The surgical treatment of the diseases of infancy and childhood / by T. Holmes.
- Timothy Holmes
- Date:
- 1868
Licence: Public Domain Mark
Credit: The surgical treatment of the diseases of infancy and childhood / by T. Holmes. Source: Wellcome Collection.
597/700
![child's hands from interfering with the operator. The latter position is perhaps more convenient and less alarming to the patient. There are two ways of removing the tonsil, viz. either with the forceps and knife, or with the guillotine. The former is the more efficient, and in adults or in steady chil- dren above a certain age is much preferable ; but for small or timorous children the guillotine is far the easier and more rapid. The guillotine which alone should be used is the French instrument which goes by the name of Charriere. It consists of two blades sliding on one another, and each terminating in a ring. The posterior edge of the upper ring is sharp. On the upper blade a groove is chiselled, along which travels an arm which carries a double-pronged fork; and this arm is so constructed that as it passes over the ring the fork is raised to a certain distance away from the ring. The frame is provided with a handle on either side for the two first fingers of the surgeon's hand and one behind for his thumb. The frame is so con- nected with the fork and blades that by press- ing the thumb forwards the operator first pro- jects the fork and then the upper ring. The instrument, being put into the child's mouth, usually depresses the tongue sufficiently, and 92- ^ tonsil ° . 7 guillotine.] thus dispenses with the necessity for a spa- tula or gag. It is then turned with the lower ring towards the tonsil, and pressed upon it so as to draw the tonsil through the ring; then by pressure of the thumb the prongs of the fork are stuck into the enlarged tonsil, and as the fork passes forwards it draws the gland further into the ring; then, by continuing the pressure of the thumb, the upper ring slides forwards and cuts off the part within the rings. The whole affair is over in a moment. The instrument must then be withdrawn, the piece of tonsil disengaged from it, and the child has suffered so little pain that he will often allow the other tonsil to be operated on; but if he is frac- tious, crying loudly and struggling, it is better to put off to another day the removal of the opposite tonsil. The main recommendation of the use of the guillotine is that it only](https://iiif.wellcomecollection.org/image/b20416325_0597.jp2/full/800%2C/0/default.jpg)
