Controversy on the artificial tympanum / by James Yearsley.

  • James Yearsley
Date:
1858
Catalogue details

Licence: Public Domain Mark

Credit: Controversy on the artificial tympanum / by James Yearsley. Source: Wellcome Collection.

    18/32 page 18
    To aid in the solution of the question, therefore, I have addressed a note of inquiry to a few of my patients, and here append their replies.* I cannot help being amused at the challenge now offered by Mr Toynbee to settle the points in dispute between us in a society of medical men, when it is remembered how he ig¬ nored a similar challenge emanating from myself, which appeared in the ‘ Medical Times and Gazette ’ so far back as June, 1857, page 576, in the following words:—“Not only with respect to this question of a closed or open cavity should unanimity prevail, but also as to the best material or appliance to be used. Of the preference to be given to the cotton-wool I am quite assured—others may differ with me. I am willing, therefore, and indeed desirous, to submit the matter to any competent tribunal of medical men or commission of inquiry, to decide these questions.” Mr Toynbee has favoured the readers of the i Medical Times and Gazette ’ with his explanation of the modus operandi of the cotton-wool when successfully applied. He says:—“ The water in the interstices of the cotton fibres acts as the succes- ful air-bubble did in my own patients, by receiving the sono¬ rous vibrations, conducting them to the air in the tympanic cavity, and confining them there for concentration on the membrana fenestrae rotundas.” On the contrary, I contend that one of the chief ends obtained by the presence of the cotton, is, firstly, to rupture the air-bubble (indicated to the patient by a distinct click, and which may be heard by a bystander); and, secondly, to prevent the re-formation of bubbles of air in the discharge in and around the perforated membrane. It was by breaking this bubble of air that my patient from New York effected temporary improvements in his hearing. It is by the same means that patients with per¬ forated tympana can improve their hearing for a few minutes, and sometimes for a longer time, by forcing air up the Eus¬ tachian tube and through the perforated membrane. In short, this said bubble of air is another difficulty in the way of Mr Toynbee’s theory of the closed cavity. I find in practice, that when in applying the cotton I produce a click, success is instantly attained. Mr Toynbee would have it supposed that there are not many difficulties in applying the cotton or artificial tympanum to an ordinary case. Such has not been my experience, and I must still maintain that those patients will always fare best who have had the advantage of skilful and experienced teach-
    No text description is available for this image
    No text description is available for this image
    No text description is available for this image