Diagnosis and treatment of ear diseases . the same position as that which the drum-mem-brane should occupy. Its edges merged imperceptibly into the surround-ing tissues. There were no landmarks of any kind by means of which Imight decide whether this membranous structure was a remnant of themembrana tympani, or a membranous transformation of newly formed in-flammatory tissue. Its situation certainly favored the former view. Thehearing-power in the L. ear was fair. Absence of the hammer.—In examining the ear of a patient at the NewYork Eye and Ear Infirmary, I was very much surprised to find th
Diagnosis and treatment of ear diseases . the same position as that which the drum-mem-brane should occupy. Its edges merged imperceptibly into the surround-ing tissues. There were no landmarks of any kind by means of which Imight decide whether this membranous structure was a remnant of themembrana tympani, or a membranous transformation of newly formed in-flammatory tissue. Its situation certainly favored the former view. Thehearing-power in the L. ear was fair. Absence of the hammer.—In examining the ear of a patient at the NewYork Eye and Ear Infirmary, I was very much surprised to find that thedrum-membrane, which seemed to be perfectly constructed in all other re-spects, totally lacked its manubrium mallei. On questioning the man, Iascertained that about four years previously an operation had been per-formed (under chloroform) on that ear, but that it had failed to relieve himof his deafness. From this statement, and from the condition observed, Idrew the inference that excision of the entire hammer had probably been. DISEASES OF THE EAR. 373 performed. In this case I searched very carefully for a cicatricial regionin the location which the manubrium should occupy, but I failed to findthe slightest difference between this portion of the membrane and the sur-rounding portions. Hook-shaped manubrium mallei.—The peculiar deformity observed in thefollowing case was probably of congenital origin. The patient, a boy thir-teen years of age, was admitted to the New York Eye and Ear Infirmary onthe 15th of May, 1872. When three years old he had passed through anattack of scarlet fever, which left him with a doubleotorrhcea. On the right side the discharge had contin-ued up to that time without interruption ; on the leftit had entirely ceased about one year previously. Onexamination I found the end of the handle of the ham-mer, on the left side, curved from behind forward, inthe manner shown in the accompanying cut. The mem-brane itself was opaque and somewhat mottl
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