None
S,, method of o}K'ning the ^^^| BicWoride of mercury^ injurious effect of, mastoid by the digastric route, 320 ^^^| upon tympanic struct urcfi, 175 tuberculosis of the middle ear, 536 ^U Ring's test, 93 Bulb of the jugular vein, infection of, 171 ^M Blake, C, J., plastic modification of mas- ^^^M toitl operation, 430 Caisson workers, aiu'al disorders of, 132 ^^^^ Blood-elot operation, 430 Calcareous degeneration of the drum ^^^H Blood-count in infective sinus throm- membrane, 227 ^H boflis (Crockett), 346 Caloric test (Barany), 2S0, 281 ■ Blood-cultiu'e«, diagnostic value of, 348 method of applying, 300 ^M use of, in atent suppurative ^M Blood-vessels of labyrinth, 273 Boils in external auditory meatus (see labyrinthitis, 301 ■ Furunculosis] use of, in suppurative labyrin- ^H Bondy's operation for chronic middle-ear thitis, acute stage, 296 ^M suppuration, 455 Canalis reuniens, 266, 270 ■ Bone conduction, hearing by, 74 Boric acid in treatment of chronic middle* Cardiac lesions as an occasional cause of ^^ objective tinnitus aurium, 139 ^M ear suppuration, 211, 214 Cardinal signs of a retracted drum mem- ^M Bougies, Eustachian, 230 brane, 147 ■ meriicated, 239 Carotid artery, possible injury to, during ^M method of using, 231 curettage of the Eustachian tube, ^M use of, in otitis media hyper- 440 ■ plastica chronica, 238 canal, relation of, to tympanic floor, ^M use of , in otitis me<lia hj'per- 15 ■ trophica chronica, 230 Catarrh, tubal, 145, 151, 153, 209, 221 ■ Brain abscess, 357 Catheter inflation, danger of rupture in at- ^M aphasia in, 371 rophy of the drum membranej ^U bacteriology of, 350 237 ■ clinical stages of, 363 in acute tjropanic disease, 178, ^M drainage of, 499 179 ■ etiology of, 357 in catarrh of the Eustachian ^M eye-ground changes in, 366 tube, ?^2 ■ focal symptoms of, 368 in chronic middle-ear catarrh, ^| pjcneral ayniptoms of, 362 230, 237, 240, 241 ■ influence of cerebral hernia upon surgical emphysema resulting ^M prognosis in, 401 from, 69 ■ mental disturbances in, 330, 368 technic of, 65 ^M modes of infection through teg- value of, as compared with ^M men tympani, 361 potitserization, 151 ^M muscular spasms and paralysis Causes of acute tympanic disease, 126 ^^^B in, 369 Cavernous sinus, thrombosis of, 348 ^^^H onset of, 363 Celb of Retains, 268 ^^H pathology of, 361 Cerebellar abscess, 375 ^^^H 574 INDEX Cerebellar abscess, Barany's symptom of, 379 diadokokinesis in, 377 differential diagnosis of, from acutelabyrinthitis, 382 from temporal lobe ab- scess, 381 direction and depth of explora- tory punctures, 502 disturbance of equilibrium in, 378 focal symptoms of, 376 general symptoms of, 375 respiratory paralysis in, 381 surgical treatment of, 502 terminal stage of, 381 unilateral incodrdination ataxia in, 377 ataxia (static), 378 nystagmus, 376 Cerumen m external auditory canal, re- moval of, 123 Ceruminous glands, 10 Cervical adenitis (associated with fu- runculosis of auditory meatus), 110 (associated with internal jugular phlebitis), 350 Chlorosis, influence of, upon progress of otosclerosis, 257 Cholesteatoma, diagnosis of, 215 effect upon contiguous bone, 196 etiological relation of, to intracranial disease, 196 to suppurative labyrinthi- tis, 293 influence of, upon character of aural discharge, 198 pathology of, 195 spontaneous elimination of, 197 treatment of, 215 Chorda tympani nerve, course of, within tympanum, 28 injurv to, during myringot- om'y. 398 Chronic hyperi)la.stic otitis media (see Otitis media hyperplast ica rhronicti) hypertroi)hir otitis media (see Otitis iiHHlia hyjxTtrophica chronica) middle-oar suppuration (see Otitis modia [)urulenta chronica) tubal ratarrh, symptoms and physical si^ns of, 219 treatment of. 222 Cisterna magna, surgical oj)ening of, 507 Claudius's cells, 271 Corairie, use of, 151 Cocldea, anatomy of, 200 aciueduct of. 2()2 function of, 274 membranous structures of, 269 spiral ligament of, 270 Cochlear nerve, 272 Cold, application of, to mastoid, 189 Comparative frequency of temporal lobe and cerebellar abscess, statistics, 358 Complications of acute purulent otitis media, 170 Concha, 2 function of. 36 abnormal aevelopment of, 517 Congenital deaf-mutism, 553 treatment of, 557 malformations of ear, 515 surgical correction of, 517 Consanguinity, parental, in relation to deaf-mutism, 554 Consonants, fundamental tones of, 82 Conversational speech, method of test- ing by, 83 normal hearing distance for, 76 sound values of various compo- nents of, 82 Corrosive sublimate, injurious effects of, upon tympanic structures, 175 Corti, organ of, 270 rods of, 270 tunnel of, 271 Cortical centre for sound memories, 332, 333 hearing centre, 273 memory centre for motor writing efforts, 332 for motor speech efforts, 333 for tactile impressions, 333 for visual impressions, 333 Cranial nerve lesions, salvarsan in relation to, 538 Crista vestibuli, 263 CristiE acusticffi, 267 Crockett, E. A., blood count in infective sinus thrombosis, 346 optic neuritis in infective thrombosis, 347 tuberculosis of the middle ear and mastoid, 536 Cupola, 268 Curvature of membrana tympani, influ- ence of, upon sound conduction, 36 Dana, C. L., auditory nerve tracts, 273 neurasthenia as a cause of tinnitus aurium, 142 Deaf -mutism, 553 causes of acquired form, 555 etiolog>' of congenital form, 553 hereditary transmission of, 553 pathology of, 556 relation of parental consanguinity to, 554 treatment of, 557 Deafness, absolute, determination of, 94 apoplectic form of, 527 chronic, treatment of, 229, 238, 255 due to alcoholism, 131 in diffuse suppurative labyrinthitis, 296 ^^^^^^^^^^^^^^INDEX ^^^^^^^^^57^^^ W Deafness, in M^ni^re'S disease, 527 Duel, A. B., electrolysis in treatment of ■ leuca*miCi 528 strictures of the Eustachian eanal» 233 B resulting from parotitis^ 128 Duel's operation for replacement of pro* m fliniulated, tests for, 90 jecting ears, 623 W surgical measures for the relief of, 258 Dura mater, structural changes in region L Dean, L. W,, aen&ory aphasia in temporo- of venous sinuses, 340 ^^^H Kphenoklal abscc$!S, 372 Dvvyer, J. D.^ vaccine therapy in aural ^^^H treatment of brain abscesses prescnt- diBease, 549 ^" ing dural fistulie, 491, 495 Deiters's cells, 271 Eagleton, W. P., Hayiies's operation for nucleus, 273 purulent leptomeningitis, 509 ^^_ Dench, E. B., inflating apparatus, 03 Ear, anatomy of, 1-28 ^^^M protrusion of jugular bulb througli aHymmetry of, 515 ^^^^| necrotic defect in tympanic floor, 138 blood-vessels of, 26 ^^^f Denker, non-syphilitic origin of otoaele- functional examination of, 74-96 ^^^| rosiB, 244 malformation of, 515-525 ^^^| Dental lesions cauBing aural symptoms, nerves of, 27 ^^^| 550 phvsical examination of, 41-69 ^^^B Dermatitis of auricle, 97 syphilis of, 305, 530, 538 ^^H tiioerculous atlfctions of^ 532-5Si' ^^^| Development of bony meatus, 4 Diatlokokinesia (Babinsky), 377 Earaciie (eee Aural pain) ^^^| Diagnostic tube, 64 causes of, 133-134 ^^H auscultatory gigns obtained in acute catarrhal otitis media, 161 V through, 65 in chronic catarrhal otitis media. 133 H DifTuse external otitis, acute, 115 in purulent otitis media, lt>|> H refiexlv induced b\" non-uural lesions, H purulent leptomeningitis, 385 suppurative kibyrinthitis, acute stage, 294 134^ ■ Eburnation of parts of temporal bone in H ' latent stage^ 299 chronic middle-ear suppuration, 194 ^^^t Dilatation of Eustachian tube, 230-233 Eczema of auricle, acute, 98 ^^^M Diphtheria, character and fre<juenc'y of treatment of, 99 ^^^| aural complications in, 127 chronic, 100 ^^H Dijiloic mastoid, 32 treatment of, 100 ^^H Diseases of auricle, 97 Ehrlich's theory of causation of cranial ^^B of brain and meninges, 337 nerve leHions following salvarsan^ 5^59 H of Eustachian canal, 145, 219 Elc^'trolysis in treafrncnt of Eusiachian H of external auditory meatus, 107 strictures (Duel), 233 ■ of labyrinth, 278 Embolism, labyrinthine, in caisson work- H of maijtoid, 181 ers' disease, 132 H of tympanum, 145 Emphysema, local, following catheter in- ^^U DiBttirbance of heiu-ing due to ossicular flation, 69 ^^M fixation in chronic middle-ear prognosis of, 69 ^^H catarrh, 224, 2^15 treatment of, 69 ^^^H in acute myringitis, 156 Eneepbaloscope, Whiting's, 499 ^^^| in otoflclerogis, 251 Endolymph, 260 ^^B in tympanic disease, 162 Epidural abscess face Extraflural abscess) ^t rcaiiiting {nnn chronic middle- Epithelioma of auriclr, 107 ^^U ear suppuration, 199 treatment of, 107 ^^H Disturbances of equilibrium due to vesti- Epit ym panic space, 10 ^^^H Erysipe as of auricle, 97 ^^H bular irritation, 287, 295 due to vestibular paralvsis, 303- treat men t of, 97 ^^H 309 Eustachian bougies, methcMl of using, 230 ^^B in cerel>ellar abscess, 37S» 379 varieties of, 230 H Drum membrane (see Membrana tym- canal, acute lesions of, 145-155 ^^^M pani) anatomy of, 28-31 ^^H appearance of, in acute tubal catarrh of (see Tubal catarrlii ^^^| catarrh, 147, MS catheterization of, 63 ^^H in otosclerosis, 253 chronic lesions of, 219 ^^H in tubotympanic eongestion, differences in infant and ailuU, 30 S 149 muscles of, 31 H Ductus cochlearis (scala media), 270 pharyngeal orifice of, 29, 31 H Duel, A. B., blood cultures in su|)purative physiology of, 30 H structuraf narrowing of, 222 H lesions of ear, 349 576 INDEX Eustachian canal, tympanic orifice of, 29, 31 Yankauer's method of curetting, 209 catheter, correct type of, 63 Ewald's experiments upon semicircular canals of pigeons, 278 theory of vestibular control of muscle tonus, 276 Examination of auricle and external audi- tory canal, 43 of drum membrane and middle ear, 53 of Eustachian tubes, 60 of nose, nasopharynx, and throat, 69 of patient, 41 Exostoses of osseous meatus, 125 External auditory canal; acute diffuse in- flammation of, 115 anatomy of, 4 bony outgrowths from, 125 comparison of infantile and adult t3rpes, 7 development of, 4 eczema of, 100 furunculosis of, 107 lining membrane of, 10 membranocartilaginous por- tion of, 4 mycosis of, 116 operations for removal of foreign body from, 122 osseous portion of, 8 removal of cerumen from, 123 removal of foreign bodies from, 119 variation in length and direc- tion of, 9 otitis, acute circumscribed (see Fu- runculosis of meatus) diffuse, 114 Extradural abscess, etiology of, 338 prognosis of, 339 symptoms and physical signs of, 338 treatment of, 340 Eye-ground changes in intracranial lesions of otitic origin, 300 Facial canal, 11 course of, 404 nerve, branch of, to stapedius muscle, 28 possible injury to, in radical operation, 442 relation of, to aditus ad antrum, 419 to ampulla? of horizontal and anterior vertical semicir- cular canals, 403 paralysis, brief discussion of, 442 Facial paralysis, otitic, causes of, 510 prognosis of, 510 postoperative, faciohypoglossal neurorrhaphy for, 513 prognosis and treatment of, 511 symptoms and signs of, 511 Faciohypoglossal anastomosis, 513 Fallopian aqueduct (facial canal), 404, 419, 442, 463 Fenestra ovahs, 11 rotunda, 11 Fissura intertragica, 2 Fissures of Santorini, 4 Fistula test, diagnostic value of, 299 method of applying, 298 Folds of dnun membrane, 25 anterior, 25 posterior, 25 Fordyce, John A., method of administering salvarsan yielding best results, 543 relation of salvarsan to disease of cranial nerves, 542 Forehead mirror, correct type for aural work, 45 method of using, 52 Foreign bodies in external auditory canal, removal of, 119 surgical removal of, 122 Formulae, 566 Fossa cochlearis, 262 incudis, 22 Fovea elliptica (recessus ellipticus)^ 263 hemispherica (recessus hemispheric cus), 267 Frost-bite, auricular, 98 treatment of, 98 Function of tympanic muscles, Mach*s theory of, 39 Functional examination of cochlear ap- paratus (hearing tests), 74 Fungi in external auditory meatus, 116 Furunculosis of external auditory meatus, 107 deformities resulting from, 110 differential diagnosis of, 110 etiology of, 107 prognosis of. Gram-negative anaerobic bacilli, relation of, to pathology of brain abscess (Neu- mann), 361 Grant, Dundas, nervous exhaustion as a cause of tinnitus aurium, 142 neurasthenia as an occasional cause of hyperaciisis, 142 Gray, A. A., theory as to pathogenesis of otosclerosis, 249, 250 Grippe as a cause of aural disease, 128 Gniening, case of multiple metastatic abscess secondary to infective sinus thrombosis, 354 corroborative value of blood exami- nations in diagnosis of infective sinus thrombosis, 348 headache and mental lethargy in in- fective sigmoid sinus thrombosis, 347 Grunert, etiology of brain abscess, 358 Hematoma auris (ortha^matoma), 102 Hair-cells of Corti's organ, 271 of crista) acustics and macula; acus- ticffi, 267 Hallucinations, auditory, 143 Hammer (malleus), 16 Handle of malleus, 18 Hartmann's differential test in otosclero- sis, 253 tuning-forks, 84 Hasslauer, bacteriology of brsun abscess, 359, 360 Haynes's operation for relief of pressure in purulent meningitis, 507 Headache in cerebellar abscess, 375, 382 in otitic leptomeningitis, 385 in sigmoid sinus thrombosis, signifi- cance of, 347 in temporosphenoidal abscess, 363 of reflex origin, 550 Head-mirror suitable for aural work, 45 Head-rest for mastoid surgery, 411 Hearing bv bone conduction, 74 37 ^ Hearing by bone conduction, Bezold's ex- planation of increase of, m tympanic disease, 78 changes in, 78 diagnostic significance of in- crease in, 79 normal ratio of, to air con- duction, 74 significance of diminution of, 80 Hearing centre in cerebral cortex, 273 power, influence of radical operation upon, 454 tests, 74 Heat, application of, to ear, 173 Heath's operation for chronic middle-ear suppuration, 454 Heimann, statistics bearing upon usual location of brain abscess, 358 Heine, safety limits in exploratory' punc- tures of brain, 499 treatment of brain abscess, 491 Helicis major, 3 minor, 3 Helicotrema, 262 Helix, 1 abnormalities of, 515 fossa of, 1 Helmholtz, greater resonance of curved membranes as compared with flat, 37 on relative maximum movements of different ossicles, 38 Helmholtz's theory of tone analysis, -274 Hemorrhage due to accidental opening of sigmoid sinus during mastoid opera- tion, 424 in exploratory operations upon sig- moid sinus, 483 into labyrinth, 526 Henle's spine (suprameatal ^ine), 402 Hensen's cells, 271 Heredity in relation to congenital deaf- mutism, 553, 555 to otosclerosis, 245 to primary middle-ear tubercu- losis, 532 Hernia cerebri, prevention of, 491 prognostic significance of, in brain abscess, 491 Herpes zoster auricula;. 356 resection versus liga- tion of jugular vein in, 477 surgical treatment of. 477 symptoms of, 345 Inflammation of geniculate ganglion, 106 Inflation of ears by catheter, 63 Politzer's method of, 61 Valsalva's method of, 60 Influenza as a cause of acute tympanic diseajse, 128 Initial incision for exposure of cerebellum, 504 of jugular vein, 48t6 of temporosphenoid lobe, 493 for radical operation, 433 for simple mastoid operation, 413 Inner t3rmpanic wall, landmarks of, 11 Insects in external auditory meatus, re- moval of, 120 Internal auditory meatus, injury to, dur- ing labyrinthine operation, 474 jugular vein, infection of, 350 ligation of, 488 resection of, 485 resection versus simple liga- tion of, 477 Intracranial compHcations of tympanic disease, 337 disease, svmptoms of, 322 lesions of otitic origin, pathways of infection from tympanum or mas- toid, 337 Intratympanic muscles, 23 operations for improvement of hear- ing, 258 Isthmus of Eustachian tube, 28 of external auditory meatus, 8 Jackson, Hughlings, muscular spasms in lesions of cerebral cortex, 326 Jacobson's nerve, 27 Jansen, circumscribed purulent leptomen- ingitis with recovery after opera- tion, 387 mortality following surgical injur>' to labyrinthine cai)sule, 318 surgical injuries as a cause of suppu- rative labyrinthitis, 292 Jansen's chisels, 40S operation for suppurative labyrinthi- tis, 465 statistics bearing upon etiologj' of brain abscess, 358 Jugular bulb, infection of, without inter- mediate mastoid disease. 171 possible injury to, during my- ringotomy, 396 INDEX 579 Jiigular bulb; relation to tympanic floor, 15 vein, infection of, 350 ligation of, 477, 488 resection of, 477, 485 Kerley, C. G., frequent absence of pain in young children suffering from o. m. p. a., 169 Knapp, Arnold, circumscribed leptomen- ingitis, 388 Kopetsky, S. J., chemical tests of cerebro- spinal fluid in meningitis, 393-394 Komer, etiology of otosclerosis, 244, 245 freauency of fistulse in otitic brain abscess, 492 influence of pregnancy upon the ad- vance of otosclerosis, 254 necessity of conservatism in advisinf; the radical operation, 216 statistics bearing upon usual loca- tions of brain abscess, 358 Komer's plastic (flap) operation, 449 Labium tvmpanicus, 269 vestibulare, 269 Labyrinth, ansemia of, 529 anatomy of, 260 blood-vessels of, 273 function of, 274 hyperaemia of, 315 inciications for operating upon, 463 leukiemia of, 528 membranous structures of, 265 nervesof, 272, 273 non-suppurative disorders of, 526 operations upon, 463 osseous portion of, 260 physioloo'^ of, 274 structural abnormalities of, in deaf- mutes, 55H changes resulting from otosclero- sis, 245 suppurative lesions of, 278 surgical guides to the vestibule of, 464 8>T>hilis of, 530 technic of opening the vestibule of, 470 tuberculosis of, ^2 Labyrinthine flstula, prognostic signifi- cance of, 298 symptoms of, 298 infection, frequency of, in suppura- tive otitis media, 293 Eathways of, 292 ule, surgical guides to, 464 Labyrinthitis, circums(^ribcd suppurative, differential diagnosis of, from other labyrinthine lesions, 313 symptoms of, 310 treatment of, 318 usual site of, 309 Labyrinthitis, diffuse serous, differential diagnosis of, from other labyrinthine lesions, 313 prognosis of, 311 symptoms of, 311 treatment of, 319 diffuse suppurative, acute stage of, 294 caloric test in acute stage of, 296 caloric test in latent stage of, 300 cholesteatoma as a cause of, 293 complications of, 309 differential diagnosis from cerebellar abscess, 382 from other laby- rinthine lesions, 313 disturbance of cochlear func- tion in, 296 estimatea mortality in cases not operated upon, 315 etiology of, 292 frequency of (Hinsberg, von Stein), 293 high mortality in cases re- sulting from stapedial in- juries, 316 latent stage of, 299 stapedial injuries as a cause of, 292 siu^cai operations for relief of, 463 symptoms of, 294 treatment of, 315 value of fistula test in, 298 Lake, Richard, leukemia of labyrinth, 529 vertigo in otosclerosis, 252 Lake's operation for relief of vertigo, 475 Lamina spiralis, 269 Landmarks of inner tympanic wall, 11 of mastoid cortex, 402 of normal drum membrane, 53 Langenbeck's periosteal elevator, 407 Lateral sinus, dural covering of, 340 suppurative disease of, 343 ventricle, puncture of, 505 Leiter's coil, application of, to mastoid, 189 Leptomeningitis, circumscribed, symp- toms of, 387 treatment of, 391 diffuse purulent, pupillary and eye- ground changes in, 386 surgical treatment of, 506- 509 symptoms of, 385-387 treatment of, 391-394 urotropine in treatment of, 393 Leucocyte extract (Hiss), 547 680 INDEX Leuka>mic deafness, 528 Levator palati muscle, 31 Libman, value of blood cultures in sig- moid sinus thrombosis, 348 life insurance, relation of aural disease to, 561 Ldgamentum spirale cochleae, 270 Ligation of jugular vein in sigmoid sinus thrombosis, 488 Light, arrangement of, for aural work, 49 reflex, 55 Lining membrane of Eustachian canal, 29 of tympanum, 24 Lobule of ear, 1 Lop ear (projecting ear), 517 plastic operations for correction of, 519 Love, J. K., etiology of deaf-mutism, 554, 556 Lucae, circumscribed leptomeningitis with recovery following operation, 388 Lumbar puncture, 387, 389, 393 Lupus hvpertrophicus, 105 of auricle, 104-105 McCaw, J. F., primary tuberculosis of middle ear, 536 Macew^en, pathology of brain abscess, 362 pupillary changes in brain abscess, , 371 McKemon, J. F., infection of jugular bulb without mastoid involvement, 171 sensory aphasia in tcmporosphenoitlal abscess, 372 treatment of brain abscess, o(M) Mach's theory of function of tympanic muscles, 39 Macrotia, common types of, 515 surgical correction of, 519 Macula acustica of saccule, 267 of utricle, 26(5 Maculic cribrosa?. 264 Malformations of e^ir, congenital, 515 rorror'tion of, 517 Malignant disrjiso of auricle. 107 Malingering, simuhitcMl deafnrss, tests for, 96 Malleus, anatomy of, 16 articulation of, 21 ligaments of. 22 Manubrium mall(M (hammer handle), 18 maximum excursions of, 38 Marginal perforations of memhrana tym- pani, pathological significance of, 193, 202, 211 Massage (pneumatic) of <lnini membrane an<l ossicles, 241 Mastoid i)erf oration in chronic middle- ear suppuration, significance of (Mv- gind), 216 Mastoid pn)cess. absence of, in f<i'tus, 182 anatoni}' of, 31 Mastoid process, changes in, as a result of chronic middle-ear suppura- tion, 194 indications for opening, 190 operations upon, 413 structural variations of, 32 suppurative inflammation of, 181 perforation of cortex of, 182, 185, 187, 216 surgical landmarks of, 402 Mastoidectomy, accidental opening of sigmoid sinus in, 424-425 after-treatment of wound, 426-430 arrested tissue repair following, treat- ment of, 429 element of time (i.e., operative speed) in, 425 exposure of normal dura in, 424 instruments required for, 406 mastoid operation (Schwartze's op- eration), 405 preparation for, 405 surgical treatment of the aditus in, 419 sutures and wound dressing in, 425 treatment of mastoid tip in, 417 of zygomatic cells in, 421 Mastoiditis, acute suppurative, clinical variations corresponding to structural variations of different temporal bones, 182 etiology of, 181 indication for opening mas- toid in, 190 in infant.s and young chil- dren, 187 non-surgical treatment of, 188 pathology of, 181 physic£usigns of, 184 prognosis of, 188 surgical treatment of, 405 symptoms of, 1H3 tJ-mperature range in, 183 Measles, character of iiural lesions caused by, 12S Meattis, external (see Internal auditory canal) MiK^hanism for control of normal tympanic tension, 39 Medicated bougi(»s, 2'M) Medicinal fornnila*, 5(>() Membrana basilaris, 2V)9 flaccida (see Shrapnell's membrane) spiralis ccM'hlese, 270 tectoria, anatomy of, 270 fun<*tion of, 275 tensa, anatomy of. 10 tympani, a<lhesion of, to tympanic wall or struct un*s, 238 anatomy of. 16, 19 atrophy of, 237 INDEX 581 Membrana tympani, calcareous thicken- ing of, 227 cardinal signs of retraction of, 147 central perforations of, 201 displacement of, 57 incision of (see Myringotomy) landmarks of, 53 layers of, 19 marginal perforations of, 203 objective examination of, 50 physiology of, 36 pouches or pockets of, 24 quadrants of, 55 removal of, with malleus and incus for relief of deafness, 259 spontaneous rupture of, in otitis media catarrhalis acuta, 161 in otitis media puru- lenta acuta, 167 structural changes in, 57 traumatic injuries of, 159 Membrane of Reissner, 270 Membrano-cartilaginous portion of exter- nal auditory meatus, 4 of Eustachian tube, 29 Membranous compartments of tvmpanic vault, 26 surgical significance of, 166 vestibule, obliteration of, for relief of vertigo (Lake), 475 Meniere's disease, etiology of, 526 prognosis and treatment of, 527 symptoms of, 527 Meningitis, otitic (see Leptomeningitis) serous, surgical treatment of, 504 symptoms of, 389 Mental disturbances in brain lesions of otitic origin, 330 Metastatic brain abscess of otitic origin (Rae), 353 Microtia, 517 Middle ear, 9 anterior wall of, 13 blood-vessels of, 26 floor of, 14 folds of mucous membrane in, 25 inflammatory diseases of (see Otitis media) lining membrane of, 24 membranous compartments of attic, 26 muscles of, 23, 39 nerve supply of, 27 non-suppurative lesions of, 219 posterior wall of, 14 roof of, 12 subdivisions of, 1 1 syphilis of, 538 tuberculosis of, 532 Milligan, Wm., primary tuberculosis of ear, 536 Milligan, Wm., surgical relief of vertigo, 476 Mirror, forehead, types of, 45 use of, 52 Modiolus, 260 absence of, in deaf-mutism, 556 central canal of, 262 injury to, during labyrinthine opera- tion, 474 Mosetig-Moorhof operation, 459 Motor aphasia, 336 Banti's case of, 373 Mucous membrane of Eustachian tube, 29 of tympanum, 24 Mumps, deafness resulting from, 128 Muscles, intratym panic, 23 of auricle, 2 of Eustachian canal, 31 Muscular spasms (unilateral), interpreta- tion of, in otitic brain disease, 326, 369 Mygind, heredity in relation to spread of deaf-mutism, 553 Myringitis, acute, 156 diagnosis of, 156 treatment of, 156 Myringotomy, indications for, 395 in otitis media catarrhalis acuta, 174 in otitis media purulenta acuta, 179 operative dangers of, 396 surgical mishaps resulting from, 396 technic of, 399 Nasal specula, 70 Nasopharyngeal adenoids, 558 Necrosis of inner margin of bony meatus in chronic middle-ear suppuration, 202,211 of ossicles in chronic middle-ear suppuration, 213 Nerves, auditory, 273 cochlear, 272 facial (see Facial nerve) glossopharyngeal, 27 hypoglossad, 513 Jacobson's, 27 trifacial, 28 vestibular, 272 Nervi carotici tympanici (tympanic branches of sympathetic), 27 Neumann, influence of Gram negative anaerobic bacilli upon brain tissue, 360 statistics bearing upon usual loca- tions of brain abscess, 358 Neumann's operation for suppurative labyrinthitis, 468 Neurasthenia as a cause of tinnitus aurium, 142 as an occasional cause of hyperacusis, 142 Noise apparatus, Barany's, 95 White's, 95 Noises as a cause of aural disorder, 131 582 INDEX Non-suppurative diseases of middle ear, 219 Normal hearing distances for watch, acou- meter, conversational voice, and whisper, 75 tympanic tension, loss of, 228 Nose, examination of, 69 Nystagmus, cerebellar, 378 physiological, distinguishing features of, 283 vestibular, characteristic features of, 281 types of, 282 Objective tinnitus aurium due to aneu- rism of basilar artery, 140 due to aneurism of internal auditory artery, 140 due to cardiac valvular lesion, 139 Obliquus auricula?, 3 Occupational diseases of ear, 130 CExlema, post auricular, deformity result- ing from, 186 due to furunculosis, 109 due to suppurative mastoiditis, 186 Okada, statistics bearing upon etiology of otitic brain abscess, 357 Opaque or covered eye-glasses, use of, in determining slight grades of nystagmus, 298 Operation for establishing faciohypoglos- sul anastomosis, 513 Operations for closing postoperative sinus behind ear, 459-462 for correction of auricular deformities, 517-525 for cure of cerebellar abscess, 502-504 of chronic middle-ear suppura- tion, 432-458 of infective sigmoid sinus throm- bosis, 477-489 of suppurative labyrinthitis, 463 475 of temporosphenoifial ahs('(»ss, 49()-.502 for iiiiprovf'iiu'nt of hearing, 25S for relief of acute ])urulent otitis nuMlia, 395-402 of otitif meningitis, 504-508 of suppurative mastoiditis, 405- 432 of v("rtiKo. 47.V-478 Oi)ium, contra-indirations to, in acute tympanic disease, 173 Oppenheimer, S., detaelunent and ex- trusion of ossicles in niiddlcM'ar tuber- culosis, 5.35 Optic neuritis in brain abscess, signifi- cance of, 3r)7 infective siinis thrombosis (Croc- kett), 347 Organ of Corti, 270 function of, 277 Organic cardiac lesions as a cause of aural symptoms, 139 Orientation, mechanism of, 304 compensatory activity of con- stituent parts of, 305 Osseous meatus, 8 development of, 4 Ossicles, 16, 213, 217, 456, 535 disarticulation and extrusion of, in middle-ear tuberculosis, 535 necrosis of, in otitis media purulenta chronica, 213 Ossicular chain, position of constituent parts, 56 physiology of function of, 37 relative maximum movements of different ossicles, 38 Ossiculectomy for improvement of hear- ing, 259 on account of necrosis, 217, 456 Otalgia (aural pain), 133 Othematoma, 102 Otic ganglion, 28 Otitic meningitis, 384 circumscribed purulent lepto- meningitis, 387 diffuse purulent leptomeningitis, 385 serous, 389 pathways of j)us to brain or menin- ges, 337 Otitis externa circumseripta acuta, 107 externa crouposa, 118 (lifTusa acuta, 115 media catarrhalis acuta, 158 bact<?ria commonly as- sociated with, 159 etiology of, 158 impairment of hearing in (Bezold), 162 incision of drum mem- brane in, 174 non-operative treatment (.f, 172 patholo^jy of. 160 ruptnrc of drum mem- ijraiie in, 161 surgical treatment of, 173, 31)5 symptoms and physical signs of, 1()0 hyperi)lasti(a chronica, 234 atrophy of drum mem- brane in, 237 I'araousis Willisii in, 235 pathology of, 234 symptoms and signs of, * 235 treatment of, 238 us(» of Eustachian bou- gies in, 238 INDEX 583 sdia hypertrophica chronica, al- terations of tympanic tension in, 22^ aurd pain in, 226 calcareous changes in drum membrane in, 227 etiology of, 223 impairment of hearing in, 224 pathology of, 223 physical signs of, 226 prognosis of, 229 relaxation of drum mem- brane in, 228 symptoms of, 224 treatment of, 229 punilenta acuta, antrum tender- ness in, 180 catheter inflation in, 178 complications of, 170 etiology of, 165 in infants, 169 myringotomy in, 179, 395 rupture of drum mem- brane in, 167 symptoms and physical signs of, 166 treatment of, 173 chronica, bone changes in, 194 central perforations of drum membrane in, 201 cholesteatomatous for- mation in, 196 complications of, 205 etiological relation of, to brain abscess, 357 etiology of, 192 formation of polypi in, 194, 200 indications for radical operation in, 216 non-operative treatment of, 205 ossicular necrosis in, 213 ossiculectomy in the treatment of, 217 pathology of, 192 perforations confined to Shrapnell's mem- brane, 203 physical signs of, 200 significance of marginal perforations in, 202, 211 significance of post au- ricular subperiosteal abscess in, 216 spontaneous resolution in, 195 Otitis media purulenta chronica, surgical treatment of, 432 symptoms of, 198 Otoliths, 268 function of, 277 Otomycosis, etiology of, 116 symptoms of, 116 treatment of, 117 Otosclerosis, Bezold's triad s3rmptom complex of, 251 combination of, with chronic tjrm- panic diseases, 255 diagnosis of, 250 etiology of, 244 Gray's theory of pathogenesis of, 249 Hartmann's test for cochlear nerve involvement, 253 Eathology of, 245 iebenmann's theory of pathogene- sis of, 247 symptoms of, 250 treatment of, 255 use of phosphorus and iodide of po- tassium in, 256 with involvement of membranous cochlea, 253 Otoscope (see Diagnostic tube) Oval window, 11 Overwork, business strain, etc., influence of, upon progress of otosclerosis, 245 Pachymeningitis, circumscribed, 384 Page, John R., brain abscess successfully drained after multiple incisions, 498 Panse, origin of subjective noises in tym- panic disease, 137 Pause's plastic (flap) operation, 450 Paracusis Willisii in otitic media hyper- plastica chronica, 235 in otosclerosis, 252 Parasitic inflammation of external audi- tory meatus (otomycosis), 116 Parental consanguinity in relation to deaf-mutism, 554 Parotitis, deafness resulting from, 129 Passau-Trautmann operation, 460 Perforation of drum membrane, diagno- sis of, 58, 164 epidermization of margins of, 193 measures for closing, 206 Perforations of Slirapnell's membrane, 203 treatment of, 214 Perichondritis of auricle, 101 etiology of, 101 • permanent deformity result- ing from, 102 symptoms and [)hysical signs of, 101 treatment of, 101 Perilabyrinthitis, definition of, 312 differential diagnosis from other laby- rinthine lesions, 313 584 INDEX PerilabjTinthitis, symptoms of, 312 treatment of, 319 Perilymph, 260 Perisinous abscess (see Abscess, i>eri- sinous) Phar>'ngeal orifice of Eustachian canal in adults, 31 in infants, 31 Phar^Tix, examination of, 71 Phillips, Wendell, Haynes's operation for purulent leptomeningitis, 509 Physical signs of acute mastoiditis, 184 Physiology of sound-conducting appara- tus, 34 of sound-perceiving mechanism, 274 Plastic operation for correction of ma- crotia, Goldstein's, 519 operations for closing postofKjrative opening behind ear, 459 Mosetig-Moorhof, 459 Passau-Trautmann, 460 for replacement of projecting auricle, 521-525 for replacement of projecting auricle. Duel's, 522 for replacement of projecting auricle, Rut tin's, 522 forming part of rsidical mastoid operation, 449 (flap) operation, Ballance's, 450 Brilhl's, 451 Komer's, 449 Panse's, 450 Sicbenmann's, 450 Pneumatic cells, wide distribution of, in temporal bone, 422 mastoid. 32 Politzer's acoumoter, 75 method of inflation, indications for, 61 technic of, 61 Polyotia, 515 Polypi, formation of, in chronic middle- ear suppuration, 194, 200 removal of, 214 Position of inembrana t3'mi)ani in in- fancy, 5 of t(Mnf)oral bono in infant fskiill, (1 Postauricular abscess, IS.j (L'dema. 1S() (liKMofiirunrulosisof meatus, 100 due to suppurative mastoiditis, IS!) opening followinji radical operation, treatment of, 4')') Posterior fold of nicmbrana tympani, 25 Pouches of dnini nicinhranc, 24 Pn'«inancv and labor, inlhicnce of, upon progress of otosclerosis. 'Jo7 Prc])arati()n of patient for mastoid opera- tion, 405 Prit<'hard, osseous stapcdio-vcstibular ankylosis following middle-ear suppura- tion, 245 Processus brevis incudis, IS mallei, 18 cochleariformis, 12 folianus mallei, 18 lenticularis incudis, 17, 19 Projecting ears, surgical treatment of, 517 Promontory, 11 Pnissak'a attachment striae, 20 space, boundaries of, 25 Psychical blindness (causing sensory vis- ual aphasia), 335 Quadrants of drum membrane, relation of, to intratympanic structures, 56 Radical mastoid operation, 432 Ballance's flap operation in, 450 Brtlhl's flap operation in, 351 dangers of stapedial injury iuj 441 detaded description of, 432 facial nerve injury and par- alysis in, 442 indications for, 216 influence of, upon hearing, 454 initial incision, 433 Korner's flapoperationin,449 Panse's flap operation in, 450 postoperative treatment, 451 -454 reduction of facial spur, 437 removal of inner margin of canal wall, 436 Siebenmann's fla[> operation in, 450 surgical treatment of Eusta- chian canal, 439 use of skin grafts in, 453 Rae, J. B., metiustatic brain abscess sec- ondare' to infective sigmoid sinus thrombosis, 353 Hecessus ellipticus (fovea clliptica), 263 sphcricus (fovea hemispherica), 263 Ho<luplications of tvmi)anic mucosa, 25 Hcik, H. ().. })lood-clot oDcration, 430 Kcissnor's mrmbranc, 270 Resection of jugular vein in sigmoid sinus thrombosis, IS") Respiratorv paralvsis in abscess of cere- bellum, 3S1 Retraction of drum niemhrane, cardinal signs of, 117 Retractors, self-rot ainintr, 407 Retrahens aurem (musculus auricularis I)osterior), 3 Retro-auricular fistula, operations for closure of, 4o0-4()2 Retzius's fibre cells. 2()S Rheumatism and gout, etiological rela- tion of, to auricular eczema, 99 INDEX 585 Rheumatism and gout, etiological relation of, to furunculosis of meatus, 108 to tympanic disease, 41 Rhinoscopy, anterior, 71 posterior, 72 Richards, Geo. L., modifications of radical operation, 456 Richards, J. D., initial incision in rarlical operation, 433 operation for suppurative labyrinthi- tis, 467 treatment of narrow bony meatus in radical operation, 443 Richards's curettes, 411 Rinn^'s test, diagnostic value of, 92 method of applying, 91 Rivinian notch, 6, 20 segment, 6, 20 Rods of Corti, 270-271 Rongeur method of opening mastoid (Bryant), 320 Rongeurs, selection of, 409 Rotary nystagmus, 282 Rotation test, diagranmiatic demonstra- tions of, 302 explanation in accordance with Ewald's experiments, 283-287 significance in diffuse suppura- tive labyrinthitis, 301-304 Round window, 11 Rudimentary auricle (microtia), 517 Rupture of membrana tympani during inflation, 237 in acute tympanic inflam- mation, 161^ Ruttin, eye-ground change in intracranial lesions of otitic origin, 366 operation for replacement of protrud- ing ears, 517 Saccular nerve, 272 Saccule, anatomy of, 266 Saccus endolymphaticus, 266 Sagging of the posterosuperior wall of meatus, significance of, 184 Salpingopharyngeal muscle, 31 Salvarsan in relation to cranial nerve lesions, 538 method of administration yielding best results (Fordyce), 543 Santorini, fissures of, 4 Satyr ear, 515 ScaJa media (ductus cochlearis), 269 tympani, 261 vestibuli, 261 Scarlet fever, bacteria?mia in, 354 character and frequency of aural complications in, 128 destruction of drum-head, 128 Scarpa's membrane, 12 Schmiegelow, perforations of ShrapnelFs membrane, 204 Schwabach's test, 91 Schwartze, pioneer work in mastoid sur- ger>', 405 Schwartze-Stacke operation, 432 Sclerotic mastoid, 32 Self-retaining retractors, 407 Semicircular canals, anatomy of, 263 author's scheme for memorizing exact position of, 285 experimental irritation of, 278 physiology of, 276 Serous meningitis, 504 men ingo-en cephalitis, treatment of, 506 Serum therapy in treatment of aural disease, 544 Shambaugh, distribution of labyrinthine blood-vessels, 273 structural and physiological analogy between hair-cells of Corti's organ and those of the crista; and macu- lae acusticse, 277 theory as to function of tectorial membrane, 276 Shrapnell's membrane, 5, 21 perforation of, 203 Siebenmann's plastic (flap) operation, 450 theory as to pathogenesis of oto- sclerosis, 247 Siegel's otoscope, 59 Sigmoid sinus, accidental opening of, dur- ing mastoid operation, 424 dural walls of^ 340 infection of, m relation to cere- bellar abscess, 341 occasional abnormal position of, 445 surgical exploration of, 483 surgical exposure of, technic, 479 Simulated deafness, tests for, 96 Sihus, cavernous, thrombosis of, 348 phlebitis, 343 thrombosis (see Infective i^ixmoid sinus thrombosis) Skin-grafting, following radical operation, 453 Slin^er, R. J., and Sir Victor Horsley, on orientation of points of space, 304 Sound-conducting mechanism, constitu- ent parts of, 1 Sound-conduction, physiology of, 34 Sound-perception, physiology of, 274 Sound-perceptive mechanism, constituent parts of, 1 Sound values in conversational speech, 82 Specula, aural, 48, 49 nasal, 69, 70 Spine of Henle, 402 Spiral ganglion, 269, 272 ligament, 270 Spur, facial, 438 Stackers operation for chronic middle-ear suppuration, 444 586 INDEX Stackers protector, 445 Stapedial ankylosis in chronic hyper- trophic otitis media, 224 fixation in otosclerosis, 246 Stapedius muscle, division of, for improve- ment of hearing, 2^8 function of, 39 motor supply of, 28 origin and insertion of, 24 Stapes, anatomy of, 18 articulation and ligaments of, 23 extraction of, for relief of deafness, 259 fixation of, as result of chronic middle- car suppuration, 199 by adhesive bands in chronic middle-ear catarrh, 224 in otosclerosis, 246 maximum excursions of, 38 mobilization of, 258 rupture of capsular ligament, 437 surgicid injury of, as cause of sup- jmrative labyrinthitis, 292 Statistics as to comparative frequency of temiwral lobe and cerebellar ab- scesses, 358 Kdmer's, bcAring u|)on comparative frequency of dural fistulaj m brain abscess, 492 Sterile gauze wicks in treatment of acute purulent otitis media, 177 UK<» of, in brain absc(»ss, 501 Stn»it'H operation for chroni(? middle-car suppuration, 456 Stuckv. J. A., treatment of otosclerosis, 257* Subjwtive noises, 136 cardiac, i.e., sounds transmittinl from carcliac valvular Unions, 139 c(Tcbral, i.e., auditory hallucina- tions duo to irritation of corti- cal hearing centres, 143 circuhitorv, ix., hl(HMi soumls due to locaf viu^ciilar chauK^'s, 13S ha'mie, i.r., a bruit sennet inies heard in nronounced j^rades of anieniia, l-U) Kihyrinthine, due to orj^anir ehan^es within labyrinth, 1 10 neurotie, i.r., due to hypenes- thc'sia of acoustic nerve. 111 tyni|)anir, ?.<•., due to lesions in- ' trrferirm with sound transmis- sion. I'M) Subperiosteal al)sc<'ss in acute niiLstoiditis, 1S5 deformity result iim from, IS.') sij^nilicanee of, in chrnni*' rnid<ll<'- ear suppuration (^!y^ind), 216 Suleus tympani«'us, (\ Supernumerary nodules, auricular, 515 treat nient of, 521 Supranu'atal spine (^spine of llenh';, -102 Surgical dislocation of stapes, pathological significance of, 316, 396, 441 exploration of brain, 495 guides to labyrinthine vestibule. 464 injuries of facial nerve during laby- rinthine operation, 471 of modiolus, pathologic signifi- cance of, 474 measures for rehef of deafness, 258 opening (accidental) of int^^mal audi- tory meatus, 474 Symptom complex of vestibular irritation, 287 Symptoms of intracranial disease, 322 S^nphilis, influence of, upon progress of intercurrent otosclerosis, 2-fi of auditory nerve, relation of salvar- san to, 538 of labyrinth, acquired, 530 congenital, 530 Taste, disturbance of, as result of injury to chorda tympani nerve, 398 Teeth, lesions of, as cause of aural symp- toms, 550 Temperature and pulse changes character- istic of intracranial disease, 324 changes in brain abscess, 364 in infective sigmoid sinus throm- bosis, 346 Temporal bone, development of, 4 relat ion of intracranial structures to, 490 wi<le distribution of pneumatic spaces in, 422 lobe abscess, aphiu^ia in, 371 bacteriology of, 359 differential diagnosis of. from cen*lx»lliu: abscess, 381 etiology of. 357 eye-ground (changes in, 366 forms of panilysis occasion- ally occurring in, 369 mental disturbances in, 330 operative treatment of, 490 ])atholony of, 361 postofMrativc treatment of, ])ulse and temperature changes in. 365 pu|)illary changes in, 371 sur>ji<*al <"xploration of tem- ])orosphenoidal lobe, 495 sym|>toms of. .'^62 technic.d faults in treatment of, 492 terminal stage of, 374 Tension of normal sound-<'onducting mech- anism, Mach's theory. 39 Tensor palati mus<"le, 'M tympani nnisclc, canal for, 12 division of, for improve- ment of hearing, 259 INDEX 587 ^ 4 Tensor tympani muscle, function of, 39 nerve supply of, 28 origin and insertion of^ 24 Thompson, J. J., jugular vein, ligation of, 477 Throat, examination of, 69 Thromoosis of cavernous sinus, obliterat- ing, symptoms of, 348 of sigmoid sinus (see Infective sigmoid sinus thrombosis) Tinnitus aurium, 136 aneurismal, due to aneurism of internal auditory or basilar artery, 140 cardiac, sounds transmitted from cardiac valvular lesion, 139 cerebral, auditory hallucinations due to irritation of cortical auditory centres, 143 circulatory, i.e., blood sounds due to local vascular changes, 138 haimic; i.e., a bruit sometimes transmitted in pronounced grades of anaemia, 140 labyrinthine, sounds due to or- ganic changes within laby- rinth (e.g.f in otosclerosis), 140 neurotic, i.e., due to hypera»s- thesia of auditory nerves, 141 tympanic, due to tympanic con- ditions interfering with sound transmission, 136 Tobacco, aural disease due to, 130 Tobey, Geo. L., ligation of internal jugular vein, 489 Tod, Hunter, ossiculectomy for relief of chronic middle-ear suppuration, 458 statistics bearing upon usual location of brain abscess, 358 Tone perception^ determination of changes m lower limit of, 84 of changes in upper limit of, 87 Helmholtz's theory of, 274 normal limits of, 74 Toynbce's artificial drum membrane, 562 Tractus spiralis foraminosus, 272 Tragicus, 3 Tragus, 2 Transversus auricula;, 3 Traumatic dermatitis of auricle, 97 injuries of membrana tympani, 159 Treatment of brain abscess drained through dural fistula, 494 Trifacial nerve, tympanic branch, 28 Tubal catarrh, acute, auscultatory signs of, 151 changes in drum membrane in, 147 in children, 153 etiology of, 145 pathology of, 145 Tubal catarrh, acute, prognosis and treat- ment of, 149 symptoms and physical signs of, 146 chronic, diagnosis of, 221 symptoms of, 219 treatment of, 222 Tuberculosis of middle ear, caries of laby- rinthine capsule in, 534 diagnosis of, 532 etiology of, 532 facial paralysis in, 535 pathology of, 533 primary, 536 prognosis of, 536 symptoms and physical signs of, 534 treatment of, 537 Tubotympanic congestion, acute, signifi- cance and physical signs of, 149 treatment of, 153 Tuning-forks, author's set, 87 Bezold's set, 87 Hartmann's set, 85 use of, 84 Tympanic cavity, anatomy of, 10 anterior wall of, 13 blood-vessels of, 26 floor of. 14 folds or mucous membrane in, 25 inflammation of (sec various forms of otitis media) landmarks of inner wall of, 11 lining membrane of, 24 membranous compartments of attic, 26 muscles in, 23 nervous supply of, 27 posterior wail of, 14 roof of J 12 subdivisions of, 10 muscles, function of, 39 ring. 5 vault, acute infection of, 166 membranous compartments of, 26 parts of ossicular chain in, 56 Typhoid fever as cause of aural disease, 128 Umbo, 19 Unilateral muscular paralysis, interpreta- tion of, in intracranial disease of otitic origin, 327, 369 Urbantschitschj eye-ground changes in in- tracranial lesions. APR 8 AUG 1 ^ 1922. 