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(PLATE X.) At this stage there is very little danger of the snare cutting through either the capsule of the tonsil or the fascia of the superior constrictor muscle.

method of dissection.

After the margin of the pillars has been separated as above, I use the curved, or dull dissector or both to further enucleate the tonsil if necessary. (Plate 8, 9 and 10).

The above procedure allows the snare wire to draw into the area of clevage between the pillars and the capsule and almost invariably it will follow this course, leaving the pillars intact and keeping outside of the capsule, thus

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(PLATE XII.) Resecting the left tonsil. Note that the Fellie-Brown is brought over to the left side of the
patient. Note also the pad clamped down in the bed where the right tonsil was resected and that
it is held in place by the assistant who is administering the ether with the Fellie-Brown.
Otherwise the detail is the same as is explained in Plate 3.

removing the entire tonsil, and of equal impor-
tance, preventing the snare cutting through the
fascia of the superior constrictor muscle of the
pharynx, just beneath which lies the tonsilar

plexus of veins. (See Plate 14 and 16).

This plexus can readily be seen in nearly every case lying in the floor of the fossa beneath the fascia. (Plate 14) is a reproduction

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This diagram is reproduced from "Applied Anatomy." By G. G. Davis. Pp. 113, Fig. 142.

at a comparatively small point and ordinarily the snare does little cutting if started right until it gets to them.

Immediately after the tonsil is removed the assistant inserts the curved Bergeron forcep with a sponge, large enough to tightly fill the tonsillar fossa. This is held in place by the anesthetist while I change to the other side

investigation of the pharynx, which can usually be done while the Bergeron forceps are still in place, or the maxillary sinuses may be opened while waiting if indicated.

I have seen no method which permits of so little bleeding, and except for bleeding from the adenoid field, very often the only sponging necessary is for mucus. I find a very satis

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(PLATE XVI.) Exaggerated view of the tonsillar plexus of veins after the tonsil is removed. The anesthetist
changes the Fellie-Brown mouth part on the opposite side as a retractor of the lips.

factory method of lessening hemorrhage from
the adenoid space to be to immediately pack a
piece of loose gauze into the pharynx as soon
as the adenoids are entirely removed. This
pack I remove just before the mouth gag is

taken out.

Some possible objections to this routine. 1. It may appear complicated and to require too much time. It does not, the very routine makes it rapid. In point of time second

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