NO. 



EAR EXOSTOSES HRDLICKA 6l 



Syphilis has been blamed for so many pathological conditions of 

 which the causes were difficult to detect that no surprise need be felt 

 that ear exostoses, too, have been attributed to the disease. 



The first to believe he saw a direct connection between the two is 

 Triquet (1857, q. by Sabroux), who says " the presence of these bony 

 tumors is not encountered except in subjects manifestly affected by 

 syphilitic infection." Roosa (1866, p. 428) believes that, as with gout, 

 " the influence of syphilis may not be denied, but must not be over- 

 estimated ". Gruber (1870) thinks syphilis acts in part as a cause; 

 so also, more or less similarly, do Politzer, Jacquemart, Fournier, 

 Noquet, Meniere, Krakauer, and Sabroux. 



To the above stand opposed Von Troeltsch. Delstanche, Schwartze, 

 Erhardt, and Hedinger. Von Troeltsch (1881, p. 142) says cate- 

 gorically — " connection with syphilis is utterly undemonstrable ". 

 Hedinger (1881), as a result of his observations on about 40 cases 

 of ear exostoses, " must exclude syphilis as an etiological factor ". 

 For Kessel ( 1889) , ascribing them to syphilis is untenable. According 

 to Duplay (q. by Sabroux, 1901, p. 25), "nothing authorizes us to 

 connect these exostoses with syphilis." 



Sabroux (1901, p. 24), though on the basis mainly of the opinions 

 of others, inclines to the view that syphilis is concerned in the genesis 

 of the congenital ear tumors ; while in the acquired forms, " syphilis 

 is quite certainly the most common agency that influences their de- 

 velopment In hereditary syphilis we have the congenital ex- 

 ostoses ; in the acquired we encounter the exostoses as one of the 

 tertiary manifestations of the disease." And for Ballenger (1914, 

 p. 662), " Syphilis is undoubtedly a cause of the growths, although 

 not in a very large number of cases." 



Yet for Bezold and Siebenmann ( 1908. p. 102) " there is no proof 

 of a special diathesis for this disease such as lues." 



There are other statements on the two sides of the question, but 

 no proofs. More recent textbooks and authors in otology tend to 

 be cautious. 



Remarks. — Not one single case in the great collection of prehis- 

 toric American material that passed through our hands in connection 

 with this study, has shown any evidence of syphilis. Nor was there 

 seen any trace of the disease in any of the Polynesian or other skulls 

 that were found to be affected with ear exostoses. 



In the 14 post-Columbian to recent Indian, Eskimo, and White 

 skulls with extensive tertiary syphilitic lesions, in the United States 

 National Museum collections, not one shows even a small ear exostosis. 

 5 



