The diseases of the ear and their treatment . ecutive tests. Forthe purpose of understanding the scheme better, the number ofseconds has always been given during which a tuning-fork has beenheard. The different diseases of the ear have a variable effect uponthe perception of the tones of the tuning-fork. According to theresults obtained there are four distinct types :— 1 Die graphische Darstellung der Resultate der Hörprüfung mit Stimmgabeln,Deutsche medicinische Wochenschrift, No. 15, 1S85. TESTING THE HEARING. 3i Type I. Approximately uniform diminution of the duration ofperception by air-co
The diseases of the ear and their treatment . ecutive tests. Forthe purpose of understanding the scheme better, the number ofseconds has always been given during which a tuning-fork has beenheard. The different diseases of the ear have a variable effect uponthe perception of the tones of the tuning-fork. According to theresults obtained there are four distinct types :— 1 Die graphische Darstellung der Resultate der Hörprüfung mit Stimmgabeln,Deutsche medicinische Wochenschrift, No. 15, 1S85. TESTING THE HEARING. 3i Type I. Approximately uniform diminution of the duration ofperception by air-conduction. Good hearing by type is to be met with in acute and chronic processes in themiddle ear. Figure 13 is the record of a patient who had sufferedfrom purulent inflammation of the middle ear on both sides. Theleft membrana tympani was totally destroyed ; in the anterior partof the right membrane, a milk-white opacity was present, of the sizeof a hemp-seed, as also a cicatricial adhesion to the promontory. 1. Fig. 13. Fig. 14. Type II. The low tones heard badly, but as the tones becomehigher the perception improves. Hearing better by bone-con-duction than by air-conduction, especially low tones. This con-dition is due to pathological processes, which lead us to suspectan anchylosis of the stapes in the fenestra ovalis, the result ofpurulent inflammation of the middle ear, and of sclerosis. 32 TESTING THE HEARING. Figure 14 represents the hearing power of a female patient whohad suffered, years previously, from purulent inflammation of themiddle ear as a sequela of scarlet fever. The perception throughthe cranial bones being good, it may be assumed that the nervewas not affected by the disease. Type III. Good perception of the low tones, and diminishedperception as the tones rise in pitch. Bone-conduction diminished,especially as regards high tones. This kind of perception we findin boilermakers, artillerymen, and in diseased conditions of thene
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