ble
checking mechanism on the handle. The author frequently used smooth
forceps for this purpose, and found them so efficient that this
dilator was devised. The edges of forceps jaws are likely to scratch
the epithelium. Occasionally the instrument is useful in the
esophagus; but it is not very safe, unless used with the utmost
caution.]

_Tissue Forceps_.--With the forceps illustrated in Fig. 28 specimens
of tissue may be removed for biopsy from the lower air and food
passages with ease and certainty. They have a cross in the outer blade
which holds the specimen removed. The action is very delicate, there
being no springs, and the sense of touch imparted is often of great
aid in the diagnosis.

[FIG. 27.--The author's upper-lobe bronchus forceps. At A is shown
the full-curved form, for reaching into the ascending branches of the
upper-lobe bronchus A number of different forms of jaws are made in
this kind of forceps. Only 2 are shown.]

[FIG 28--The author's endoscopic tissue forceps. The laryngeal length
is 30 cm. For esophageal use they are made 50 and 60 cm. long. These
are the best forceps for cutting out small specimens of tissue for
biopsy.]

The large basket punch forceps shown in Fig. 33 are useful in removing
larger growths or specimens of tissue from the pharynx or larynx. A
portion or the whole of the epiglottis may be easily and quickly
removed with these forceps, the laryngoscope introduced along the
dorsum of the tongue into the glossoepiglottic recess, bringing the
whole epiglottis into view. The forceps may be introduced through the
laryngoscope or alongside the tube. In the latter method a greater
lateral action of the forceps is obtainable, the tube being used for
vision only. These forceps are 30 cm. long and are made in two sizes;
one with the punch of the largest size that can be passed through the
adult laryngoscope, and a smaller one for use through the
anterior-commissure laryngoscope and the child's size laryngoscope.

[FIG. 29.--The author's papilloma forceps. The broad blunt nose will
scalp off the growths without any injury to the normal basal tissues.
Voice-destroying and stenosing trauma are thus easily avoided.]

[FIG. 30.--The author's short mechanical spoon (30 cm. long).]

_Papilloma Forceps_.--Papillomata do not infiltrate; but superficial
repullulations in many cases require repeated removals. If the basal
tissues are traumatized, an impaired or ruined voice will result. The