48 SMITHSONIAN MISCELLANEOUS 'COLLECTIONS VOL. 93 



For Von Troeltsch (1881) the " exostoses " were pathognomically 

 close to tumors, the " hyperostoses " close to diffuse osteophytic 

 growths. 



Hedinger ( 1881) diagnosed his case as " ostoid metamorphosis of 

 inflammatory proliferation of papillary and connective tissue, with 

 lime deposits " — no regular bone formation. 



Moos (1881) regarded his cases as simple hyperplasias arising 

 from irritative processes at a time when the tympanic ring fuses 

 with the adjacent parts of the temporal ; Roosa, about the same time, 

 viewed them as " hyperplasias of the periosteum and the underlying 

 bone"; Politzer (1893) as "partial hyperplasias of development and 

 ossification." 



Steinbriigge (1891) terms the outgrowths "periosteal osteomata." 

 Virchow (1893) considers them as " plainly products of pathological 

 nature .... examples of disturbed development, which probably 

 l)egins in and proceeds from the end parts of the annulus tympanicus ", 

 and says later, " The localization of the exostoses of the auditory 

 canal implies that they, as the exostoses of other parts of the skeleton, 

 may be conceived as excessive bone growths on places which are 

 advancing toward ossification." 



Whitney puts them, ab orig'uie, under " cartilaginous exostoses." 



BraunBerger (1896, p. 6) thought that " if we want to give these 

 exostoses an anatomically and physiologically substantiated position 

 in ear pathology, we must range them with connective tissue tumors 

 in the ectodermal part of the sound-conducting apparatus of the ear." 



Ranke (1900) believed that the growths "were examples of an 

 endemic disease common to the burial grounds of Ancon as well as 

 those of old Peru in general." 



Sabroux (1901, p. 13) says, " Exostoses of the auditory canal are 

 tumors formed by an abnormal and circumscribed production of bony 

 tissue on the surface of the canal." They are " benign tumors, harm- 

 ful only by mechanical obstruction." 



Mayer (1923, 1924) attaches these exostoses (as also otosclerosis) 

 to the " hamartomata " or defect-developments (Fehlbildungen), and 

 refers them to a defective condition of the periosteal connective tissue. 



For Marx (1926, p. 500), " exostoses of the auditory canal repre- 

 sent circumscribed bony neoplasms and are to be counted with the 

 tumors, in distinction from the more dift'use hyperostoses, that belong 

 to the hyperplasias. A sharp division of the two is, however, not 

 always possible, as evidently there are transitional forms and as cir- 

 cumscribed exostoses may also occur in a meatus narrowed through 

 hyperostosis." 



