and careful’ operator, who has. had 
opportunities of frequently practifing this operation, either of the in- 
ftruments now in queftion might be fafe, and I fhould be forry to 
fappofe that any fatal accidents have happened in thefe our days 
in confequence of ufing them without due attention. But when 
we confider that trepanning is an operation of the utmoft neceflity, 
and feldom will admit of delay; that the patient who has met 
the accident and is to be relieved is often too remote from fuch 
help as he or his friends would with to apply to; that the neareit 
practitioner is to be called upon, who muft go to work without 
the advantage of having the advice or affiftance of an affociate of 
the profeffion, which is not the cafe in general. with moft other 
furgical operations, where the patient has time to confider and 
make choice of the perfon into whofe hands he will commit him- 
felf, and leifure perhaps to remove to the place where the affiftance 
he approves of is to be obtained ; but injuries of the head will not 
at all times allow of fuch advantages. 
Waen, I fay, we confider all thefe circumftances, and reflec 
that fo many of the moft eminent and able operators have differed 
~ materially in the choice and form of the inftruments for the pur- 
pofe of perforating the cranium, and that the objections made to 
any one inftrument were in fome meafure applicable to them all, 
we fhall be led to think that if an inftrument-could be devifed, in 
which might be united the expeditious and equal working of the 
trepan, with the fafety of the trephine, a valuable addition there- 
by would be made tothe manual part of furgery. It will be readily 
granted, that in every profeffion all are not alike expert in ufing 
their 
