A text-book of the diseases of the ear and adjacent organs . h larger and lighter in its colour, the latterbeing modified as above described (v. p. 76). Pneumatic Speculum. — To the above-mentioned methods ofexamining the membrana tympani must be added that with thepneumatic speculum, a method most important for the diagnosisof affections of the middle ear, and by the invention of whichSiegle {Deutsche Klinik, 1864) has won everlasting fame. Thisinstrument (Fig. 71) differs from the ordinary speculum in havingits outer end closed by an obliquely-inserted plate of glass—whichmust be inserted as
A text-book of the diseases of the ear and adjacent organs . h larger and lighter in its colour, the latterbeing modified as above described (v. p. 76). Pneumatic Speculum. — To the above-mentioned methods ofexamining the membrana tympani must be added that with thepneumatic speculum, a method most important for the diagnosisof affections of the middle ear, and by the invention of whichSiegle {Deutsche Klinik, 1864) has won everlasting fame. Thisinstrument (Fig. 71) differs from the ordinary speculum in havingits outer end closed by an obliquely-inserted plate of glass—whichmust be inserted as far as possible into the speculum so as to avoidthe disturbing effect of reflected rays of light—and a small nippleprojecting from its side, to which is fastened an india-rubber tubefurnished with a small balloon. By means of an olive-shaped nozzle 80 PNEUMATIC SPECULUM. (Delstanche, Fig. 72), or by putting a small piece of india-rubbertubing on the nozzle (of which it has three sizes), the instrumentcan be hermetically fixed in the external To examine the membrane, the speculum, inserted into the meatus, isfixed with the left hand, so that reflection from the glass plate does not interfere with theexamination. Thenthe membrana tym-pani is illuminatedby means of theconcave mirror, andthe air in the ex-ternal meatus is alternately condensed and rarefiedby the balloon, by compressing it slightly with twofingers of the right hand, quickly releasing it aftereach pressure. Condensation of air by blowing intothe speculum with the mouth is unsuitable, as theinner surface of the glass is dimmed by the con-densed breath. In place of the small balloon one can use the rarefacteur invented by Charles Delstanche (), which is provided with a double valve. It isused with the Siegle speculum as well for diagnosticas therapeutical purposes, and has the advantage,according to the direction of the stopcock A, ofeither alternately condensing and rarefying the airin the extern
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Keywords: ., bookcentury1800, bookdecade1890, booksubjecteardiseases, bookyear
