A discussion of some questions relating to tonsillotomy : read before the State Medical Society of Pennsylvania, at its meeting in 1882, and published in The Medical Record of February, 1883 ; Clinical remarks upon deflections of the nasal septum, with a presentation of two cases made before the Allegheny County Medical Society, at its meeting, November, 1883 / by W.H. Daly.

  • Daly, W. H. (William Hudson), 1842-1901.
Date:
[1883]
Catalogue details

Licence: Public Domain Mark

Credit: A discussion of some questions relating to tonsillotomy : read before the State Medical Society of Pennsylvania, at its meeting in 1882, and published in The Medical Record of February, 1883 ; Clinical remarks upon deflections of the nasal septum, with a presentation of two cases made before the Allegheny County Medical Society, at its meeting, November, 1883 / by W.H. Daly. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    The guillotine is the best instrument for the operation if the growths are not too large to enter the fenestrum. The one I prefer is that of Professor Physick, of Philadelphia, as modified by Morell Mackenzie, of London (Fig. i). With this instru- Fig. i. ment a firm grasp can be had upon its handle, with which to hold it in place while operating. The guillotine of Dr. Wm. B. Fahnestock, of Lancaster, Pa., is perhaps better known throughout the world, and more mod- ifications have been made upon its original pattern than any other guillotine. Guersant, Velpeau, Chassaignac, and Maissonneuve all made important modifications of it, and it is probably the instrument most used by surgeons everywhere. The Physick guillotine being ready for use, the hilt is grasp- ed in the left hand, and with the index finger of the right hand the right tonsil of the patient is sought, and surrounded by the fenestrum. Some pressure is made by the guillotine as well as by the assistant, that the growth may be well encircled to its base. Then the knife is with the thumb of either hand pushed quickly home. The tonsil is usually brought away in the instrument, having caught by some shreds in the sulcus or slit which receives the knife. I prefer to operate with the left hand first, as in case of any unruly behavior on the part of the patient, the dexter hand remains to do the operation on the other tonsil quickly. The entire operation can be done in a minute, and is usually painless. When the growths are either too large to be easily removed by the guillotine, or when they are like a narrow flap project- Jng into the throat, I then use these laterally curved knives