A text-book of the diseases of the ear and adjacent organs . g the airin the external meatus or of rarefying it only. Itsaction is more energetic than the ordinary Sieglespeculum, and is able by aspiration to replace anabnormally depressed membrane nearer to its properposition. In the normal state, during this method ofexamination, considerable movement of the mem-brana tympani is observed, greatest midway be-tween the malleus and the periphery. The moststriking sign of movement is the change in theform of the cone of light, which becomes con-siderably smaller during condensation. But onclose
A text-book of the diseases of the ear and adjacent organs . g the airin the external meatus or of rarefying it only. Itsaction is more energetic than the ordinary Sieglespeculum, and is able by aspiration to replace anabnormally depressed membrane nearer to its properposition. In the normal state, during this method ofexamination, considerable movement of the mem-brana tympani is observed, greatest midway be-tween the malleus and the periphery. The moststriking sign of movement is the change in theform of the cone of light, which becomes con-siderably smaller during condensation. But onclose inspection of the handle of the malleus a verydistinct movement of it is also visible, for duringcondensation either its inferior extremity movesdownwards and inwards, or the whole handle movesin this direction. This mobility of the handleof the malleus undergoes many changes in disease of the middle ear, beinglost either partially or completely by thickening and inflexibility of themembrana tympani, or by rigidity and anchylosis of the articulation of the. METHODS OF EXAMINATION OF THE MIDDLE EAR. 81 malleus and incus, or lastly, by abnormal adhesion of the head of the malleusto the adjacent walls of the tympanic cavity. As Siegle has mentioned, the pneumatic speculum is used withmost success in cases where it is required to ascertain whether themembrana tympani, through thickening of its layers, has decreasedmobility, or through atrophy and formation of cicatrices themobility is increased; and farther, if some of its parts be adherentto the inner wall of the tympanic cavity. The examination showsthat those portions of the membrane which are united with theopposite wall of the tympanic cavity remain unmoved during con-densation and rarefaction of air with this instrument, or make onlyslight excursions, while the portions which are not adherent exhibita distinct movement. The changes in the bloodvessels of the membrana tympani andin the external meatus during this mode of exami
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Keywords: ., bookcentury1800, bookdecade1890, booksubjecteardiseases, bookyear
