. Diseases of the ear; a text-book for practitioners and students of medicine. is less disagree-able to the patient than a metallic instrument, while it is ofequal service to the examiner. An instrument constructed inthis manner can be introduced through a small perforation inthe membrana tympani, or into a sinus in front of or behind theshort process, and be carried into the upper part of the impressions resulting from the proper manipulation ofthe instrument afford valuable information. The mobility of the membrana and ossicles should be de-termined as the next step of the exa
. Diseases of the ear; a text-book for practitioners and students of medicine. is less disagree-able to the patient than a metallic instrument, while it is ofequal service to the examiner. An instrument constructed inthis manner can be introduced through a small perforation inthe membrana tympani, or into a sinus in front of or behind theshort process, and be carried into the upper part of the impressions resulting from the proper manipulation ofthe instrument afford valuable information. The mobility of the membrana and ossicles should be de-termined as the next step of the examination. This may be * Rev. mens, de laryngol., vol. x, p. Trans. Am. Otol. Society, 1872. THE PNEUMATIC SPECULUM. IOi done by making use of Siegles speculum (Fig. 42). It con-sists of a hard-rubber speculum, the wider extremity ofwhich is screwed tightly into one end of a short cylinder ofthe same material as the speculum, while the extremity in-troduced into the canal is covered with a small bit of rubbertubing to effect an air-tight closure of the meatus. The op-. Fig. 42.—Siegles pneumatic speculum. posite end of the cylinder is closed by a cap which makes anangle of forty-five degrees with the axis of the the centre of this cap is an opening covered with one side of this cylindrical chamber is an opening intowhich a short tube is screwed. The free extremity of the tubeis connected with a small air pump, bellows, or atomizer bulbby a short piece of flexible-rubber tubing. After the speculum has been carefully inserted into theexternal auditory meatus, the air in the canal can be exhaustedby means of the small air pump or rubber bulb with whichthe instrument is provided, or the flexible tube may be heldbetween the lips and the air withdrawn in this manner. Thedensity of the air in the meatus can be increased if desired byreversing the direction of the current. The glass in the outerextremity of the instrument permits the examiner to watch th
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