Membrana

It sometimes happens likewise that they appear at the same time, when the membranæ are bordered by knotty excrescences and the lungs with tubercles.

By it he also explains the appearances which have induced Henle to imagine that it was furnished with innumerable glandular follicles, inasmuch as in vertical sections of the membranæ the appearance afforded by the deeper furrows is precisely that of mucous follicles.

Chronic aural catarrh most surely exists now on the right side, and as the membranæ are similar in appearance, each presenting unmistakable evidences of the aforesaid disease, I believe the left side had been affected by the chronic catarrh some time before, which in all probability induced the vertiginous attacks by an extension of disease to the labyrinth, and perhaps to the semicircular canals.

By this means the adhesion was divided, that portion of the membrana which was adherent being cut away and either removed or left adherent to the inner tympanic wall.

July 21st, 1893, the patient was etherized, and I endeavored to remove first the right and then the left incus, after their exposure by exsection of the posterior-superior quadrants of the membranæ.

Otoscopic examination of the ear revealed retracted but not thickened membranæ. The incus was visible through each. Hearing in the left ear was nil; in the right ear by means of the ear-trumpet only. The tuning-fork was not heard per ossa in either ear. The membranæ were found restricted in their movement under the pneumatic speculum.[…]By November 1st the right membrana had healed, and the man could hear conversation close to his ear without an ear-trumpet. A little tinnitus existed. / The day after the removal of the incus the patient could hear the voice close to the left ear, which had been impossible before. This ability, however, gradually disappeared before the membrana closed.

Sept. 20th. Is very sick. Pulse is 115. Temperature 103. I simply examined the membranæ, which were normal. / Sept. 22, 24 and 26. Patient too sick to examine for hearing. Membranæ both normal.

Paint the upper and lower surfaces of the membrana to be removed with some suitable anæsthetic; allow time for this to act, secure the membrana firmly with a pair of forceps or by passing a fine silk thread through it, and excise with a small pair of curved scissors or sharp scalpel as close to the inner canthus as possible.[…]In several cases which were kept under close observation for three or four years the animals did not in any way appear to be inconvenienced by the removal of their membranæ.