Contributions to aural surgery / [W.R. Wilde].

  • William Wilde
Date:
1844-1848
Catalogue details

Licence: Public Domain Mark

Credit: Contributions to aural surgery / [W.R. Wilde]. Source: Wellcome Collection.

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    Up to a very recent period we possessed no better means of examining the external meatus and the membrana tympani than that afforded by the usual ear speculum, made somewhat in the form of a crane-bill forceps, and derived, with various modifica¬ tions, from the time of Fabricius Hildanus. Itard, Deleau, and Kramer have improved upon this speculum, which is that in ge¬ neral use in this country at present. Another description with three arms, and opening by a screw in the form of a vagina specu¬ lum has been manufactured by Mr. Weiss, the celebrated instru¬ ment maker of London, on the supposition that the external audi¬ tory passage could be increased in calibre by mechanical means. In making examinations of the meatus and membrana tympani with any of these instruments the chief requisite is a strong direct light, transmitted without interruption to the tympanal membrane or that portion of the passage which we wish to ex¬ amine; this is best effected by means of the sun’s rays, but as the ordinary specula can only dilate or straighten the external cartilaginous portion of the passage, a person accustomed to aural examinations can frequently, especially where the meatus is of a large size, observe the tympanal membrane, or, at least, a portion of it, without, as well as with, such an instument, by merely lifting up the auricle with one hand and pressing the tragus forward wfith the thumb of the other,if the light is strong and made to fall directly upon the passage. In all such exami¬ nations, however, the patient must be seated beneath the ope- ator, with the head slightly bent, opposite a window through which the sun is shining at the moment, and (in this country at least) if possible, between the hours of eleven and three. Artificial light has, however, been recommended, but it is not so requisite in this as in other countries.* Cleland used a convex glass, which was held before a wax light in order to concentrate the rays of light into the meatus. Boz- zini to this apparatus added a concave mirror, but without * In Vienna, for instance, daring the winter months, there were very few days on which there was sufficient sunlight for accurate aural examinations.
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