An Improved Tonsilotome.
Year: 1894

page_text: Date of Application, 24th Jan., 1894
Complete Specification Left, 24th Nov., 1894-Accepted, 19th Jan., 1895
An Improved Tonsilotome.
1, CHARLES AUGUST TESKE of 3, Raphael Street, Knightsbridge, London,
Surgical Instrument Maker, do hereby declare the nature of this invention. to be
as follows:-
My invention relates to an improved tonsilotome or instrument for removing the
tonsils by cutting, and the improvements consist essentially:
:-
1st. In a circular knife to which is imparted a combined movement of translation
and of rotation, that is to say conjointly with the usual longitudinal motion along
the frame of the instrument a rotary motion about its own axis whereby the knife
is caused to act. by a drawing cut which renders its operation much more easy and
efficacious;
2ndly. In particular arrangements of mechanism by which the combined move-
ments of rotation and translation are imparted to the knife;
3rdly. In the combination, with a knife thus operated, of a fork or needle by
which the tonsil about to be operated on is transfixed and held extended whilst
under the operation of the knife, this fork or needle being actuated in advance of
the operation of the knife and remaining stationary during the operation of the knife,
the fork or needle and the knife being operated in succession by a single movement ;
4thly. In the particular construction of the mechanism whereby the necessary
movements are imparted to the fork or needle ;
5thly. In the combination, with the instrument, of a handle so arranged that
whilst the instrument may be held in proper position for use by the fingers the
reach of the thumb is so extended as to enable the needle or fork and the knife to
be actuated consecutively, as above described, by one continuous movement of the
thumb in the same direction ;
And lastly-In means by which the handle is removably and reversibly attached
to the frame of the instrument so as to enable its position to be readily changed
with regard thereto, as may be required, to adapt the instrument for operation on
the right or left tonsil.
The knife to which the combined movement of translation and of rotation is
imparted, may be of disc form with exterior cutting edge or of annular form with
interior cutting edge and it is fitted to slide and revolve over an aperture in a plate
forming part of the frame of the instrument and provided with means for guiding the
knife in its motion and, in the case of the disc-knife, with guards shielding the edge
of the knife, so as to prevent it cutting except where it passes across the aperture.
The movement of translation is imparted to the knife by a longitudinally sliding
member to which the knife is pivoted by a central pivot, in the case of a disc
knife, or within which it is embraced in the case of an annular knife so as, in
This rotary
either case, to leave the knife free to revolve about its own axis.
motion, as well as the motion of translation, is imparted to the knife by the sliding
member above referred to, through the medium of toothed gear consisting
preferably of a longitudinal stationary rack in the guide frame with which the
knife is geared through the medium of a pinion carried by the sliding member, so
that as by the longitudinal motion of the latter the pinion rolls along the rack it
transmits rotary motion to the knife which is carried along by the same longitudinal
motion.
The teeth on the knife are peripheral and occupy a segment of about one-third

page_text: its circumference, the remaining two-thirds being cutting edge. By this arrange-
ment a sufficiently long drawing cut may be obtained without detracting from the
necessary thinness of the knife.
Instead of the rack and pinion there may be employed, with either form of knife,
a toothed segment gearing directly with the knife and pivoted to the longitudinally-
sliding member, said segment being constrained, by a stud working in an oblique
cam slot, to swing about its pivotal centre when partaking in the motion of the
longitudinally-sliding member so as to thereby transmit rotary motion to the knife.
The needle or fork receives motion in the direction of its length and its operating
point also receives a motion in a direction perpendicular to the plane of the knife
so as, after having transfixed the tonsil, to draw it further through the aperture in
the frame and hold it extended when under the operation of the knife. For this
purpose the forward section of the stem is made flexible and is adapted to ride up
on a cam incline carried by a stationary bridge piece spanning the knife guard
frame whereby the needle or fork just before reaching the end of its course is
deflected from its original plane. The stem of the needle or fork is made in two
sections working telescopically. This telescopic stem is fitted to slide in guides on
the frame of the instrument and when in the extended position the two sections
are rigidly connected by a spring-actuated locking stud by which telescopic action
is prevented so that the necessary thrust may be transmitted through the stem
from a thumb piece at the rear end. At a certain point in the longitudinal
movement of the stem the locking stud connecting the two sections is disengaged
by its spring riding up another cam incline on the frame whereby the motion of the
needle or fork proper ceases and the one part of the stem telescopes into the other
by the continued motion of the thumb piece.
In this continued motion the thumb piece is caused to carry forward along with
it the longitudinally-sliding member by which the knife is operated, as above
described, and in this way the consecutive action of the needle or fork and of the
knife is brought about by one continuous motion of the operating part.
The handle is affixed to the frame of the instrument in a position perpendicular
to the plane thereof; it is formed with loops or bows to receive the second and
third fingers and with a grip for the first finger so as to enable the instrument to
be firmly held without gripping by the palm or thumb, leaving the latter member
free to reach to the extent necessary for imparting the continuous motion required
for the consecutive operation of the needle and knife, as above described.
The handle is detachably and reversibly attached to the frame by its forked
upper end being notched to embrace the edges of the frame and provided with
binding or thrust pins whereby the frame is tightly gripped in the said notches, these
binding pins being thrust against the frame either directly by a screw fitted in or
forming part of, the handle or through the medium of a spring cam or wedge
actuated by a set screw, screwing into the handle.
Dated this 24th day of January 1894.
By A. M. & Wm. Clark,
53, Chancery Lane, London, Chartered Patent Agents.
COMPLETE SPECIFICATION.
An Improved Tonsilotome.
I CHARLES AUGUST TESKE, of 3 Raphael Street, Knightsbridge, London,
Surgical Instrument Maker, do hereby declare the nature of this invention and in
what manner the same is to be performed to be particularly described and
ascertained in and by the following statement:-
My invention relates to an improved tonsilotome or instrument for removing the
tonsils by cutting, and the improvements consists essentially in a circular knite to

page_text: which is imparted a combined movement of translation and of rotation, that is to
say conjointly with the usual longitudinal motion along the frame of the instrument,
a rotary motion about its own axis whereby the knife is caused to act by a
drawing cut which renders its operation much more easy and efficacious; and
in a fork or needle by which the tonsil about to be operated on is transfixed and
held extended whilst under the operation of the knife, this fork or needle being
actuated in advance of the operation of the knife and remaining stationary during
the operation of the knife, the fork or needle and the knife being operated in
succession by a single movement.
In the accompanying two sheets of illustrative drawings
Fig. 1 is a side elevation of a tonsilotome constructed according to this invention
and having a disc knife and Fig. 2 is a plan of the same the needle for holding the
tonsil whilst being cut being supposed removed.
Fig. 3 is a plan of the needle.
Fig. 4 is a sectional front view of the handle of the instrument.
Fig. 5 is a front view of the cover plate of the main frame.
Fig. 6 is an end view of the back end of the sliding frame carrying the disc
knife.
Fig. 7 is a side elevation of a tonsilotome having a ring knife and the needle for
holding the tonsil whilst being cut being supposed removed. Fig. 8 is a plan of
the same.
Fig. 9 is a plan of the frame in which the ring knife slides and
Fig. 10 is an end view of the handle.
Referring to Figs. 1 to 6 the knife a is in the form of a disc having a cutting
edge bat a portion of its circumference and teeth c in the remaining portion, is
mounted loosely on an axis d fixed in the bifurcated end of the frame e adapted to
slide on the main frame f and over an aperture g in the front end of the main
frame which also forms a guard to shield the edge of the knife so as to prevent
its cutting except where it passes across the aperture. A small pinion h mounted
loosely on a stud carried by the sliding frame gears into the teeth c of the knife
disc and also into the rack teeth i on the side of a slot 7 in the main frame.
will thus be seen that as the sliding frame moves in the direction of its length on
the main frame, the pinion his rotated by the teeth i and in turn rotates the knife
disc a which has thus a drawing cut in conjunction with the usual longitudinal
motion. The sliding frame e is kept down on the main frame f by the cover
plate secured by the screwed pin and nut m and is guided by a block n fitting in
a slot in the bottom of the main frame and projecting above its upper surface.
It
The needle bar o slides at some distance from its front end on a small bracket
P
having a shaped shank passing through a hole in the cover plate and through
a central slot in the sliding frame and through the block n of the main frame and
secured by giving it a half turn. At its back end the needle bar slides in
recess in the back end of the sliding frame and is retained by the spring catch
plate r.
Near the front end of the needle bar is a pin s which when the needle
bar has nearly finished its forward stroke rises up the inclines t on the cover plate /
The
and causes the point of the needle to rise and so raise the tonsil to be cut.
needle passes between the inclines t which thus help to guide it. The needle bar
is constructed in two parts adapted to telescope together but secured in its
extended position by the spring catch secured to one part and having a pin
taking into the other part. The spring catch is adapted to be raised as the needle
bar is forced inwards by the inclines and so release the two parts, which then
telescope together.
It is inserted
The instrument being in its extended position as shown in Fig. 1 it is ready for
an operation. The instrument is held by the handle y the thumb of the operator
being inserted through the ring z at the back end of the needle bar.
into the mouth of the patient to be operated upon so that the tonsil to be cut is
within the aperture g.
The ring is then forced inwards as far as it will go by
the thumb of the operator and the operation is completed by this stroke. The

page_text: needle first moves inwards and comes in contact with the tonsil and holds it up.
At this point the two parts of the needle bar are released so that further motion
only telescopes the parts without affecting the needle and the ring comes against
the back end of the sliding frame. The further motion of the ring thus forces
inwards the sliding frame causing the knife disc to move inwards and at the same
time rotate on its pin so that it cuts off tonsil with a drawing cut at 14.
In order to facilitate the easy operation of the instrument the handle is arranged
so that it can readily be fixed in any position in a vertical circle. The block 1 is
clamped by the screw 2 to a desired part of the main frame and the flexible band 3
passes round the block and is secured by screwing the handle up the tapered
screw 4 which is in two parts that are forced together on screwing up the handle.
A slight turn serves to loosen or tighten the handle. The handle is conveniently
shaped as shown so that it can be firmly grasped and held in position by the fingers
of the operator the thumb being left free to actuate the instrument.
The spring plate 5 held by the headed pin 6 and a lip on its front end covers
the slot 7 of the main frame. It is placed in position by sliding the slot 8 at its
back end under the headed pin and rotating it into position when it springs into
place its lip engaging with edge of the back of the hole g.
In the modification shown in Figs. 7 to 10 a ring knife a is employed having a
cutting edge b. On its outer periphery is a groove in which passes a cord 10
secured at one end to the frame at 11 and at the other end to the front part of the
sliding frame e having rack teeth 12 gearing with a pinion h. The back part of
the sliding frame has rack teeth 13 also gearing with the pinion h. On forcing
forwards the back part of the frame, the rack teeth 13 rotate the pinion h which
actuates the front part of the frame through the teeth 12 and draw it backwards,
drawing back the ring a and at the same time rotating it to give a drawing cut the
tonsil being cut at 14. The roller 22 fixed on the end of the bar 23 sliding in a
slot in the front part of the sliding frame e and acted on by the spring 24 serves to
keep the chain tight. The arrangement of the needle is similar to that shown in
Figs. 1 to 6 the point of the needle being forced out only as far as the point 14.
A collapsing handle is also shown to this arrangement but the handle shown in
Fig. 1 to 6 can be employed or any other suitable handle whether fixed or
stationary. The bent frame 15 is pivoted to the main frame at 16 and has pivoted
to it near its outer end a short link 17 itself pivoted to a longer link 18 having at
its end a head 19 on which are two flats. The head is inserted through the round
hole 20 and pushes towards the pivot 16. When the head is at 20 the handle can
be folded down as shown in dotted lines. The pin 21 helps to fix the handle.
The ring knife works in a shallow box having a removable cover plate 25.
In either case any other suitable form of gearing may be employed to rotate
the knife but the arrangement shown in Figs. 7 to 10 gives a short instrument
easily manipulated.
Both instruments are adapted to be easily separated into the elementary parts so
that they can be thoroughly cleaned after each operation.
Having now particularly described and ascertained the nature of my said inven-
tion and in what manner the same is to be performed, I declare that what I
claim is :-
1. In a tonsilotome a circular knife to which a combined movement of translation
and rotation is imparted substantially as described.
2. In a tonsilotome, a telescopic needle bar and needle for holding the tonsil
whilst being cut the two parts of the bar being so connected and operated that it is
actuated during the first motion of the instrument in advance of the knife and
remains stationary during the operation of the knife and the needle and knife
being operated in succession by a single motion of the operator substantially as
described.
3. The arrangement of a tonsilotome arranged and constructed substantially as
described with reference to Figs. 1 to 6.

page_text: 4. The arrangement of a tonsilotome arranged and constructed substantially as
described with reference to Figs. 7 to 10.
Dated this 24th day of November 1894.
WHEATLEY & MACKENZIE,
40, Chancery Lane, London, W.C., Agents.