complex of Bezold-shortening of the lower tone-limit, prolongation of bone-conduction, negative Rinne. The cases where this clinical picture was present have at autopsy always confirmed the diagnosis.

In regard to the treatment the author thinks that all local treatment, from the simple Politzer douche to extraction of the stapes, has given such poor results that its employment cannot be recommended, especially as the condition has been made worse by treatment in some of the cases. The very annoying subjective noises in some cases where other means have failed have been favorably influenced by electromotor massage of the drum-membrane and even caused to disappear for a greater or shorter length of time.

2. PANSE demonstrated microscopic specimens and drawings of cases which had been examined functionally and of the ears of two deaf-mutes.

3. BEZOLD: The hearing examination with tuning-forks in unilateral deafness and the deductions which can be drawn therefrom for bone-conduction and the function of the soundconducting apparatus.

Bezold showed six years ago that the hearing remnants found in cases where the labyrinth had been destroyed on one side were an exact picture of the hearing of the other ear, which could not be excluded in examining the upper portion of the tone scale.

As this picture is a definite reproduction of the hearing of the other ear, the diagnosis of one-sided deafness no longer causes any difficulty. The author described the result of examining the patient with a defective labyrinth on one side with a continuous tone-series to show the presence of a direct bone-conduction of air sound-waves through the bone to the labyrinth, and concludes that such a direct conduction does not exist, and that there is no hearing for the lower half of the tone scale without a tympanic membrane and an ossicular chain, and that in the case of the upper part of the scale the sound waves are transmitted to the labyrinth by vibrations of stapedial foot-plate.

4. WANNER Spoke on the functional examination in labyrinth necrosis and one-sided deafness, a contribution to the diagnosis of labyrinth suppuration and one-sided deafness.

The report consists of 27 functional examinations of 22 patients. In 50% of the cases labyrinth-suppuration was the cause

of one-sided deafness. In 2 a labyrinth-sequestrum had been exfoliated. In the other II cases primary disease of the inner ear was present in 3.

The hearing charts of the two cases of labyrinth-necrosis were described. In one of these, in which the other side was perfectly normal, the continuous increase of the hearing perception, from the lowest to the highest tones which are perceived by the deaf ear, was present, as has already been described by Bezold in labyrinth necrosis. The lower tone-limit was d sharp, the first unloaded tuning-fork to be perceived was c; then the hearing perception for the various tones diminished.

A similar condition was found in the second case. Though corresponding to the defect in the hearing ear, the hearing perceptions on the deaf side were in general very much shortened.

The average of the hearing charts in six cases was demonstrated where, according to the tests of Lucae-Dennert, one ear was deaf for speech and the other ear was practically normal. This average agrees with the conditions found in the aforementioned first case, and the function of this ear, deaf for speech, was completely destroyed. The amount of hearing perceived by a deaf ear depends upon the hearing ear. This is especially well shown in cases where the hearing ear presents large defects. The diagnosis of one-sided deafness can be made when

(1) In the examination of the hearing duration the above-described continuously ascending condition from the lowest to the highest perceived note is present, and when by marked diminution for some tones on the hearing ear a corresponding diminution or absence is found for the deaf ear.

(2) For the case when the middle tone of the scale a' of 435 double vibrations is no longer perceived per air.

(3) When the voice is not perceived or, as in the Lucae-Dennert test, the hearing is the same when both ears are closed as when the deaf ear alone is open.

(4) When the lower tone-limit is situated in the small octave or in its neighborhood, though never lower than d sharp.

(5) When Weber's test with A and a is transmitted to the healthy ear; and

(6) When Schwabach's test is abbreviated.

5. LUCAE: On the relation of tone hearing to speech hearing. The following case confirms the recently published observation of the author that perception of the most important

musical tones is only of value to voice hearing when these are perceived as such and not as noises :

A musical man, twenty-six years old and otherwise healthy, was always hard of hearing on his right ear, and seven years ago after a cold bath lost the hearing for voice on his left ear with constant tinnitus. Objective condition of both ears was negative.

Right: whisper at ear fork c per air; fork per bone = 18; c air = 8; c', c', c', and c were perceived as musical tones; C and contra G uncertain whether as noises or not.

Left: loud voice heard as individual sound; air; not determinable on account of tinnitus. All tones from to cas tinnitus: C and contra G not perceived.

The unquestionable labyrinth disease was treated with a pilocarpine cure; whisper on right side improved, numbers were heard at 0.6m. The right ear was treated with the pressure probe for four months. Then whisper in 2m; c bone=1; c air=18; but cunchanged. The improvement after treatment with the pressure probe is explained by the presence of an associated rightsided disease of the sound-conducting apparatus. To support this a case is cited where with a positive Rinne the autopsy showed a diminished mobility of the stapes from rigidity of the annular ligament.

6. OSTMANN: On the amplitudes of Edelmann's C and G forks as objective, uniform hearing measure.

All investigators who have examined the objective, uniform hearing measure have found it essential to determine experimentally the curves of cessation of the unloaded C and G forks from the large to the 4-crossed octave.

Ostmann has succeeded in solving this problem for the latest Edelmann's forks and so that those amplitudes not directly examined could be determined by interpellation.

The curves of cessation of the forks C, G, c, g, could be measured to the point of the threshold value, but in the higher forks a part of the curves were unmeasurable on account of the smallness of the amplitudes. With aid of the law of the normal threshold values, these curves could be completed to the point of normal amplitude, and thus the question was completely solved.

The curves of cessation were demonstrated on an enlarged scale, 40:5000 to 1. By means of these curves, tables of amplitude and hearing tests for the forks C, G, c, g, c', g', c2, c3, c', could be

made, which gave for every second of the cessation: (1) the extent of the amplitude; (2) the extent by which the amplitude diminishes compared to that of the preceding second; (3) the number of normal amplitudes contained in the amplitude.

The last statement permits the objective measure of the hearing power of the diseased as compared to the normal ear. The table also permits the representation of the hearing of the diseased ear as a part of the normal hearing, as the hearing power is inversely to the squares of the amplitudes.

7. BENNINGHAUS. A study of sound conduction based on the anatomy of the ear of the whale.

DISCUSSION TO THE PRECEDING SEVEN PAPERS.

HINSBERG: Histological examination of infected labyrinths has shown an uneven distribution of the morbid disease, so that it is not unusual that a labyrinth infection does not lead to complete deafness. The presence of hearing islands in deaf-mutes also speaks for this.

KUEMMEL maintains that in stapes anchylosis the local cause should be inquired into—that is, venous stasis in the tympanic cavity.

KRETSCHMANN found in persons suffering from sclerosis the specific gravity of the urine to be increased, with an absence of sugar and albumin.

ESCHWEILER reported on the hearing examination in one case of unilateral deafness. On closing the healthy ear, the lower tone-limit descended from a sharp to d' sharp.

SIEBENMANN says in 100 ear patients there is I suffering from stapes anchylosis; the drum membrane in most cases is unchanged; the redness of the labyrinth wall shines through in the region of the oval window.

SCHEIBE: According to statistics, sclerosis occurs more frequently in women than in men. On the other hand, middle-ear disease in general attacks the male more frequently. The cause for stapes anchylosis is not yet known. He would like to ask Siebenmann what the results of his treatment with phosphorus have been.

SIEBENMANN replied that about 50% of his patients had been treated with phosphorus. The result with regard to diminution of hearing had been a very satisfactory one. The dose is 2 X 10g

of the Kassowitz solution or 2 X 1g of an oily solution, and must be continued for from 2 to 3 years.

PANSE found osteophytes in the tympanum during the puerperium; variations in hearing may be produced by changeable thickenings of the membrane of the round window.

BLOCH found stapes anchylosis combined with a labyrinth affection in most cases. Occasionally the labyrinth affection is bilateral and the stapes anchylosis is only on one side, which speaks for primary disease of the labyrinth capsule.

SPORLEDER gives phosphorus in larger doses, viz., of 0.02-0.025: 100.0 solution (dose 2 to 3 teaspoons). He reports a very favorable case.

MANASSE has examined microscopically 13 temporal bones with chronic progressive deafness, and found in 2 anchylosis from calcification of the labyrinth capsule; in 8 the labyrinth was atrophied.

8. MOXTER presented a patient suffering from a very severe middle-ear tuberculosis. The patient was forty-five years old and at the operation the bone was found destroyed up to the sinus and the dura, with facial paralysis. Recovery took place after a radical operation and the application of concentrated solutions of chloride of zinc. The facial paralysis disappeared. Discussion. KIRCHNER has had favorable results with a similar treatment.

9. SCHEIBE: Deafness in furuncle of the auditory canal. In furuncle of the canal, deafness may be produced either by occlusion of the lumen or by patent lumen through collateral œdema of the tympanum. This form of deafness in furuncle is not at all rare, though often not recognized. Scheibe has observed 304 cases of furuncle; in these the hearing was tested of 149 cases. Of these, 64 heard not quite normally. In one-half, the hearing distance for whisper was 3 to 6m; in one-quarter, to 3m; and in the remaining one-quarter, underm. The greatest diminution in previously normal hearing was whisper in 20 cm.

The lower tone-limit, bone-conduction, and Rinne's test are similar to acute middle-ear inflammation. On catheterization, the air enters the middle-ear without any râles and the hearing is decidedly improved. Prognosis is favorable.

Discussion.-JOEL believes that the above-described symptoms are those of a simple ear-catarrh.

10. SIEBENMANN brings a contribution on congenital labyrinth anomalies. The specimens are very similar to those of