l6 SMITHSONIAN MISCELLANEOUS COLLECTIONS VOL. 93 



The maximum incidence of ear exostoses is not in Peru, but ap- 

 parently among the tribes with fronto-occipital head deformation of 

 the Cokimbia watershed, and in the Tennessee-Ohio mound and stone- 

 grave region ; also apparently in the old population that has left its 

 skeletal remains in the caves of Coahuila, northeastern Mexico. 



The data will receive further attention in the discussion of causa- 

 tion. For the present it is sufficient to note the fact that in America 

 itself very marked dilYerences exist, as to tribe and location, in the 

 frequency of the growths under consideration. 



There is but a single observation on a series of Eskimo skulls and 

 that is negative — Russell in 54 specimens found no exostosis. 



From regions other than Europe and America the data on ear ex- 

 ostoses are as yet very inadequate. There is little or nothing in this 

 respect on the peoples of the densely populated areas of China, India, 

 and Malaysia, of the rest of Asia or of Negro Africa, but there are 

 indications that the abnormalities in question are relatively frequent 

 annong the IVjlynesians. The data are given in the table on page 15. 



CLINICAL MATERIAL 



In addition to the data tabulated in the preceding pages, there arc 

 scattered through medical literature of the last and present centuries 

 reports of perhaps as many as 300 separate clinical cases of ear ex- 

 ostoses in white Europeans and Americans. A large majority of these 

 are reported more or less defectively as to nationality, sex, age, and 

 other details of importance, attention having been centered on the 

 pathology and cure of the condition. Anthropologically, they add but 

 little to the knowledge of the growths beyond showing further that 

 they occur with no great rarity in England, France, Belgium, Germany, 

 Italy, and other European countries, as well as in the United States. 



Numerous as these reports are, they would not suffice to give a clear 

 and full picture of the abnormalities. But here and there interesting 

 points appear, and collectively there is much of value on the histology 

 and especially on the etiology of these ear tumors. 



The earliest comprehensive account of this nature is that of Joseph 

 Toynbee (1850). He reports 12 cases of such "tumors", 10 (ap- 

 parently) in males and 2 in females, mostly elderly people of British 

 extraction. The exostoses consist of very hard and dense bone, are 

 of slow growth, and develop frequently " unattended with any symp- 

 toms." He strongly suspects their connection with gouty diathesis 

 and from a further standpoint of causation divides them into two 

 classes — one " in which the disease appears associated with congestion 



