Report on ophthalmology and otology : delivered before the Illinois State Medical Society, at its Thirty-Second Anniversary Meeting, held at Quincy, May, 1882 / by A.E. Prince.

  • Prince, A. E. (Arthur E.)
Date:
1883
Catalogue details

Licence: Public Domain Mark

Credit: Report on ophthalmology and otology : delivered before the Illinois State Medical Society, at its Thirty-Second Anniversary Meeting, held at Quincy, May, 1882 / by A.E. Prince. 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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    rob the operation of half its power to benefit mankind. In the first place, the physician is not provided with the instru- ments ; in the second place, if he had the instruments, the pa- tient is remote from the office, and the instruments are not at hand when the operation .should be performed ; and in the third place, the patient may be a crying, restless child, with perhaps a narrow or swollen meatus, and the conditions would be unfavorable for the use of light and specula if they were at hand. Hence, with the belief that these are essential in performing the operation, it is in but a small minority of the cases that the physician could avail himself of its benefi- cent effects. We here need an CEdipus to assist us in solving the riddle, by presenting the relations of the four essential parts concerned in the mechanical execution of the operation. This will enable us to see what parts are vulnerable and what are impregnable. These four parts concerned are : 1st, the drum membrane with the manubrium reaching from above down to about its centre; 2d, the chorda-tympani nerve which skirts the tympanic cavity opposite the upper fifth of the membrana-tympani ; 3d, the fenestra-ovalis, occupied by the base of the stapes, which lies so high in the tympanic cavity that if we conceive the external auditory-meatus to be continued directly inwards, it would be entirely below the location of this foramen ; 4th, the fenestra- rotunda looking backwards and outwards, and lying behind the promontory, and so protected by it, that if an instrument were to be passed into the middle ear, following the direction of the external meatus, its situation would protect it from the possi- bility of injury. It therefore appears that nature has so dis- posed the essentia] parts of the organ of hearing (as is amply illustrated in the general disposition of those structures in other regions, which are most tender and delicate and liable to injury)