Manual of diseases of the ear : including those of the nose and throat in relation to the ear : for the use of students and practitioners of medicine / by Thomas Barr and J. Stoddart Barr.

  • Barr, Thomas, 1846-1916
Date:
1909
Catalogue details

Licence: In copyright

Credit: Manual of diseases of the ear : including those of the nose and throat in relation to the ear : for the use of students and practitioners of medicine / by Thomas Barr and J. Stoddart Barr. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    xxi.] DIAGNOSIS OF TOTAL DEAFNESS IN A CHILD. examination pathological states of the tympanic membrane, such as chalky deposits, indrawn membrane, cicatrices, or even perforations. These are in most cases merely accidental, having nothing to do with the serious deafness, the causes of which are more deeply seated. After the first year, it is generally possible to determine whether or not marked deafness exists. The mother’s anxiety is aroused by tlic delay of the child in beginning to speak, and by its inattention to loud sounds produced in its neighbourhood. Suspicion being excited, the child should be tested in various ways. While its eyes are turned away from the source of sound, a bell or whistle is sounded, or the hands are clapped, or vowel sounds are loudly pronounced. If the attention of the child is not excited, as shown by the head not being turned round towards the source of the sound, it may be concluded that there exists no actual power of perceiving sound. It is well that such tests should also be applied by the parents at home. In testing the child’s power of hearing a tuning-fork we should first apply it to the forehead or near the ear, while it is silent, when the child’s features will probably remain impassive; but if applied afterwards while vibrating, the child’s smile, or cry of surprise will inform us that he hears the sounding-fork. In this way we may generally ascertain if a tuning-fork is heard by a child over two years of age. Testing with an extensive series of tuning- forks ranging from the lowest to the highest notes may, in children of sufficient age, demonstrate at certain places in the scale islands of hearing, with, at other places, gaps of no hearing. Some modicum of hearing is possessed by a large number of deaf- mutes, probably by 7 5 per cent. Bezold found in 276 ears of deaf-mutes tested by him only 79 absolutely deaf. Loud, sharp sounds are most frequently heard, or the loud pronunciation close to the ear of vowel sounds. In a smaller number complete words are heard when shouted loudly into the ear. The use of the hearing tube may be in these cases of great service, and should be utilized in the instruction of deaf- mutes in articulate speech. Without Training or Education, deaf-mutes are apt to become violent and possessed of little self-restraint. Their tempers are often ungovernable, and their passions uncontrolled. The prognosis of the deafness in deaf-mutism is very unfavourable. If the middle ear be diseased, suitable treatment may improve the hearing. In Politzer’s experience deaf-mutism from congenital causes is more hopeful than total deafness, if acquired He has seen a number of cases of total deafness, of a congenital nature, during the first few years of life, in which ultimately partial, and in one case complete, hearing existed. The writer has not seen a single case of improvement in cases due to cerebro-spinal meningitis, probably the most frequent cause of the acquired form.