Lectures on diseases and injuries of the ear : delivered at St. George's Hospital / by W.B. Dalby.

  • William Bartlett Dalby
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on diseases and injuries of the ear : delivered at St. George's Hospital / by W.B. Dalby. Source: Wellcome Collection.

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    tlie speculum be made of silver or vulcanite : tlie latter kind, perhaps^ from tlie contrast in colour, ren- ders slight changes in this respect on the tympanic membrane more strongly marked; but unless the meatus is of a fair average calibre the silver speculum will give the better view, as it does not occupy so much space in the canal. Both kinds remain in the ear without holding. With regard to the specula which are made to dilate with a screw, and the specu- lum of Kramer, which opens out with handles after it has been introduced, it is idle to suppose that the meatus under ordinary circumstances will admit of dilatation, and therefore for general occasions they are useless. There are some cases where Ea'amer's specu- lum may be serviceable, and these are those in- which the tragus is situated in a more advanced position than natural, and the anterior and posterior boundaries of the cartilaginous part approximated more than usual, giving rise (to a narrowing of this part, so that the orifice is more like a slit than the ordinary shape. But these are exceptional instances; and, speaking generally, the object in using a speculum is, not to dilate, but to make a straight tunnel for light, and as the tunnel can be moved about, a complete view of the meatus and the tympanic membrane can in this way be obtained. In introducing a speculum into the ear the auricle should be pidled upwards by the left hand, as this will raise the external moveable part of the meatus to a level with the rest of it. I call your attention to the necessity of exercising great gentleness in using the
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