_Safety-pin Closer_.--There are a number of methods for the endoscopic removal of open safety-pins when the point is up, one of which is by closing the pin with the instrument shown in Fig. 37 in the following manner. The oval ring is passed through the endoscope until it is beyond the spring of the safety-pin, the ring is then turned upward by depressing the handle, and by the aid of the prong the pin is pushed into the ring, which action approximates the point of the pin and the keeper and closes the pin. Removal is then less difficult and without danger. This instrument may also be used as a mechanical spoon, in which case it may be passed to the side of a difficultly grasped foreign body, such as a pebble, the ring elevated and the object withdrawn. Elsewhere will be found a description of the various safety-pin closers devised by various endoscopists. The author has used Arrowsmith's closer with much satisfaction. _Mechanical Spoon_.--When soft, friable substances, such as a bolus of meat, become impacted in the upper esophagus, the short mechanical spoon (Fig. 30) used through the esophageal speculum is of great aid in their removal. The blade in this instrument, as the name suggests, is a spoon and is not fenestrated as is the safety-pin closer, which if used for friable substances would allow them to slip through the fenestration. A longer form for use through bronchoscopes and esophagoscopes is shown in Fig. 36. A laryngeal curette, cautery electrodes, cautery handle, and laryngeal knife are illustrated in Fig. 34. The cautery is to be used with a transformer, or a storage battery. _Spectacles_.--If the operator has no refractive error he will need two pairs of plane protective spectacles with very large "eyes." If ametropic, corrective lenses are necessary, and duplicate spectacles must be in charge of a nurse. For presbyopia two pairs of spectacles for 40 cm. distance and 65 cm. distance must be at hand. Hook temple frames should be used so that they can be easily changed and adjusted by the nurse when the lenses become spattered. The spectacle nurse has ready at all times the extra spectacles, cleaned and warmed in a pan of heated water so that they will not be fogged by the patient's breath, and she changes them without delay as often as they become soiled. The operator should work with both eyes open and with his right eye at the tube mouth. The operating room should be somewhat darkened so as to facilitate the ignoring of the image in the left eye; any lighting should be at the operator's back, and should be insufficient to cause reflections from the inner surface of his glasses. [FIG. 40.--The author's endoscopic bougies. The end consists of a flexible silk woven tip attached securely to a steel shank. Sizes 8 to 30 French catheter scale. A metallic form of this bougie is useful in the trachea; but is not so safe for esophageal use.]