RT Journal A1 FRANK T1 CRanial technic JF Journal of the American Medical Association JO Journal of the American Medical Association YR 1909 FD January 9 VO LII IS 2 SP 99 OP 02 DO 10.1001/jama.1909.25420280013002b UL http://dx.doi.org/10.1001/jama.1909.25420280013002b AB The most frequent causes of death following operations on the brain are shock and sepsis. Shock is given by Horsley as the cause in 8 per cent, of tumors diagnosed and removed and in 37 per cent. of those inaccurately diagnosed and not removed. Sepsis increases just in proportion as one is obliged to drain and is unable to heal by primary union; 30.8 per cent, of deaths is the usual proportion.THE PRIME REQUISITES  To avoid these dangers the following five requisites must be secured:Instruments which will open the skull quickly over any desired area and to any extent. The preferred instruments are the motor, saw and guard, osteotome, drill, fraise and measure used by me.A method of craniocerebral topography which will permit an accurate exposure of the intended cerebral area. It should be so accurate that the flap is neither too large nor too small. Chipault's