Elevators were used to pull up the bone from around depressed skull fractures. This instrument also doubled as a rasp to scrape soft tissue from the bone. Made from high quality steel and with an ebony handle secured with studs. Signed by Strange who was an instrument maker to Bartholomew's Hospital from 1815 to 1820 and worked at 44 West Smithfield in  London from 1820 to 1826 when he was taken over by Ferguson