464 OTOLOGY AND LARYNGOLOGY 



VI. Technology 



A few words must suffice to remind you of the great importance 

 of every technological progress for those whose special practice 

 lies in the treatment of throat, nose, and ear diseases. From year 

 to year these specialties tend more and more to become branches 

 of surgery, and the question of their surgical equipment therefore is 

 constantly with us. Most of our instruments are no doubt invented 

 by specialists themselves, but in not a few cases we are only able 

 to give a leading idea to the instrument-maker, and the success or 

 otherwise of our idea depends upon the constructive talent of the 

 latter. Nor is it rare that patients themselves devise improvements 

 of existing instruments and apparatus. Thus, for instance, the 

 most ingenious and at the same time simplest speaking-apparatus 

 which I have ever seen used by patients condemned to wear for 

 a time or forever a tracheal cannula was constructed by a watch- 

 maker who had the misfortune himself to belong to the class 

 of patients in question. A glance at the innumerable "modifica- 

 tions" of instruments now in general use recommended in the 

 catalogues of various instrument-makers shows the intimacy and 

 importance of our relations with technology, and I desire in con- 

 clusion of this reference only to remind you of the quiet revolu- 

 tion that has been going on in our tools of late years in proportion 

 to the greatly increased importance of aseptic surgery, and in the 

 course of which it has become the aim to have all our instruments 

 fashioned out of metal, and to banish wood entirely. 



VII. Music 



Next we come to a most fascinating subject the relation of 

 the noble art of music to laryngo-rhino-otology. Of the intimacy 

 of this relation there can be no possible doubt; without what is 

 called a "musical ear" music is an impossibility altogether; with- 

 out the possession of a healthy larynx, singing cannot be thought 

 of. When I speak of a "musical ear" I mean, of course, the con- 

 trol exercised by the ear over the technique of executants; that 

 music in its highest forms is completely, or at any rate nearly, 

 independent of the power of hearing has been shown by nothing 

 more conclusively than by the case of deaf composers, whose "inner 

 voice," to speak with Robert Schumann, elevated them beyond 

 the apparently indispensable faculty of hearing. Beethoven was 

 deaf when he wrote the Ninth Symphony, and nothing more path- 

 etic surely can be imagined than, when his audience after its first 

 performance rose to an indescribable pitch of enthusiasm, one of 

 the singers had to turn the deaf Maestro round in his chair to see 



