rrier C, armed with the sponge, S, when rotated as
shown by the dart, D, wipes the field, P, at the same time wiping the
lamp, L. The lamp does not need ever to be withdrawn for cleaning
during bronchoscopy. It is protected in a recess so that it does not
catch in the sponges.]

[FIG 15.--Exact size to which the bandage-gauze is cut to make
endoscopic sponges. Each rectangle is the size for the tubal diameter
given. The dimensions of the respective rectangles are not given
because it is easier for the nurse or any one to cut a cardboard
pattern of each size directly from this drawing. The gauze rectangles
are folded up endwise as shown at A, then once in the middle as at B,
then strung one dozen on a safety pin. In America gauze bandages run
about 16 threads to the centimeter. Different material might require a
slightly different size and the pattern could be made to suit.]

[32] The gauze sponges are made by the instrument nurse as directed in
Fig. 15, and are strung on safety pins, wrapped in paper, the size
indicated by a figure on the wrapper, and then sterilized in an
autoclave. The sterile packages are opened only as needed. These
"bronchoscopic sponges" are also made by Johnston and Johnston, of New
Brunswick, N. J. and are sold in the shops.

_Mouth-gag_.--Wide gagging prevents proper exposure of the larynx by
forcing the mandible down on the hyoid bone. The mouth should be
gently opened and a bite block (Fig. 16) inserted between the teeth on
the left side of the patient's mouth, to prevent closing of the jaws
on the delicate bronchoscope or esophagoscope.

[FIG. 16.--Bite block to be inserted between the teeth to prevent
closure of the jaws on the endoscopic tube. This is the
McKee-McCready modification of the Boyce thimble with the omission of
the etherizing tube, which is no longer needed. The block has been
improved by Dr. W. F. Moore of the Bronchoscopic Clinic.]

_Forceps_.--Delicacy of touch and manipulation are an absolute
necessity if the endoscopist is to avoid mortality; therefore, heavily
built and spring-opposed forceps are dangerous as well as useless. For
foreign-body work in the larynx, and for the removal of benign
laryngeal growths, the alligator forceps with roughened jaws shown in
Fig. 17 serve every purpose.

[FIG. 17.--Laryngeal grasping forceps designed by Mosher. For my own
use I have taken off the ratchet-locking device for all general work,
to be reapplied on the rare occasion