348 OPERATIONS ON THE DIGESTIVE APPARATUS, 



time of exposing- the animal to the possible accidents which mar 

 attend this mode of restraint. We hold strongly to the expedi- 

 ency of performing the operation in the standing position. There 

 will necessarily be cases in which to attempt to remove a tooth 

 with the animal standing would be simple folly and time lost, but 

 with many operators in this country, we have in several instances 

 succeeded in extracting a condemned molar without any other 

 means of restraint than a twitch on the patient's lower lip or on 

 his ear. The removal of molars is effected in two ways — by pul- 

 hng, or by rejjulsion or gouging out. 



The method by extraction or emdsion, is preferable whenever 

 it is practicable, having the advantage of causing less injury to 

 the surroimding structures, and is objectionable, principally for 

 the posterior teeth, which always oppose great difficulties to the 

 operation. The oldest instrument used in this operation is the 

 enlarged key of Garangeot, as modified by Delamarre. Its appli- 

 cation has always seemed to us difficult, if not dangerous, and we 

 think that it involves more or less risk of fracture of the plates of 

 the maxillary bone, on which account we prefar the large tooth 

 forceps, which may be found under many forms and designs. The 

 forceps of Plasse (Fig. 351), of Wendenburg (Fig. 353), of Pill- 

 wax (Fig. 354), of Gowing (Fig. 355), of the same inventor, as 

 modified by Bouley (Fig. 356), those of Gunther (Fig. 358), the 

 key-forceps of Bouley (Fig. 357), those of House, of Walters, and 

 many others will furnish the operator a large collection from which 

 to select. Many of these instruments are very compHcated (as that 

 of Scheffer) ; some are clumsy and difficult to handle ; have levers, 

 like those of Wendenburg and Pillwax; many woi'k by merely 

 grasping the tooth and holding it by a peculiar arrangement of 

 spring, or of thread-screw, and thus to the end of the chapter. 



We have for many years given the preference to the simple 

 forceps of Gowing, leaving off the little rod which is connected 

 with the cross-piece which carries the thread, and which is to be 

 screwed on the handles of the instrument to hold them firmly to- 

 gether. What we think most essential in the instrument is that 

 its arms should be firm and so soHd as not to bend or yield when 

 the screw is applied on them, and that the jaws of the forceps 

 should not be too narrow nor too curved, and above all, that the 

 instrument should not be made mmecessarily heavy, a fault which 

 we have too often observed in some of the continental pattei-ns. 



