oval or round window but only on the front of the promontory. The result is the same if a dry or a wet pledget is used. Lucae explains this fact by the supposition that sound waves in absence of the drum pass through the promontory and the window in order to enter the labyrinth. Through this passage the sounds may be weakened. The wadding on the promontory wall retards interference, and the result is improvement in hearing. With a defective drum membrane, Lucae admits that the sound waves enter through the promontory.

As to Rinne's experiment, there is no doubt of its diagnostic value in ear disease. It does not lose in value even if one accepts with Zimmermann the difference between the two methods. Bezold (12) also recognized this difference, but according to him the experiment with the handle of the fork for tests with air must be different from those with the branches. If both are made to vibrate in the long diameter at the opening of the ear, the procedures are surely dissimilar. Bezold places the fork a1 first on the mastoid process, then brings the branches in front of the meatus until the vibrations have ceased, and inserts the handle in the auditory canal. The tuning-fork will then be heard twelve seconds more. The same is the case with all tuning-forks up to c2. Bezold believes that this meatus caused a resonance-space.

More extended research is still needed to settle the question. It does not detract from Helmholtz's credit if his theory has been amplified or modified.

Whilst this was in press a discussion of the work of Carlo Secchi (13), La finestra rotunda é la sola via dei suoni dall'aria al labyrinto, by Morpurgo, appeared in the Arch. f. Ohrenheilk., vol. lv., Nos. 3 and 4. From this it appeared that Secchi had already maintained in 1890, before the international congress at Berlin, that the only way sound could reach the labyrinth through the air of the drum cavity was through the round window. He has compared the middle ear with König's gas chamber, but Secchi had experimented only with air-chambers in air, whereas the experiments of

The latter are Secchi's experi

Kleinschmidt were performed under water. nearer the natural conditions than Secchi's. ments on animals are interesting, and they support his theory conclusively. He fastened a manometer in an opening in the bulla ossea of dogs and cats, and found that the tympanic air pressure was about 4mm of alcohol greater than that of the atmospheric air. Every note, even the slightest which caught the attention of the animal, raised the pressure in the drum cavity. The pressure was also elevated if vowels where spoken in the ear, more with a, e, and o than with i and u. Variations in the pressure was brought

about reflexly by the intrinsic muscles of the ear.'

He experimented in total defects by conduction notes from a tuning-fork through a pointed glass tube. The sounds appeared more intense at the round window than at the oval. The summary of his results is as follows: "From the consistent results of physical and physiological experiments and the clinical observations, I arrived at the conclusion that transmission of sound waves through the labyrinth takes place only through the air in the drum cavity. The drum membrane serves only on the one hand as a stopper, and on the other as a passive regulator of pressure. mastoid cells help to stop the phenomena or resonance just as the boxes in a theatre. The ossicles under the action of the intrinsic muscles regulate the intratympanic pressure during attentive hearing and protects the organ against detonations. During repose the pressure is regulated through the Eustachian tube."

The

Secchi's theory is imperfect, inasmuch as it does not admit of sound conduction through bone, for which there is unanswerable proof. Consequently the problem remains unsolved.

BIBLIOGRAPHY.

I. POLITZER, Lehrbuch der Ohrenheilkunde, 4th ed.

2.

3.

4.

ZIMMERMANN, Die Mechanik des Hörens und ihre Störungen, 1900. HELMHOLTZ, Die Mechanik der Gehörknöchelchen. Pflüger's Arch. POLITZER, Untersuchung über die Schallfortpflanzung und Schallleitung im Gehörorgane im gesunden und kranken Zustande. Arch. f. Ohrenheilk.

vol. i.

5. LUCAE, Untersuchungen Uber die sogenannte Knochenleitung und deren Verhältniss zur Schallfortpflanzung durch die Luft. Arch. f. Ohrenheilk., vol. i.

6. BECKMANN, Zur Theorie des Hörens. Verhandl, der deutsch, otol. Gesellschaft, 1898.

7. BEZOLD, Ueber die functionelle Prüfung des menschl. Gehörorgans, 1897.

8. LUCAE, Zwei physiologische acustische Vorträge. Arch, f. Ohrenheilk., vol. liv.

9. KLEINSCHMIDT, Ueber die Schallleitung zum Labyrinthe durch die derselben vorgelagerte Luftkammer (geschlossene Paukenhöhle). Zeitschr. f. Ohrenheilk., vol. xxxix.

10. DENNERT. Acustische Untersuchungen über Mittönen und die Helmholtz'sche Lehre von den Tonempfindungen.

II. KAISER, Ueber acustische Erscheinungen in flüssigen Medien. Zeitschr. f. Ohrenheilk., vol. xxxvii.

12.

BEZOLD, Eine Analyse des Rinne'schen Versuchs. Zeitschr. f. Ohrenheilk., vol. xxxvii.

13. SECCHI, La finestra rotunda é la sola via dei suoni dall'aria al labyrinto. Reviewed in Arch. f. Ohrenheilk., vol. 55, Nos. 3 and 4.

REPORT ON THE PROGRESS OF OTOLOGY DURING THE FIRST QUARTER OF THE

I.

YEAR 1903.

BY DR. ARTHUR HARTMANN.

Translated by Dr. ARNOLD Knapp,

ANATOMY OF THE EAR.

Souques et Heller.

Congenital facial paralysis from lack of development of the temporal bone. Arch, internat. d'otologie, etc., 1903, p. 170. 2. Apert. Congenital atrophy of the left auricle; malformation of the right auricle; facial asymmetry; deformity of the parietal bones; supplementary fontanelle. Arch, internat. d'otol., etc., 1903, p. 175.

3. Moutard-Martin. Malformation of the external ear. Arch, internat. d'otol., etc., 1903, p. 181.

4. Jurgens, E. On the external auditory meatus in children. Dissertation. St. Petersburg, 1903.

5.

Reitmann, Karl, cand. med. (Vienna). On the structure of the cartilage of the Eustachian tube in man. M. f. O., 1903, 2.

6. Haike, H., Berlin. On the anatomy of the carotid sinus (plexus venosus caroticus) and its relation to diseases of the ear. A. f. O., vol. lvii., p. 17. 7. Rubaschkin, W. (Petersburg). On the relation of the fifth nerve to the olfactory mucous membrane. Anatomischer Anzeiger, vol. xxii., 1903, pp. 407-415.

8. Hammar, J. Aug. On the development of the foregut and several of the adjoining organs. Part II. The development of the second pharyngeal fissure. Archiv f. mikr. Anat., 1902, vol. lxi., pp. 404-458.

9. Cohn, Franz. On the development of the olfactory organ in the chick. Archiv für mikroskopische Anatomie, 1902, vol. lxi., pp. 133-150.

10. Zuckerkandl, E. On the turbinal of the monotremes. Anatomischer Anzeiger, vol. xxi., 1902, pp. 386-391.

II. Berliner, Kurt. The development of the olfactory organ in the selachiae. Archiv für mikroskop. Anatomie, 1902, vol. lx., pp. 386-406.

I. A boy six years of age with bilateral rudimentary development of the external ear and right-sided facial paralysis. No

hearing examination was possible. Congenital bilateral hernia and monorchidia. The case is clinically analogous to the one described by Marfan and Armand Delille. The autopsy showed that the temporal bone consisted only of a small mass of bone, where the middle and internal ear as well as the facial trunk were absent. The authors believe that the same anatomical conditions exist in their patient, and explain the facial paralysis by the absence of the peripheric facial trunk.

2.

OPIKOFER.

Insufficient development of the auricles as well as flattening of the left face of a child, where hydramnion was found present in the mother. The developmental disturbance is regarded as the result of an unusually high intra-uterine pressure, which compressed the various parts of the foetus as well as the left half of the head and the left shoulder for a considerable length of time. OPIKOFER.

Rudimentary development of the left auricle, absence of the auditory meatus, left-sided deafness. Right ear normal. Similar to the preceding case, inasmuch as the left half of the face and of the skull were insufficiently developed, though a condition like hydramnion could not be discovered. OPIKOFER.

4. From his numerous and profound investigations the author comes to the following conclusions:

(1) In the first and second year the mastoid process is always compact.

(2) The squamoso-mastoidal suture is always patent up to the second year.

(3) The length of the drum membrane is not greater than the breadth, up to the fourth month. From the fourth month on, the length is greater than the breadth.

(4) The vertical and horizontal diameters of the auditory meatus do not change in the child proportionately in the various periods. Individual variations may occur.

(5) In all periods, of the four walls of the external meatus the lower one is always the longest; then comes the anterior; the posterior; and, as shortest, the upper.

(6) In the new-born there is no lumen in the auditory meatus. It is formed in the third month of extra-uterine life.

(7) There is a certain connection between the largest diameter of the external auditory meatus and the greatest diameter of the skull in the child.