An indirect laryngoscope (because the larynx was not seen directly, but indirectly through the reflection of a mirror). The gag reflex would be suppressed using crushed ice (after 1884 cocaine spray was used as a local anaesthetic). The bottom blade of the speculum would hold down the tongue whilst the top blade would be positioned against the soft palate so that a light source would illuminate the mirror. In turn the mirror would reflect back a view of the larynx and glottis. The first laryngoscope was attributed to Manuel Garcia (a Spanish singing professor) in 1854. It was quickly adopted by the medical profession; initially Ludwik Turk in Vienna, Czermak in Budapest and in England Morell Mackenzie pioneered the development of laryngology. This rare French example signed Mathieu Paris (Brevete) probably dates to the last 1/4 of the 19th century