Renaissance-Europe-17th Century.

The authors of the texts described in this chapter will have had access to the anatomy of Vesalius; a marked step forward. However, there was no equivalent advance in physiology. Harvey's book on the circulation of the blood was published in 1628 but it took many years for its contents to be accepted as standard teaching. The century saw the development of instruments some of which look more like instruments a modern surgeon would recognize. The two major technical advances were the acceptance of a single-handed trephine and the design of crown trepans with a conical shape and blades extending up the sides. Moreover, the crown trepan had once again become the favored instrument for gaining access to the interior of the cranium. In terms of technique there was a worrying trend that surgeons could feel when they had penetrated the inner table of the skull without the need to probe. All the way back to Hippocrates, it had been customary to use probes to assess depth while trepanning. Thus, the abandonment of this safety measure if it was real, is cause for concern. However, it is not impossible that probing was continued and simply not mentioned as it was so obviously necessary as not to require comment. The lenticular illustrated remains of the triangular shape first illustrated by Vidius. It is important to note that it was not used to incise the skull but to smooth of rough edges and spicules.