A probationary essay on the special pathology of the accessory organs of hearing : submitted ... to the examination of the Royal College of Surgeons of Edinburgh ... for admission ... / by James Mercer.

Date:
1840
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Licence: Public Domain Mark

Credit: A probationary essay on the special pathology of the accessory organs of hearing : submitted ... to the examination of the Royal College of Surgeons of Edinburgh ... for admission ... / by James Mercer. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    companied by an audible gurgling noise, during the first part of its passage to the membrana tympani, and followed by an agreeable sensation of relief to the ear, a diminution of the tinnitus, and a material improvement in the power of hearing. Sometimes the stream of air does not at first enter the ear at all, and in spite of the greatest attention, no noise is heard in the ear, and no alleviation or alteration in the symptoms perceived, till after repeated sittings. Small bubbles of air are at length heard to enter the tympanum, then a fine shrill sounding stream of air, which gradually becomes larger and fuller ; and exactly in proportion as it does so, it is accompanied by increased alleviation of all the complaints, including the dulness of hearing. Kramer is of opinion, and I think rightly, that the number of un- successful sittings should be limited to four, for, says he, if, after the fourth sitting, no distinctly audible stream of air makes its way to the membrana tympani, and no per- ceptible improvement in the hearing takes place, there exists a structure or obliteration of the Eiistachian tube, which requh-es another mode of treatment.' When such a state of parts exists, so that no air can be made to pass up to the membrani tympani, it has been proposed to dilate the canal by the use of sponge-tents and bougies, either of catgut or silver. The use of sponge-tents was first proposed by Deleau; and the reporters on his work to the French Academy, viz. Majendie, Percy, Pelletan, and Savart, state confident- ly, that they had no doubt of Deleau being able to intro- duce these, along the Eustachian tube, though they had never seen it done. Yet, however high the authority of these re- spected names are, when the extreme narrowness of the canal, its hidden situation, its distance from the surface of the body, and the comparatively incompressible nature of its walls are considered, this mode of procedure appears to me extremely difficult, if not almost impossible. The catgut bougie, or a silver wire with a bulbous extremity,