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conservative and only advised this operation when absolutely necessary.
Dr. McKERNON thought that hearing after radical operation at first was apt to be very much better than it was a year later.
Dr. WHITING spoke of a case presenting a perforation above the short process with symptoms of retention. The patient desired the least radical treatment, but he would not agree to it and performed the radical operation. He found the incus entirely gone, the aditus widened, the tegmen antri absent, and the antrum extending downward into a large granulating cavity almost as far as the tip.
Dr. GRUENING thought that defect of the tegmen antri and the presence of granulations in the dura in this region were not at all infrequent, and thought that in these cases we must remember that the site of the disease is in the antrum and not in the ossicles, and consequently the removal of the ossicles would not be sufficient to cure the patient.
Dr. DENCH thought the ossicles could be removed just as carefully and with as little damage through the posterior opening as through the canal.
Dr. Duel thought removal of the ossicles furnished a better drainage for the cavities, and should be done for this purpose where there was evidence of necrosis of the attic walls, even though there was no necrosis of the ossicles themselves.
Dr. McKERNON spoke of 14 cases where he had performed an atypical operation, namely, draining the middle ear through the posterior opening. He had had excellent results in 11 of these.
Dr. Whiting had performed this method but had given it up on account of subsequent atresia of the canal.
Dr. McKERNON thought this was due to the fact that the fibro-cartilaginous part of the canal had not been completely detached, as he had had only one case of atresia.
Dr. Duel presented an aural snare which had been introduced by Dr. Oatman ten years ago and described at that time in the Medical Record. The advantage was that the ends of the wire were held down by two eccentric levers so the wire could be shortened at will.
Dr. WHITING spoke of an instrument which he had described and called the encephaloscope, which he thought of great advantage in brain abscesses and thought it was entitled to greater use. He described two brain abscesses which he had recently
operated upon where he had been very much helped in the after treatment by this instrument. The first was an acute abscess. On spreading open the walls of the abscess it was possible to survey the entire lining of the cavity and to see that there was no dense fibrous membrane and that the brain substance everywhere was shut off by very thin, pink granulations. He thought in this case irrigating would have forced the pyogenic material into the neighboring brain structure, and as there was no dense 'resisting membrane he drained the entire cavity by the insertion of a single wick of iodoform gauze, the walls collapsed completely, and the patient recovered. In the second case the abscess was chronic, and on examination with the encephaloscope the walls were everywhere found to be dense and fibrous and covered with pus. He inserted a single drain, but this did not do well, and shortly after he filled the cavity with iodoform gauze.
This had as a result change of the entire healing process, and at present the wound is healing well.
REPORT ON THE PROGRESS OF OTOLOGY DURING THE SECOND QUARTER OF
THE YEAR 1902.
BY DR. A. HARTMANN.
Translated by ARNOLD KNAPP, M.D.
65. Anton. Studies on the distribution of lymphatic tissue in the Eustachian tube and in the tympanum in the foetus, in the newly born, and in the child. Zeitschr. f. Heilk., vol. xxii., No. 7.
66. Rozier. The floor of the tympanum. Ann, des mal. de l'or., du lar., No. 4, 1902.
67. Denker. On the anatomy of the hearing organ in the cetacea. Anat, Hefte, vol. xix., No. 2, 1902.
68. Ramon y Cajal. The termination of the external lemniscus in the secondary acoustic nerve tract. Deutsche med. Wochenschr., No. 16, 1902.
69. Mangakis. A case of Jacobson's organ in man. Anatomischer Anzeiger, vol. xxi., pp. 106-109.
70. Hinsberg. The development of the nasal cavities in the amphibia. Part III., Gymnophions. Arch. f. mikrosk. Anatomie, vol. lx., pp. 369-385.
71. Peter. The plan and homology of the turbinals in man and in the vertebrates. Arch. f. mikrosk. Anat., vol. lx., pp. 339-367.
65. The author has investigated this question macroscopically and microscopically in serial sections. The material studied consisted of 3 foetuses, 6 newly born children, 10 children of one year, and 16 children from 1 to 10 years of age. The entire extent of the Eustachian tube was examined and it was found that adenoid tissue shows a certain constancy both in amount and in form in the tubes of the fætus, the newly born, and the child. In the foetus lymphatic tissue is absent in the tube ; in the newly born it is usually present; in children it increases up to the second year and then appears to diminish. In the newly born it appears as a cellular infiltrate of the striated fascia ; in the first
year as a ring-formed zone of infiltration at the pharyngeal end, and an infiltration in the shape of folds at the tympanic end of the tube. Between the first and the tenth year there is a uniform and complete infiltration of the folds which project into the lumen of the tube. Occasionally in the pharyngeal segment lymph follicles are present. A correlation between the pharyngeal tonsil and the lymphatic tissue of the tube may exist, but is not regularly present. The system of folds at the tympanic end of the tube is prolonged into the tympanum in the form of circumscribed round structures, sometimes raised above the level of the membrane, which appear like warts, and microscopically are dense lymphatic infiltrations with sharply defined areas of concentration. The author has designated these structures as the tympanic tonsil.
Piffl. 66. This careful paper, richly illustrated, presents nothing new. The topography of the recessus hypotympanicus is mentioned. Its thin lower bony wall communicates by venous and arterial vessels with the jugular vein and the carotid artery and it may contain many pneumatic cavities.
ZIMMERMANN. 67. Two skulls of the phocæna and a fresh head of the brownfish were examined. DENKER gives an exact description of the external, middle, and internal ears of this species of whale, and believes that hearing takes place as follows: The sound waves transmitted through the water strike the bones of the head. The air contained in the pneumatic spaces within the bony skeleton of the head is set in vibration. These vibrations act upon the lateral labyrinth wall, especially on the cochlear window, and through this the impact is communicated to the fluid of the tympanic scala. The stapes is not adherent to the margin of the vestibular window. The author, however, does not believe that this bone together with the other ossicles serves as a sound conveyer because the external ear is very narrow and tortuous and the hammer is adherent to the tympanic bone.
ESCHWEILER. 68. This paper is not at all suited for a short abstract.
NOLTENIUS. 69. A soldier presented two symmetrical tracks on both sides of the nasal septum. These passages began with two broad openings at the middle of the anterior part of the septum, and termi.
nated in the niiddle of the posterior free margin. Both tracks were 6.2 cm. long. The anterior openings were easily seen to communicate with each other through the septum. The tracks were lined with mucous membrane similar to the nasal mucosa of the respiratory and olfactory regions of the nose.
ESCHWEILER. 70. This paper is a continuation of one reported in volume xxx. of these ARCHIVES. As in the case of the anures and the urodeles, the olfactory plate occurs in the gymnophions through the lengthening of the sensory layer of the ectoderm while the protecting layer of the latter disappears. The olfactory plate develops into the olfactory groove, and this, in turn, forms a blind bag with a narrow external opening. The olfactory bag is, in the beginning, in connection with the pharynx by means of a solid epithelial strand; secondarily, this receives a lumen and develops into the naso-pharyngeal passage. The olfactory groove is situated in the gymnophions between the median and lateral frontal processes. Finally, the development of the lower blind sac is treated of, and appears to be less of a homologue than an analogue of the Jacobson's organ in the amniotes.
ESCHWEILER. 71. The author discusses the paper of Schoenemann and differs from the latter author as regards the origin of the ethmoid turbinals. While the maxillo-turbinal and the naso-turbinal perhaps develop from the lateral nasal wall, the ethmo-turbinals originate from the original median — that is, the septal wall of the primitive nasal cavity. This cannot be definitely proven in man. It can, however, be assumed to be correct by analogy from conditions found in the vertebrates. The homology between the turbinals of the vertebrates and man may be expressed as follows: The maxillo-turbinal corresponds to the concha inferior, The naso-turbinal
agger nasi, The ethmo-turbinal I.
concha media, II.
concha superior, III.
concha suprema, concha obtecta
a.-REPORTS AND GENERAL COMMUNICATIONS.
72. Randall. Report of ten years' work in the aural department of the University. Univ. of Penn., Medic. Bulletin, May, 1902.