An American text-book of the diseases of childrenIncluding special chapters on essential surgical subjects; orthopaedics, diseases of the eye, ear, nose, and throat; diseases of the skin; and on the diet, hygiene, and general management of children . tonsillotome answeringthis purpose, at the same time that the vulsellum prongs grasp the tonsil todraw it from its bed into the ring of the tonsillotome. The proper line or point for abscission I believe to be close to the base ofthe gland, but not so close as to constitute a total extirpation. A stumpshould be left, but one not much larger than t
An American text-book of the diseases of childrenIncluding special chapters on essential surgical subjects; orthopaedics, diseases of the eye, ear, nose, and throat; diseases of the skin; and on the diet, hygiene, and general management of children . tonsillotome answeringthis purpose, at the same time that the vulsellum prongs grasp the tonsil todraw it from its bed into the ring of the tonsillotome. The proper line or point for abscission I believe to be close to the base ofthe gland, but not so close as to constitute a total extirpation. A stumpshould be left, but one not much larger than the normal gland, and not of suf- DISEASES OF THE PHARYNX AND NASO-PHABYNX. 425 ficient size to protrude from or T^-idely separate the pillars of the fauces. Atotal extirpation would seem unnecessarily hazardous on account of difficulty ofaccess to bleeding vessels should hsemorrhage occur, and I cannot think thatheemorrhao-e is any less prone to occur after tot al extirpation, as recently stated,than after abscission. On the other hand, when a considerable portion of the gland is left, onlythe cortical laver being removed, redevelopment of the growth is common. Very larc^e and densely fibrous tonsils in older children are best removed Fig. The Authors Method of Tonsillotomy. by the galvano-cautery snare, since they are especially apt to bleed if cut,and are difficult to abscise by a cold wire. In rare instances haemorrhageeven then occurs, either primarily when the wire is overheated, or second-arily on the separation of the slough. The chief objection to the methodfor general use is the intense inflammation of the fauces which is liable tofollow it. This can be, in part, but not wholly, obviated if one is carefulnot to singe the pillars, which, however, are not so easily avoided in the useof the cautery snare. To this end, Dr. Jonathan Wright has adapted theframe of the Mackenzie tonsillotome to galvano-cautery purposes by substi-tuting for the steel blade a wire mounted o
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