THE HISTORY OF CRANIOTOMY: AN ACCOUNT OF THE METHODS WHICH HAVE BEEN PRACTICED AND THE INSTRUMENTS USED FOR OPENING THE HUMAN SKULL DURING LIFE

THE HISTORY OF CRANIOTOMY: AN ACCOUNT OF THE METHODS WHICH HAVE BEEN PRACTICED AND THE INSTRUMENTS USED FOR OPENING THE HUMAN SKULL DURING LIFE

'Tis Man's worst deed

To let the things that have been, run to waste

And in the unmeaning Present sink the Past. LOWELL

Ideas are born; they develop; they are transformed; they never die. The history of ideas is the history of the race. They are the real events. Let them be never so new or strange, they have their roots in the far past with a continuity of growth.

INTRODUCTION

Familiar though most of us are with the modern methods of performing craniotomy, not all of us are equally well acquainted with the way in which the operations practiced today have evolved from the more primitive efforts of our surgical forefathers. Nor do all of us realise how ancient an operation craniotomy really is, how many and varied have been the methods practiced for its performance and how curious and highly ingenious have been certain of the implements used by its practitioners.

Prof. Archibald Young in his presidential address for the year nineteen twenty-four to the Royal Medico-Chirurgical Society of Glasgow, used these words:

Many addresses and lectures have been written in recent years, and many papers contributed to medical journals, whose chief purpose has been to dilate upon the great advances of modern surgery. The lay Press has contributed its quota to the same process of what one may almost call self-deception. We are too apt, in consequence, to get into the habit of thinking that most of the achievements of present day surgery are peculiar to this century, or perhaps even to this last decade; that there was no such thing as surgery, in the real sense, until almost within the memory of, say, our grandfathers.

It is a very salutary corrective to this impression or assumption to glance back for a little upon the history of surgery in the past.

If any of us have acquired this impression or assumption, this paper may prove a salutary corrective such as that to which Prof. Young refers, but it was not with this high object that its preparation was undertaken but because of a much more lowly one. At one stage in his ascent of the Mountain of Purgatory, Dante reached a high terrace from which, while resting for a moment, he turned to the East and remarked to his conductor: "all men are delighted to look back," and from the terrace reached by the practice of cerebral surgery today I am delighted to look back and report the retrospect.

While the knowledge gained by the toil of one generation soon becomes the commonplace of the next, it is equally true that the discoveries of our forefathers have a habit of attaining a new importance many decades later. This is well exemplified in the history of surgical craniotomy. It will be seen that certain instruments used for performing the operation in quite recent years and even some of the most modern had their prototypes which were used by our surgical forefathers many decades before and were subsequently lost or forgotten.

In an introduction to an account of surgical instruments in Greek and Roman times, published in nineteen zero seven, the author, Mr. J. S. Milne, remarked that prior to the publication of his essay, no systematic attempt to reconstruct the surgical armamentarium of the ancients had been made, that comparatively little attention had been given to this department of archaeology, and that literature bearing on it was scarce. If this applies to surgical instruments generally, it does so with greater force as regards those instruments appertaining to a particular operation such as opening the skull. A research into the literature has failed to reveal any systematic and comprehensive account of this aspect of the history of surgery so that the time seems opportune to present this brief history of the methods which have been practiced and the instruments used for opening the human skull during life.