26 PEEHISTOIMC TREPHINING. 



chosen. M. Paris did not meet with any instances in which the operation 

 had been performed upon subjects of less than tenor more than sixty years 

 of age. 



The instruments are rude and simple enough, consisting of a razor, a 

 serpette, one or two saws, some straight and curved elevators, and the 

 hrima, or perforator. This latter is a metal rod, as thick as a ramrod, with 

 a point an eighth of an inch long, but not over one-third of the diameter 

 of the rod, which thus forms a shoulder and prevents too deep a penetration 

 of the instrument. (See Plate VIII.) The point being fixed in the bone, 

 after removal of the scalp by a crucial incision, the rod is taken between 

 the hands of the operator, and by a rapid to-and-fro motion is made to 

 revolve so that a puncture is produced. This is followed by another and 

 another, until the fracture or the portion of bone intended to be removed is 

 surrounded with a row of these holes, very close together. The saw is used 

 to run them one into the other, and by means of the elevator the fragment 

 is removed. The dentated edges are smoothed, a shield is fastened over the 

 aperture, and appropriate dressings, with many ceremonies, applied. The 

 operation is performed with great slowness, and is not generally completed 

 at one sitting. It must, one would think, be exquisitely painful, but it is 

 held to be a point of honor to exhibit no evidence of suffering, and if 

 the patient should be so weak as to utter cries, he is jeered at, and even 

 beaten. 



The foregoing description of the method of operating is taken from the 

 article by M. Martin. There is a difference in the pro- 

 cedure as related by M. Paris, who does not mention 

 the use of the brima or of any analogous instrument. 

 He says that the thehibe cuts out a square jiiece of 

 bone, inclusive of the injured portion, with a saw, lift- 

 F.u. 2.-rragment from Kabjio iug the fragment witli tlio clcvator. Great violence is 



skull, forcibly broken out in the , i-.i- .r.i i* 1 



opcaiicn. sometimes used m tins part ot tlie operation, and a 



portion, of the outer or inner table is occasionally forced off, as in the accora- 

 l)anying figure; the bone from which it was drawn was in the possession of 

 M. Paris. 



