A text-book of the diseases of the ear for students and practitioners . spots. Through the thin layer of secretion,the congested vessels of the manubriumand the processus brevis can still beplainly seen. On the other hand, whenproliferation and thickening of theepidermic layer take place, the mem-brane is covered by a whitish-yellow,non-transparent epidermic layer which PlG. 107—Granulationscompletely masks the malleus, and which on the Membrana Tym-is only removed with great difficulty bysyringing. In such cases the greatlyswollen dermic layer appears intenselycongested, flattened and velvety
A text-book of the diseases of the ear for students and practitioners . spots. Through the thin layer of secretion,the congested vessels of the manubriumand the processus brevis can still beplainly seen. On the other hand, whenproliferation and thickening of theepidermic layer take place, the mem-brane is covered by a whitish-yellow,non-transparent epidermic layer which PlG. 107—Granulationscompletely masks the malleus, and which on the Membrana Tym-is only removed with great difficulty bysyringing. In such cases the greatlyswollen dermic layer appears intenselycongested, flattened and velvety afterdesquamation of the epidermis, andirregular reflections of light are seenscattered over its surface. When theepidermic layer is partially detached, the congested areas maybe mistaken for ulcers of the membrana tympani. Chronic myringitis sometimes leads to the formation ofpapillary excrescences (vide p. 230) ; they appear as light-redpapillae, the size of a pins head or hemp-seed, and may eitheroccur singly, in groups (Fig. 107),* or in great numbers over the. pant of a Young Girl who suffered for seve-RAL Years from Dis-charge from the Ear. Removal of the growths bytouching them with sesquichlor. * Politzers Atlas, Plate II. 240 DISEASES OF THE EAR entire membrane. In the latter case, the membrane has theappearance of a purple raspberry, with numerous dots of lightscattered over it. In one case, the author saw an isolated growthexactly at the point of the processus brevis, and in another, uponShrapnells membrane. At times the papillary formation extendsfrom the posterior superior quadrant of the membrane to theposterior superior wall of the osseous meatus. Diagnosis. — The changes perceptible on the drum mem-brane during an inflation of air are important for the diagnosisof primary chronic myringitis. When Valsalvas method or thatof the author is employed, the membrane becomes bulged outwardsand the characteristic perforation sound is absent. By this meansc
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