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A Controller of the Tongue and 
 
 Palate During General 
 
 Anesthesia 
 
 JOSEPH E. LUMBARD, M.D. 
 
 Instructor in Anesthesia, University and Bellevue Hospital Medical 
 
 College; Anesthetist to Harlem, Knickerbocker 
 
 and Lying-in Hospitals 
 
 NEW YORK 
 

A CONTROLLER OF THE TONGUE AND PALATE 
 DURING GENERAL ANESTHESIA* 
 
 Joseph E. Lumbard, M.D., New York 
 
 Instructor in Anesthesia, University and Bellevue Hospital Medical 
 
 College; Anesthetist to Harlem, Knickerbocker and 
 
 Lying-in Hospitals 
 
 It is of great importance to maintain an unobstructed air 
 way during the administration of a general anesthetic. The 
 prevention of obstruction to free breathing through the upper 
 air passages is one of the most important details with which 
 the anesthetist has to cope. The most common' form of 
 respiratory obstruction, during anesthesia, is the falling back 
 of the tongue into the pharynx, owing to the relaxation of the 
 muscular support. 
 
 There are several instruments to overcome this difficulty, 
 known as air ways, breathing and pharyngeal tubes. Those 
 best known are the tubes devised by Hewitt of London and 
 
 Lumbard's controller of the tongue and palate for general anesthesia, 
 thirteen-twentieths actual size. The pharyngeal end is at the left. 
 
 Connell of New York. Both give excellent results, but are 
 open to the great objection of becoming obstructed with 
 mucus. 
 
 To overcome' this I have devised an instrument which con- 
 sists essentially of a double row of four bent wires, running 
 parallel, about an eighth of an inch apart, and firmly held 
 together by wire bands, two at each end. The instrument 
 measures 5^4 inches in length, three-fourths inch in width 
 and one-fourth inch in thickness : It presents a double curve 
 which adapts itself to the dorsum of the tongue. The instru- 
 ment is easily introduced, by placing the pharyngeal end 
 between the tongue and the soft palate, until it rests in the 
 pharynx. No attempt should be made to do this until the 
 
 * Shown at the New York Academy of Medicine (Section on Sur- 
 gery), March S, 1915. 
 
patient is well anesthetized. The use of the instrument is 
 also indicated in obstructions of. the nose and mouth. It 
 obviates the barbarous methods of tongue retraction and 
 jaw holding, and an instrument of this nature should be 
 considered as an essential part of every anesthetist's outfit. 
 
 ADVANTAGES 
 
 1. It is easily and quickly introduced. No mouth-gag or 
 manipulating of the tongue are necessary. 
 
 2. It will not clog with mucus, which is the chief defect of 
 similar instruments. 
 
 3. It is easily kept in position. 
 
 4. It is quickly cleansed. 
 
 5. It will not conduct a fluid anesthetic to the throat, an 
 accident that is liable to occur with other instruments. 
 
 6. It cannot be compressed by the teeth or gums. 
 
 I wish to thank Dr. W. H. Luckett for his valuable sug- 
 gestions in developing this instrument. 
 
 1925 Seventh Avenue. 
 
 Reprinted from The Journal of the American Medical Association 
 May 22. 1915, Vol. LXIV, />. 1757 
 
 Copyright, 1915 
 American Medical Association, 535 N. Dearborn St., Chicago 
 
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