DEAFNESS, 
remains pa ses the functions of the organ are not much 
ed 5 
the ponderous ee s of a ham 
hardened wax, the praétitioner will have recourfe to exami- 
nation, by which he may reduce it to a certainty. Any 
means capable of removing the infp:ffated wax may 
adopted; but fyringing the paflage with w 
mo ae y and effec cual, and the oie expe 
an i lceratio on, which 
and not only obftrucs = eve ey » but is a one 
panied with much foeto ifea on not unfr equent 
It generally yields to a application of folutions of the me 
tallic falts, as as of muriated mercur ime water; or of vi- 
triolated zinc ; or to the ufe‘of the caeetan hydragyri ni- 
tratum ; calomel, or other alteratives being taken at the fame 
tine. — on the Ear 
Sometimes polypous excrefcence occur in the external 
peilege, aad impede the e paflage is rendered 
the preffure - the n 
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2. Deafnefi from Obftruétion of os Eyfaclian 7. vibe. — 
euftachian tube is a pa gC eac 
the internal cavity of the 
of the air, contained in a ‘cavity, dane the vibration of 
anum, it facilitates that vibration, 
rcan no longer be admitted into 
the cavity of t pene and the included portion either 
is abioned, or it remains. tn the mipiad cafe, the included air, 
enfa- 
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membrane of t Mpanum into the tympanum, as far as it 
will go, in ace ftate it will reft, and cannot vibrate in any 
confiderable degree. Either hypothefis will account for the 
deafnefs. But it has been fuggelted, he ss arc hae to 
the obliteration of the euftachian tube, the included air 
abforbed, and the cavity of the tympanum filled with mucus $ 
at teaft the cavity was found in this ftate in two inftances of 
ciffe&tion, where the euftachian tube wasclofed. See Saun- 
ders on the pene and Difeafes of the Ear, p. 42. 
The obftruGtion of the = moft frequently arifes from 
fy philitic aa in the throat, 0 
he deafnefs ne on the healin 
r floughing in the cynanch 
ma laa fae of the ulcers 
tuat is, when the obftruCion is complete. efcent of a 
nafal polypus into the pharynx, and enlarged tonfils, have alfo 
been known to clofe the tube. 
ifthe. patient blows, with his nofe and mouth flopped, he 
does not experience that eel ree which arifes from 
the inflation of the tympanu peaks only ofthe lofs 
of fenfe, and complains of no aad fymptom. The dea 
nefe differs in this re{pe& from ail other yeas ; the patient 
not being haraffed with ‘ikeeling noifes, which are falfe per- 
~ will then is 
sa ong etic: aay a difeafed ftate of the auditory nerves, 
or proceeding from real impreffions on the nerves produced 
by noi: caufes in the organ. 
Generally the obftru€tion comes on in confequence of fome 
notable difeafe in the throat, and the cartilaginous extremity 
of the tube is moft commonly the feat of it; yet it occafion. 
e bony portion. It 1s then flower in its 
m 110 obvious caufe, and confifts in aa 
compelled to truft to the eee account, This will be 
fufficient when the obftru€tion has been preceded by an ul- 
ceration or difeafe of the throat 
Ae are indebted to *helpenetration of Mr. Aftley Cooper, 
for enfe of hearing, which the ob- 
ftruétion piel He bad ee in fuppurations of the 
ea aa which had injured and even deftroyed the mem- 
the tympanum, that the fenfe of hearing was only 
mpaet * eae loft, and that the alias of deafnefs, 
when the membrana tympani was only inj m 
equalled de produced by the obfbrudied be 
thi was in 
ment even to a found ear, and in this 
means of reftoring to the organ the ex ace of its fundtions. 
Thi ith great fuc~ 
ce a fimilar lak of the 
operation in the han 
The operation is saaise od by paffing an inftrument into 
the external paffage, and doa ‘ Te ~ eS as 
inferior ail of the membrane e tympan 
neceffary to ftate the reafon fe making the ponéture j in a this 
place ; the ‘pot ion of the manubrium of th 
demands this precaution. A little Ga will mmeditely re 
perceived, fimilar to what is occafioned by the puncture of 
parchment, more particularly needs be ile asthe found 
more ana rom the rapid en e of the air 
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When the pun@ure sae spare re made, the patient 
is inftantaneou fly reftor rfeet hearing. The effect 
{the operation is the en fubftitution of a {mall hole 
in the membrana tympani for the euftachian tube; and 
air being admitted into the tympanum, the mobility: of the 
membrane returns, an the action of the machinery of the 
ie ee is re-eftablifhed. 
e only obftacle to the ah aa fuecefs of this pun@ure 
For this reafon, it is often necef- 
to make rather a large bee in the membr: se before 
you can infure the patient plane the recurrence of the deaf- 
nefs. a large hole diminifhes the perfeGion of the 
fenfe. Tenfion is the ftate effential to the membrane of the 
tymp his tenfion is not aries by a {mall per- 
foration i but if the membrane be much lacerated or seagate 
ing may generally te ‘epee than can be made 
