ohol, and the light-carriers with the lamps in place are kept in a
continuous sterilization box containing formaldehyde pastilles. It is
of the utmost importance that instruments be always put away in
perfect order. Not only are cleaning and oiling imperative, but any
needed repairs should be attended to at once. Otherwise it will be
inevitable that when gotten out in an emergency they will fail. In
general surgery, a spoon will serve for a retractor and good work can
be done with makeshifts; but in endoscopy, especially in the small,
delicate, natural passages of children, the handicap of a defective or
insufficient armamentarium may make all the difference between a
success and a fatal failure.
A bronchoscopic clinic should at all times be in the same state of
preparedness for emergency as is everywhere required of a fire-engine
house.

[PLATE I--A WORKING SET OF THE AUTHOR'S ENDOSCOPIC TUBES FOR LARYNGOSCOPY,
BRONCHOSCOPY, ESOPHAGOSCOPY, AND GASTROSCOPY:
A, Adult's laryngoscope; B, child's laryngoscope; C, anterior
commissure laryngoscope; D, esophageal speculum, child's size; E,
esophageal speculum, adult's size; F, bronchoscope, infant's size, 4
mm. X 30 cm.; G, bronchoscope, child's size, 5 mm. X 30 cm.; H,
aspirating bronchoscope for adults, 7 mm. X 40 cm.; I, bronchoscope,
adolescent's size, 7 mm. x 40 cm., used also for the deeper bronchi of
adults; J, bronchoscope, adult size, g mm. x 40 cm.; K, child's size
esophagoscope, 7 mm. X 45 cm.; L, adult's size esophagoscope, full
lumen construction, 9 mm. x 45 cm.; M, adult's size gastroscope. C,
I, and E are also hypopharyngoscopes. C is an excellent esophageal
speculum for children, and a longer model is made for adults.
If the utmost economy must be practised D, E, and M may be omitted.
The balance of the instruments are indispensable if adults and
children are to be dealt with. The instruments are made by Charles J.
Pilling & Sons, Philadelphia.]

[52] CHAPTER II--ANATOMY OF LARYNX, TRACHEA, BRONCHI AND ESOPHAGUS,
ENDOSCOPICALLY CONSIDERED

The _larynx_ is a cartilaginous box, triangular in cross-section, with
the apex of the triangle directed anteriorly. It is readily felt in
the neck and is a landmark for the operation of tracheotomy. We are
concerned endoscopically with four of its cartilaginous structures:
the epiglottis, the two arytenoid cartilages, and the cricoid
cartilage. The _epiglottis_, the first landmark in direct
laryngoscopy, is a leaf