ult in serious trauma. The half curved
hook shown in Fig. 38 is the safest type; better still, a spiral twist
to the hook will add to its uses, and by reversing the turning motion
it may be "unscrewed" out if it becomes caught. Hooks may easily be
made from rods of malleable steel by heating the end in a spirit lamp
and shaping the curve as desired by means of a pin-vise and pliers.
About 2 cm. of the proximal end of the rod should be bent in exactly
the opposite direction from that of the hook so as to form a handle
which will tell the position of the hook by touch as well as by sight.
Coil-spring hooks for the upper-lobe-bronchus (Fig. 39) will reach
around the corner into the ascending bronchus of the
upper-lobe-bronchus, but the utmost skill and care are required to
make their use justifiable.

[FIG. 39.--Author's coil-spring hook for the upper-lobe, bronchus]

_Safety-pin Closer_.--There are a number of methods for the endoscopic
removal of open safety-pins when the point is up, one of which is by
closing the pin with the instrument shown in Fig. 37 in the following
manner. The oval ring is passed through the endoscope until it is
beyond the spring of the safety-pin, the ring is then turned upward by
depressing the handle, and by the aid of the prong the pin is pushed
into the ring, which action approximates the point of the pin and the
keeper and closes the pin. Removal is then less difficult and without
danger. This instrument may also be used as a mechanical spoon, in
which case it may be passed to the side of a difficultly grasped
foreign body, such as a pebble, the ring elevated and the object
withdrawn. Elsewhere will be found a description of the
various safety-pin closers devised by various endoscopists. The author
has used Arrowsmith's closer with much satisfaction.

_Mechanical Spoon_.--When soft, friable substances, such as a bolus of
meat, become impacted in the upper esophagus, the short mechanical
spoon (Fig. 30) used through the esophageal speculum is of great aid
in their removal. The blade in this instrument, as the name suggests,
is a spoon and is not fenestrated as is the safety-pin closer, which
if used for friable substances would allow them to slip through the
fenestration. A longer form for use through bronchoscopes and
esophagoscopes is shown in Fig. 36.

A laryngeal curette, cautery electrodes, cautery handle, and laryngeal
knife are illustrated in Fig. 34. The cautery is to be used wit