The use of Billing’s Tonsillotome requires but one hand. The middle and index fingers are placed in the double rings of the lower shank, the thumb into the ring of the blade. The blade moves along grooves in the lower shank. The operator draws the blade back to open the aperture and seizing forceps to receive the tonsil. Once the tonsil is in place, the blade is pushed home by the thumb, this transects the tonsil whilst the forceps secures the excised part. The closing movement of the forceps is automatic.