Abstract
The chapter begins with also an outline of the characteristics of four surgeons who changed the direction of thinking and hence of practice. This is followed by a review of the changing ideas which governed surgical practice. Chapter "Two surgical instruments" by Jeremy C. Ganz has examined the uses of drills and lenticulars. In this chapter there is an appraisal of the other instruments used during cranial surgery and how their use related to changing ideas. Finally, there is a concluding section which ties all these elements together.
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