US1193782A - Thomas m - Google Patents

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US1193782A
US1193782A US1193782DA US1193782A US 1193782 A US1193782 A US 1193782A US 1193782D A US1193782D A US 1193782DA US 1193782 A US1193782 A US 1193782A
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frame
jaw
tongue depressor
slide
carried
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    • CCHEMISTRY; METALLURGY
    • C21METALLURGY OF IRON
    • C21BMANUFACTURE OF IRON OR STEEL
    • C21B13/00Making spongy iron or liquid steel, by direct processes
    • C21B13/12Making spongy iron or liquid steel, by direct processes in electric furnaces

Definitions

  • his invention relates to a mouth gag and tongue depressor and it has for its object the provision of an improved device of this character particularly adapted for use in operative mouth and throat work, although it is likewise adapted for use in ordinary mouth and throat work.
  • my improved mouth gag and tongue depressor can be so firmly attached to the lower jaw of the patient as to be carried entirely thereby in such manner that it will not fall from the mouth of the patient if the mouth be opened a little wider than it was at the time the instrument was set.
  • the tongue depressor is removable independently of the rest of the instrument leaving the remainder of the instrument in place, and this tongue depressor is so constructed that when it is in place it will be impossible for the tongue to fall back and close the larynx and cause the asphyxiation of the patient.
  • Figure 1 is a side view of a device constructed in accordance with the invention.
  • Fig. 2 is a plan view thereof, with the tongue depressor removed.
  • Fig. 3 is a front elevation thereof.
  • Fig. 1 is a sectional view upon line -l-l of Fig. 2.
  • Fig. 5 is a sectional view through one of the jaw plate supporting posts hereinafter described.
  • Fig. 6 is a sectional view through a slide binding element hereinafter described.
  • Fig. 7 is a sectional view through the binding element of the frame, and
  • Fig. 8 is a perspective view of a tongue depressor.
  • the invention comprises a pair of diverging base plates 5 and 6 which carry at their lower edges inturned flanges 7 and 8. At their forward ends, the plates 5 and (3 are provided with inturned overlapping members 9 and 10. These members are slotted at 11 to permit of the lateral adjustment of the plates 5 and 6 with relation to each other.
  • a stud 13 has its inner end fixed to a guide plate 1 1, said stud passing through the slots 11.
  • a threaded stud 15 carried by the guide plate 1% passes through the slots 11 and is engaged by a thumb nut 16. By loosening the thumb nut 16 it is possible to adjust either of the plates 5 and 6 laterally with relation to the guide plate 1 1 and to bind them in their adjusted positions by tightening said thumb nut.
  • the guide plate 1a has its lower portion bent rearwardly to provide a chin engaging bearing plate 17 the flanges 7 and 8 have secured thereto inwardly extending jaw engaging fingers 18 and 19 which fingers engage beneath the aws of the patient, while the bearing plate 17 engages beneath the chin.
  • a slide 20 is mounted in the guide plate 14 and is kept in proper engagement therewith by flanges 21 of said guide plate which flanges engage over the edges of the slide 20. This slide is slotted at 22 and 23.
  • the guide plate 14 carries a stud 24 which engages in the slot 23.
  • a threaded stud 25 passes through the slot 22 and is engaged by a thumb nut 26.
  • the head 27 of the stud 25 spans the slot 22 at the rear face of the slide 20 and consequently tightening the thumb nut 26, binds slide 20 in its adjusted position with relation to the guide plate 14.
  • the slide 20 serves to support the tongue depressor and to that end it is provided with a post 28 in which an adjusting screw 29 is threaded.
  • This adjusting screw is provided with a knurled head 30 and its upper end bears against the under face of a keeper plate 31, the latter being hinged at 32 to the upper edge of the slide 20.
  • the tongue depressor proper is indicated at 33 and when in use is held against vertical movement by its edges engaging beneath the inturned flanges 3-1- of the keeper plate 31.
  • the tongue depressor is notched at its opposite edges as indicated at 35 so that by moving the tongue depressor toward the left in Fig. 1 to bring this notched out portion between the flanges 34, the tongue depressor may be lifted and bodily removed from the keeper plate. It is by virtue of this construction that it is possible to apply or remove the tongue de pressor without removing the remainder of the instrument. Tongue depressors of varying sizes and shapes are used in conjunction with instruments of this kind, the shape of the'tongue depressor being varied to suit the work being done. For instance when operating and with the patient under the influence of an anesthetic, a curved tongue depressor like that shown in Fig.
  • a finger grasp is provided by the downwardly curved portion 33
  • Secured to the plates 5 and 6 are guides 36 and 37.
  • a post 38 is slidably mounted in the guide 37 and is provided. with a set screw 39 by means of which it may be secured in any desired Vertical adjustment.
  • the upper end of the post 38 carries a curved arm 40 and a lower jaw plate 41 preferably provided with a ribbed or serrated lower face.
  • the guide 36 carries a post 42, said post being provided with a set screw 43 by means of which it may be secured in any desired vertical adjustment with relation to the guide 36.
  • the upper end of the post 42 carries a fixed aw 44 which terminates in a curved portion 45 and carries a jaw plate 46 which corresponds to the jaw plate 41.
  • a movable jaw 47 is pivoted at 48 to the jaw 44 and terminates in a curved portion 49 which carries an upper jaw plate 50.
  • a rack 51 is carried by the jaw 44 and passes through the jaw 47 which rack is engaged by a pinion 52 carried by a stub shaft 53, journaled in aw 47.
  • the shaft 53 carries an operating thumb piece 54.
  • a pawl 55 is pivoted at 56 to the jaw 47 and is normally moved by a spring 57 to a position where its nose engages the pinion 52 to prevent reverse movement of said pinion.
  • the structure is clamped to the lower jaw of the patient through the medium of the fin gers 18 and 19, and the jaws 41 and 46.
  • the thumb piece 54 By operating the thumb piece 54 to open the jaw 47 with relation to the jaw 44, the jaws of the patient are forced open and held in open position by the plates 46 and 50.
  • the various adjustments provided by screw 29,- the vertical movement of the slide 20, and the lateral adjustment of the plates 5 and 6 with relation to guide plate 14 adapts the device to mouths of varying sizes and patients of varying ages.
  • a finger piece 57 is secured to the rear face of of members carried thereby arranged to en' gage above and below the lower jaw of a patient to clamp said frame to the lower jaw, a tongue depressor and means for removably mounting said tongue depressor with relationto said frame.
  • a frame comprising a pair of side members adjustable toward and from each other, of means arranged to engage above and below the lower jaw of a patient for clamping said frame'to the lower jaw, a vertically movable slide supported from said frame, a tongue depressor and a keeper plate for said tongue depressor mounted upon said slide.
  • a device of the character described the combination with a frame comprising a pair of side members adjustable toward and from each other, of means arranged to engage above and below the lower jaw of a patient for clamping said frame to the lower jaw, a vertically movable slide supported from said frame, a tongue depressor and a keeper plate hinged to said slide;
  • a device ofthe character described the combination with a frame comprising a pair of side members adjustable toward and from each other, of means for clamping said frame to the lower jaw of a patient, a vertically movable slide supported from said frame, a tongue depressor and a keeper plate for said tongue depressor mounted upon said slide, and means for adjusting said keeper plate with relation to said slide.
  • a device of the character described the combination with a frame comprising a pair of side members adjustable toward and from each other, of means for clamping said frame to the lower jaw of a patient, a vertically movable slide supported from said frame, a tongue depressor and a keeper plate hinged to said slide, and an adjusting screw for rocking said hinged keeper plate.
  • a frame comprising a pair of members, means for mounting said members of the frame for lateral adjustment with relation to the guide plate, lower jaw engaging members carried by said frame, and an upper jaw engaging gag supported from said frame.
  • a supporting frame comprising a pair of diverging members, elements carried thereby arranged to engage beneath the lower jaw of a patient, vertically adjustable posts car ried by the frame members, lower jaw engaging plates supported from said posts, a pivoted arm, an upper jaw engaging plate carried by said pivoted arm and a rack and pinion mechanism for imparting movement to said arm.
  • the combination with a frame com prising a pair of diverging members each of which is provided with a flange at its lower edge, of jaw engaging lingers carried by said flange and arranged to engage beneath the lower jaw of a patient, guides carried by said members of the frame, posts mounted in said guides, means for binding said posts in varying positions of adjustment with relation to said guides, curved arms supported from each of said posts, lower jaw engaging plates carried by said curved arms, a movable jaw pivoted to one of said arms, a rack and pinion mechanism for imparting movement to the movable jaw, means for preventing movement of the rack and pinion mechanism, and means carried by said movable jaw for engaging the upper jaw of a patient.
  • a frame comprising a pair of diverging members each of which is provided with a flange at its lower edge, of jaw engaging fingers carried by said flange, and arranged to engage beneath the lower jaw of a patient, guides carried by said members of the frame, posts mounted in said guides, means for binding said posts in varying positions of adjustment with relation to said guides, curved arms supported from each of said posts, lower jaw engaging plates carried by said curved arms, a movable jaw pivoted to one of said arms, a rack and pinion mechanism for imparting movement to the movable jaw, means for preventing movement of the rack and pinion mechanism, means carried by said movable jaw for engaging the upper'jaw of a patient, and means for adjusting the members of the frame laterally with relation to each other.
  • a frame comprising a pair of diverging members each of which is provided with a flange at its lower edge, of jaw engaging fingers carried by said flange, and arranged to engage beneath the lower jaw of a patient, guides carried by said members of the frame, posts mounted in said guides, means for binding said posts in varying positions of adjustment with relation to said guides, curved arms supported from each of said posts, lower jaw engaging plates carried by said curved arms, a movable jaw pivoted to one of said arms, a rack and pinion mechanism for imparting movement to the movable jaw, means for preventing movement of the rack and pinion mechanism, means carried by said movable jaw for engaging the upper jaw of a patient, and means for adjusting the members of the frame laterally with relation to each other, a guide plate to which said frame members are bound, a slide mounted in said guide plate, a chin engaging element carried by said guide plate, a keeper plate pivoted upon said slide, an adjusting screw for said keeper plate and a tongue depressor carried by said
  • clamping elements carried thereby arranged Y to engage above and below the lower jaw of a patient to positively clamp said frame to the jaw for bodily movement therewith, a j

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  • Engineering & Computer Science (AREA)
  • Chemical & Material Sciences (AREA)
  • Manufacturing & Machinery (AREA)
  • Materials Engineering (AREA)
  • Metallurgy (AREA)
  • Organic Chemistry (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)

Description

' T. M. HENDERSON.
MOUTH GAG AND TONGUE DEPRESSOR.
APPLICATION FILED uov.22. ms.
11 9 3,782 Patented Aug. 8, 1916.
2 SHEETS-SHEET l.
wnnouns nzrsns na. PNOI'D-LITNO sums-mu. o, c.
M- wiwnwsp 11.19pm GAG AND TONQUE :QEPRESSQB. 1
AP P LlCATION FILED NOV. 22. I915.
1,1 9:51.752, Patented Aw. 8,1916.
2 SHEETS-SHEET 2.
THOIVIAS 1V1. HENDERSON, OF PENDLETON, OREGON.
MOUTH-GAG AND TONGUE-DEPRESSOR.
Specification of Letters Patent.
Patented Aug. 8, 1916.
Application filed. November 22, 1815. Serial No. 62,753.
To all whom it may concern Be it known that I, THOMAS M. HENDER- soN, a citizen of the United States of America, residing at Pendleton, in the county of Umatilla and State of Oregon, have invented-certain new and useful Tm provements in Mouth-Gags and Tongue-Depressors, of which the following is a specification.
his invention relates to a mouth gag and tongue depressor and it has for its object the provision of an improved device of this character particularly adapted for use in operative mouth and throat work, although it is likewise adapted for use in ordinary mouth and throat work.
Among the advantages possessed by my improved mouth gag and tongue depressor is that it can be so firmly attached to the lower jaw of the patient as to be carried entirely thereby in such manner that it will not fall from the mouth of the patient if the mouth be opened a little wider than it was at the time the instrument was set.
The tongue depressor is removable independently of the rest of the instrument leaving the remainder of the instrument in place, and this tongue depressor is so constructed that when it is in place it will be impossible for the tongue to fall back and close the larynx and cause the asphyxiation of the patient.
Further objects and advantages of the invention will be set forth in the detailed description which now follows.
In the accompanying drawing :Figure 1 is a side view of a device constructed in accordance with the invention. Fig. 2 is a plan view thereof, with the tongue depressor removed. Fig. 3 is a front elevation thereof. Fig. 1 is a sectional view upon line -l-l of Fig. 2. Fig. 5 is a sectional view through one of the jaw plate supporting posts hereinafter described. Fig. 6 is a sectional view through a slide binding element hereinafter described. Fig. 7 is a sectional view through the binding element of the frame, and Fig. 8 is a perspective view of a tongue depressor.
Referring to the drawing it will be seen that the invention comprises a pair of diverging base plates 5 and 6 which carry at their lower edges inturned flanges 7 and 8. At their forward ends, the plates 5 and (3 are provided with inturned overlapping members 9 and 10. These members are slotted at 11 to permit of the lateral adjustment of the plates 5 and 6 with relation to each other. A stud 13 has its inner end fixed to a guide plate 1 1, said stud passing through the slots 11. A threaded stud 15 carried by the guide plate 1% passes through the slots 11 and is engaged by a thumb nut 16. By loosening the thumb nut 16 it is possible to adjust either of the plates 5 and 6 laterally with relation to the guide plate 1 1 and to bind them in their adjusted positions by tightening said thumb nut. The guide plate 1a has its lower portion bent rearwardly to provide a chin engaging bearing plate 17 the flanges 7 and 8 have secured thereto inwardly extending jaw engaging fingers 18 and 19 which fingers engage beneath the aws of the patient, while the bearing plate 17 engages beneath the chin. A slide 20 is mounted in the guide plate 14 and is kept in proper engagement therewith by flanges 21 of said guide plate which flanges engage over the edges of the slide 20. This slide is slotted at 22 and 23. The guide plate 14; carries a stud 24 which engages in the slot 23. A threaded stud 25 passes through the slot 22 and is engaged by a thumb nut 26. The head 27 of the stud 25 spans the slot 22 at the rear face of the slide 20 and consequently tightening the thumb nut 26, binds slide 20 in its adjusted position with relation to the guide plate 14. The slide 20 serves to support the tongue depressor and to that end it is provided with a post 28 in which an adjusting screw 29 is threaded. This adjusting screw is provided with a knurled head 30 and its upper end bears against the under face of a keeper plate 31, the latter being hinged at 32 to the upper edge of the slide 20. The tongue depressor proper is indicated at 33 and when in use is held against vertical movement by its edges engaging beneath the inturned flanges 3-1- of the keeper plate 31.
At one point in its length the tongue depressor is notched at its opposite edges as indicated at 35 so that by moving the tongue depressor toward the left in Fig. 1 to bring this notched out portion between the flanges 34, the tongue depressor may be lifted and bodily removed from the keeper plate. It is by virtue of this construction that it is possible to apply or remove the tongue de pressor without removing the remainder of the instrument. Tongue depressors of varying sizes and shapes are used in conjunction with instruments of this kind, the shape of the'tongue depressor being varied to suit the work being done. For instance when operating and with the patient under the influence of an anesthetic, a curved tongue depressor like that shown in Fig. 1 is employed, the curved rear end 33 thereof engaging behind and drawing the tongue forward in such manner as to effectually prevent the choking of the patient, while in ordinary mouth or throat work where an anesthetic is not required a straight tongue depressor like that shown in S is employed, but in both cases the tongue depressor is provided with the notched out portions 35 to permit of its ready insertion or removal. It will be apparent that in placing the tongue depressor in position, the cutout portion of the tongue depressor is brought into alinement with the flanges 34 and the tongue depressor is wedged into the keeper plate 31 by the same forward movement which draws the tongue of the patient toward the front of the mouth to which end the tongue depressor tapers slightly from the tongue engaging end. A finger grasp is provided by the downwardly curved portion 33 Secured to the plates 5 and 6 are guides 36 and 37. A post 38 is slidably mounted in the guide 37 and is provided. with a set screw 39 by means of which it may be secured in any desired Vertical adjustment. The upper end of the post 38 carries a curved arm 40 and a lower jaw plate 41 preferably provided with a ribbed or serrated lower face. The guide 36 carries a post 42, said post being provided with a set screw 43 by means of which it may be secured in any desired vertical adjustment with relation to the guide 36. The upper end of the post 42 carries a fixed aw 44 which terminates in a curved portion 45 and carries a jaw plate 46 which corresponds to the jaw plate 41. A movable jaw 47 is pivoted at 48 to the jaw 44 and terminates in a curved portion 49 which carries an upper jaw plate 50. A rack 51 is carried by the jaw 44 and passes through the jaw 47 which rack is engaged by a pinion 52 carried by a stub shaft 53, journaled in aw 47. The shaft 53 carries an operating thumb piece 54. A pawl 55 is pivoted at 56 to the jaw 47 and is normally moved by a spring 57 to a position where its nose engages the pinion 52 to prevent reverse movement of said pinion.
It is believed that the operation of the device will be apparent without further discussion, however it may be briefly stated that the structure is clamped to the lower jaw of the patient through the medium of the fin gers 18 and 19, and the jaws 41 and 46. By operating the thumb piece 54 to open the jaw 47 with relation to the jaw 44, the jaws of the patient are forced open and held in open position by the plates 46 and 50. The various adjustments provided by screw 29,- the vertical movement of the slide 20, and the lateral adjustment of the plates 5 and 6 with relation to guide plate 14 adapts the device to mouths of varying sizes and patients of varying ages. To aid the operator in adjusting the device to the mouth of the patient a finger piece 57 is secured to the rear face of of members carried thereby arranged to en' gage above and below the lower jaw of a patient to clamp said frame to the lower jaw, a tongue depressor and means for removably mounting said tongue depressor with relationto said frame. 7
2. The combination with a frame, means arranged to engage above and below the lower jaw of a patient for clamping said frame to the lower jaw, a tongue depressor support carried by said frame, a tongue depressor having removable engagement with said support, and means for adjusting said support vertically with relation to said frame.
3. In a device of the character described the combination'with a frame comprising a pair of side members adjustable toward and from each other, of means arranged to engage above and below the lower jaw of a patient for clamping said frame'to the lower jaw, a vertically movable slide supported from said frame, a tongue depressor and a keeper plate for said tongue depressor mounted upon said slide.
4. In a device of the character described the combination with a frame comprising a pair of side members adjustable toward and from each other, of means arranged to engage above and below the lower jaw of a patient for clamping said frame to the lower jaw, a vertically movable slide supported from said frame, a tongue depressor and a keeper plate hinged to said slide;
5. In a device ofthe character described the combination with a frame comprising a pair of side members adjustable toward and from each other, of means for clamping said frame to the lower jaw of a patient, a vertically movable slide supported from said frame, a tongue depressor and a keeper plate for said tongue depressor mounted upon said slide, and means for adjusting said keeper plate with relation to said slide.
6. In a device of the character described the combination with a frame comprising a pair of side members adjustable toward and from each other, of means for clamping said frame to the lower jaw of a patient, a vertically movable slide supported from said frame, a tongue depressor and a keeper plate hinged to said slide, and an adjusting screw for rocking said hinged keeper plate.
7. In a device of the character described the combination with a guide plate, of a slide mounted for vertical movement therein, means for binding said slide to said guide plate, a frame comprising a pair of members, means for mounting said members of the frame for lateral adjustment with relation to the guide plate, and lower jaw engaging members carried by said frame.
8. In a device of the character described the combination with a guide plate, of a slide mounted for vertical movement therein, means for binding said slide to said guide plate, a frame comprising a pair of members, means for mounting said members of the frame for lateral adjustment with relation to the guide plate, lower jaw engaging members carried by said frame, and an upper jaw engaging gag supported from said frame.
9. The combination with a guide plate, of a chin engaging element carried by said guide plate, a slide mounted in said guide plate, a keeper plate upon said slide and a tongue depressor arranged to be engaged by said keeper plate when a forward movement is imparted to the tongue depressor with relation to said keeper plate.
10. The combination with a guide plate, of a chin engaging element carried by said guide plate, a slide mounted in said guide plate, a keeper plate upon said slide and a tongue depressor arranged to be engaged by said keeper plate when a forward movement is imparted to the tongue depressor with re lation to said keeper plate, and means for adjusting the angle of said keeper plate with relation to said slide.
11. In a device of the character described, a supporting frame comprising a pair of diverging members, elements carried thereby arranged to engage beneath the lower jaw of a patient, vertically adjustable posts car ried by the frame members, lower jaw engaging plates supported from said posts, a pivoted arm, an upper jaw engaging plate carried by said pivoted arm and a rack and pinion mechanism for imparting movement to said arm.
12. In a device of the character described the combination with a channeled keeper plate having overhanging flanges, of a tongue depressor having a cut-out portion arranged to enter between said flanges and a wider portion which engages beneath said flanges when longitudinal movement is imparted to the tongue depressor with relation to said keeper plate.
13. In a device of the character described the combination with a vertically movable slide, of a post carried thereby, an adjusting screw threaded in said post and a keeper plate hinged upon said slide and against which said screw bears to thereby adjust the angle of the keeper plate with relation to the slide and a tongue depressor detachably engaged with said keeper plate.
let. The combination with a frame com prising a pair of diverging members each of which is provided with a flange at its lower edge, of jaw engaging lingers carried by said flange and arranged to engage beneath the lower jaw of a patient, guides carried by said members of the frame, posts mounted in said guides, means for binding said posts in varying positions of adjustment with relation to said guides, curved arms supported from each of said posts, lower jaw engaging plates carried by said curved arms, a movable jaw pivoted to one of said arms, a rack and pinion mechanism for imparting movement to the movable jaw, means for preventing movement of the rack and pinion mechanism, and means carried by said movable jaw for engaging the upper jaw of a patient.
15. The combination with a frame comprising a pair of diverging members each of which is provided with a flange at its lower edge, of jaw engaging fingers carried by said flange, and arranged to engage beneath the lower jaw of a patient, guides carried by said members of the frame, posts mounted in said guides, means for binding said posts in varying positions of adjustment with relation to said guides, curved arms supported from each of said posts, lower jaw engaging plates carried by said curved arms, a movable jaw pivoted to one of said arms, a rack and pinion mechanism for imparting movement to the movable jaw, means for preventing movement of the rack and pinion mechanism, means carried by said movable jaw for engaging the upper'jaw of a patient, and means for adjusting the members of the frame laterally with relation to each other.
16. The combination with a frame comprising a pair of diverging members each of which is provided with a flange at its lower edge, of jaw engaging fingers carried by said flange, and arranged to engage beneath the lower jaw of a patient, guides carried by said members of the frame, posts mounted in said guides, means for binding said posts in varying positions of adjustment with relation to said guides, curved arms supported from each of said posts, lower jaw engaging plates carried by said curved arms, a movable jaw pivoted to one of said arms, a rack and pinion mechanism for imparting movement to the movable jaw, means for preventing movement of the rack and pinion mechanism, means carried by said movable jaw for engaging the upper jaw of a patient, and means for adjusting the members of the frame laterally with relation to each other, a guide plate to which said frame members are bound, a slide mounted in said guide plate, a chin engaging element carried by said guide plate, a keeper plate pivoted upon said slide, an adjusting screw for said keeper plate and a tongue depressor carried by said keeper plate.
17. The combination with a frame, of clamping elements carried thereby arranged to engage above and below the lower jaw of a patient to positively clamp said frame to the jaw for bodily movement therewith, a support extending upwardly from said frame, a tongue depressor andmeans for detachably mounting said tongue depressor on said support.
18. The combination with a frame, of
clamping elements carried thereby arranged Y to engage above and below the lower jaw of a patient to positively clamp said frame to the jaw for bodily movement therewith, a j
support extending upwardly from said frame, a tongue depressor and means for detachably and pivotally mounting said I Copies of this patent may be obtained for five cents each, by addressing the Commissioner 01' Patents Washington, D. C.
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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3146776A (en) * 1960-05-24 1964-09-01 Duncan Robert Bruce Surgical instruments
US4064873A (en) * 1976-06-10 1977-12-27 Swenson Rudolph E Tongue blade for mouth gag
US4213451A (en) * 1978-08-21 1980-07-22 Swenson Rudolph E Tongue blade for mouth gag for adults

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3146776A (en) * 1960-05-24 1964-09-01 Duncan Robert Bruce Surgical instruments
US4064873A (en) * 1976-06-10 1977-12-27 Swenson Rudolph E Tongue blade for mouth gag
US4213451A (en) * 1978-08-21 1980-07-22 Swenson Rudolph E Tongue blade for mouth gag for adults

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