A system of surgery : theoretical and practical . pparatus which do not admit of so precise a definition ;for, although in many diseases it happens that at first only one portion of the ear isafiected, in the later stages of some afiections two, and sometimes the three, divisionsbecome involved in turn. This observation will be found to be true in the case ofpolypus and other morbid growths, acute inflammations which accompany the exan-thematous fevers, disease of the temporal bone, syphilitic aflfections, and others whichmight be enumerated. Examination of the Ear. For a complete examination
A system of surgery : theoretical and practical . pparatus which do not admit of so precise a definition ;for, although in many diseases it happens that at first only one portion of the ear isafiected, in the later stages of some afiections two, and sometimes the three, divisionsbecome involved in turn. This observation will be found to be true in the case ofpolypus and other morbid growths, acute inflammations which accompany the exan-thematous fevers, disease of the temporal bone, syphilitic aflfections, and others whichmight be enumerated. Examination of the Ear. For a complete examination of the ear it is necessary that a thieefold methodshould be employed. In the first part, the external canal and tympanic membraneare brought under observation; in the second, the degi-ee of patency or obstructionof the Eustachian tube, and the normal or undue secretion within the tympanum, areestimated ; by the third, abnormalities in the conduction or perception of sonoiousvibrations are determined. Fig. 6.—Hand-mirror. Fie. 7.—Ear It is agreed amongst all piactised observers that the external canal and tympanicmembrane can be most satisfactorily examined by i-eflecting light from a concaveperforated hand-mirror of eight-inch focus down a funnel-shaped speculum of thekind known as Grubers; owing to the gi-eat variety in the calibre of the meatus,several sizes should be at hand. The patient, who must be seated close to a window,should have his head turned away from the II. K 130 AND INJURIES OF THE EAR. The speculum being then introduced, by moving it gently in different directionsevery part of the canal and membrane may be brought into view. Such movementsare necessary on account of the curvature of the meatus, which winds at first a littledownwards, then backwards, and slightly upwards, as far as the middle portion,beyond which it curves downwards until the tympanic membrane is reached. If any manipulation or operative proceeding is required
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