Affections of the Ear.
These, are so common, that, in almost every family, they require attention, at one time or another. And deafness, which so often results from these disorders, is so serious a misfortune that every affection of the ear should receive early attention.
Examination of the Meatus. For examining the meatus, or external passage of the ear, there is perhaps no better instrument than a simple silver or glass tube, of the size and shape represented in Fig. 185.
To make the examination properly, place the patient either in a sitting, kneeling, or standing posture, as may be most convenient, with the ear directly under a good stream of gas or lamp or sun light. Then take hold of the ear with the thumb and finger, and gently draw it outward and backward, and with the other hand introduce the small end of the tube or speculum, and carry it forward as far as it will go without producing pain. Then by gently swaying the large end of the tube back and forth, a stream of light may be made to illuminate all sides of the passage. If the lining of this passage is smooth, dry, pearly white, and shining, and is without wax, it may be regarded as healthy. At the close of the passage, the tympanum may be seen, and should be semi transparent, dry, and grayish white. Within this may be seen the handle of the malleus, coming from above downward and forward. This bone runs about half way across the tympanum, and divides it into an upper front, and a lower back part. This lower back portion, when viewed through the speculum, is more glistening than the upper and front part, and a bright spot of light is seen on its most rounded portion, which is just below and behind the point of the malleus. Inflammation causes this innermost part of the meatus to become thickened, vascular, or granular, like the conjunctiva of the eye when it is inflamed; it also causes it to secrete and discharge matter. INSERTIMAGE
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