Winter Auvard's Combined Cranioclast and Cephalotribe This instrument is a combination of the cranioclast and cephalotribe designed by Auvard and Winter, and was used for obstetric surgery. It is made of nickel-plated metal, heavily corroded. The outside arms are marked numbers "1" and "2". These are the main forcep arms, while a third central one has an engraving on the handle of its curved shape to distinguish it. The third arm was present to allow application of a heavy pressure. A swivel turning threaded arm bolt completes the locking of the three arms together. The central pointed and serrated blade functioned as a perforator and was screwed into the foramen magnum. The two outer blades were subsequently applied over the face and occiput, the screw tightened to effectively crush the skull against the centrally retained blade. The modification of Auvard's design was made by the obstetrician Dr Winter in the late 1890s. 1900-1949