Surgical applied anatomy / by Sir Frederick Treves.

  • Sir Frederick Treves, 1st Baronet
Date:
1892
Catalogue details

Licence: Public Domain Mark

Credit: Surgical applied anatomy / by Sir Frederick Treves. Source: Wellcome Collection.

    24/602
    haemorrhage be determined as follows :—A liiie is drawn around the skull at the level of the upper margin of the orbit, and is throughout parallel with Reid's base-line, Fig. 2. (See also page 35.) The trephine is fii'st placed at a point on this line, which is from 1} to li inches (according to age and size of head) behind tlie external angular process of the frontal bone (a, Fig. 2). Should no clot be revealed, a second hole is made upon the same line just below the parietal eminence, and at a point where a vertical line carried up from the posterior border of the mastoid process bisects the line already given (b. Fig. 2). Trephining for intracranial abscess.—The abscess is often due to middle-ear disease, and is then veiy commonly found in the tempoi'O-sphenoidal lobe or in ^Vhe cerebellum. It is estimated to be three times more common in the cerebrum than in the cerebellum. The abscess of the temporo-splienoidal lobe is usually found, according to Mr. Barker, between two lines drawn at right angles to Reid's base-line. These lines are about inches apart;/one passes througli tlie meatus, the otlier about 1^ inches behind tliat opening (xx, Fig. 2). The trephine should be intro- duced in the centi'e of tlie space marked out by these two lines, and at a distance of about li inches above the base-line (c, Fig. 2). In dealing with an abscess of the cerebelljmLi, tlie best spot to select is, in the adult, 1.^ inclies beliind the centre of the meatus and 1 incli below the base- line (e, Fig. 2). Traphining for cerebral f7imo7(r.—The position of the opening in the slcull is ol)viously determined by the localising symptoms. It is remarkable tli;it little trouble from hasmorrlmge has attended tliese operations. In any case, after trc)ihining, the portion or portions ot bone removed may—if projterly treated—