(“Neurologischer Centralblatt,” No. 14.) Professor W. v. Bechterew treats of the conduction of sound and percussion of the bones of the skull and vertebral column. Dr. W. O. Kunew (“Wratch,” 1893, Nos. 48 and 49) has already indicated a method of examination for suppurative inflammation of the mastoid process in disease of the middle ear. He employed a common india-rubber tube, such as is used for otoscopic examination. The earpiece is inserted into the auditory meatus, and the funnel laid upon the mastoid process. If a tuning fork be now made to vibrate on the vertex of the head, the tone is always more distinct on the sound mastoid process than on the diseased one. He holds that examination of the conduction of sound is indispensable in deciding the question whether the mastoid process should be trephined or not. Diminution of the intensity and muffling of the sound of the tuning fork if conducted through the bone is an infallible symptom of deep disease, suppuration, caries of the bone, or new formation. This new method of diagnosis enables the surgeon to trephine early.
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