Contributions to aural surgery. Pt. III. Inflammatory affections of the membrana tympani and middle ear / by W.R. Wilde.

  • Wilde, William Robert Willis, 1815-1876.
Date:
1848
Catalogue details

Licence: Public Domain Mark

Credit: Contributions to aural surgery. Pt. III. Inflammatory affections of the membrana tympani and middle ear / by W.R. Wilde. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    some remarks, in the hope of putting a stop to practices not only useless, but in some cases highly injurious. I allude to the common resort of syringing, and also of probing the ears indiscriminately, and without proper inspection of the parts. The former is of daily occurrence. A patient labouring under deafness, or, what perhaps is worse, violent pain in the ear, is examined either with the unassisted eye, or by means of some of the old divaricating specula, most probably in a badly- lighted apartment,—at all events, without the membrana tym- pani being brought into view, a dark cavity being all that the explorer has been able to perceive,—it is deemed advisable to try what might come out by squirting hot water into this dark passage for the ensuing quarter of an hour; but, nothing satis- factory following this operation, the diagnosis that there is no wax in the ear is accordingly made. Now, there may be a col- lection of cerumen, which may not be got rid of by this opera- tion ; while, if the cause of the pain or deafness is owing to an inflammatory condition of the auditory canal and its mem- branous extremity, a decided increase of the symptoms is pro- duced by this unnecessary and cruel proceeding. Again, I have frequently seen inflammation produced by unnecessarily syringing an ear where no wax was present. The practice of exploring an ear by means of a probe I cannot too strongly condemn, and yet that it is frequently resorted to surgeons are well aware. To introduce a probe down to the membrana tympani, without having that mem- brane fairly within view, and without a speculum being passed down to it, but merely for the purpose of satisfying the ex- aminer as to Avhether the membrane is perforate or not, is, I tliink, a most unjustifiable proceeding. The degree of deafness may be measured by holding an ordinary watch near the external meatus, and the distance at which the tickings can be accurately counted, and at which the patient is conscious of an interval between these sounds should be recorded. To effect this properly the watch should be ap- proached gradually to the ear till it. gets within the hearing
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