part of the labyrinth." Surely the Professor cannot have examined any of the works treating of muteism, or he would have been aware of the well-established fact, that in every country in which the subject has been carefully examined, and faithful statistics collected, the number of the acquired cases of deaf-dumbness is about one-eighth of the whole. A case has been related in which the auricle consisted in a fold of integument perforated with two apertures, and with the concavity turned towards the head. The auricle is sometimes the seat of congenital nævus, either alone or in connexion with the same disease in the neighbouring parts. In 1810 the late Professor Colles tied the posterior auris for aneurism by anastomosis of the auricle.

Congenital malformations and abnormal peculiarities of the external meatus and auditory canal are by no means uncommon; the passage is frequently smaller, and often more tortuous than natural, and it has been found closed with a polypous excrescence at birth. There is great variety in the length, caliber, and curvatures of the sides of the external auditory passage among different persons,—perhaps just as much as there is in the shape of the nose, the auricle, or any other feature of the face. I had no idea how much diversity existed in the auricle until I began to study diseases of the ear; and latterly I have so frequently observed congenital peculiarities and malformations of the auricle in persons who have applied for advice on account of some aural disease, that I have been forced to the conclusion, either that these peculiarities occur much more frequently than is supposed, or that, in some way which is at present unaccountable, persons possessing such peculiarities are more subject to aural diseases than the rest of the community.

I have met with cases, both in children and adults, in which the external auditory canal would not admit anything larger than the end of an ordinary dressing-probe. I have also seen an hour-glass contraction in the centre of the passage, which, although it had never impaired the hearing, was yet a considerable impediment to the removal of some hardened wax which had accumulated behind it. The external meatus is sometimes preternaturally wide. The meatus has been found double; the

supernumerary canal opening behind the auricle. False membranes stretching across the meatus have been recorded by many observers; and such cases are susceptible of relief by surgical operation, although considerable difficulty is always experienced in keeping open the newly-formed aperture. Several cases have been noted of imperforate meatus with and without any abnormal condition of the auricular cartilage. Sometimes the place of the external aperture is merely marked by a slight depression in the skin, at others the membranous portion of the canal is perfect, but beyond that all is solid bone. I have met with three such cases: one was a boy six years of age, labouring under otorrhoea on the left side; upon the right the membranous portion of the canal was perfect, but the osseous part was closed by firm bone, covered by a thin layer of integument. The second was in a woman, aged 30, born deaf and dumb; there was no osseous canal on either side. The third case was as follows:

A female, aged 20, applied at the hospital on account of otorrhoea of the left side. On examination, I found the right auricle normal, but the meatus ended in a shallow cul de sac, lined by smooth, white membrane, which just admitted the end of the little finger. She was completely deaf on that side, but, strange to say, until she had the inflammation and otorrhoea of the other, she was quite unconscious of her imperfection. How frequently do we meet with instances of total blindness of one eye, evidently congenital, discovered by the merest accident long after birth. Although the bottom of the shallow cavity in this case felt and sounded solid, I determined upon exploring it, and made upon two occasions a crucial incision; but all behind the membrane, which appeared to be a thin layer of cartilage covered with fine integument, was perfectly solid.

WOUNDS AND INJURIES OF THE AURICLE.

These injuries, either from accident or design, are not as frequent in this country, nor indeed any other, as in former days. "Cropping the ears" was, in the time of the civil wars, not an unusual punishment, and it is still resorted to in some Eastern countries. I remember a baker in Cairo being nailed by the ear

to his own door for selling bread beneath the standard weight. The punishment was a very severe one, as the man's toes scarcely touched the ground. I suppose "nailing the ear to the pump" was, from the popular adage, a common form of punishment in other days. Splitting or cutting off the ears was a cruel mode of maiming and ill-treatment resorted to by the insurgents in this country formerly; yet we read in history of celebrated generals forwarding to their sovereigns the ears of the vanquished, as trophies of conquest. Having had an opportunity of examining many of the wounded French soldiers after the battle of Constantina, I was struck with the number of sword-gashes about the head and face, and of the auricle in particular. I was informed they were inflicted by the yataghan, the mode of using which, somewhat after the fashion of carving a round of beef, may explain the way in which these wounds were inflicted. In Germany, when sword duels were common among the students, surgeons had considerable practice in simple incised wounds of the ear. Instances have been related of adhesion having taken place even after the part had been completely removed. Writers seem to be averse to the employment of sutures, but we have not in these kingdoms much experience of the matter. The application of lint, spread with white of egg, so as to keep the parts in strict apposition, I have seen used with advantage. A cork pad, accurately adjusted to the space between the posterior surface of the auricle and the mastoid region, has been recommended, but the ingenuity of the surgeon will, I think, without adhering to any definite rules, generally enable him in every case to adapt the means to the end. I have seen the auricle lacerated and contused by pressure against a wall, by falls, and by the transit of a cartwheel; and in the days of faction fights in Ireland, I have dressed many dozen auricles split and bruised by blackthorn sticks, and have often wondered at the small amount of injury or deformity which follows such injuries. Fracture of the cartilage has taken place from suddenly and violently doubling up the ear.

The operation of piercing the lobe for the introduction of earrings, either as a sanitary measure, or for ornament, so common among all nations, is not always unattended with unpleasant con

N

sequences. I have seen it give rise to erysipelatous inflammation, to eczematous eruptions spreading over the side of the face, and also to abnormal growths in the lobe. Piercing is usually performed with a sharp awl pressed through, against a cork held at the back of the lobe, by the jewellers, and those who dispose of the wares, ornamental or medicinal, to be inserted therein.

The skin of the auricle is, as already stated, highly sensitive. People speak of "blushing to the ears," because that part becomes red and hot upon mental emotion. Besides this, there are many popular adages relating to this part. We have all felt one or both ears unaccountably hot, and apparently swollen at particular times. If the left ear is red, it is said "somebody is speaking well of you," but if the right, the contrary. When, according to the Mosaic law, a bondsman's term of servitude had expired, and that from affection to his master he desired to remain, the owner was directed to "take an awl and thrust it through his ear unto the door: and he shall be thy servant for ever"-Deut. xv. ver. 17;—and my friend, Dr. Carter, has informed me, that whenever a negro in the West Indies wishes to attach to himself a dog, he nails his ear for a day to the door-post of his cabin. The state of the auricle is said to be characteristic of disease in other organs: it is red in congestion of the head; livid in diseases of the circulating system; and cold, thin, and insensible in nervous deafness, or in diseases of the internal ear. Pulling children's ears is, I have no doubt, conducive to inflammatory affections, both in the auricle and meatus. Boys increase the angle of the auricle, and give themselves what are called " dog's ears," by pulling down. their hats or caps; and, on the other hand, old women, from having tied up the auricle for many years, have so squeezed and flattened this part, that it lies close to the head, and the various curvatures, particularly of the helix, are obliterated. Sloughing and gangrene may ensue from long-continued pressure during lingering illness, or from exposure and want of due circulation, as in fever, when the extremities at times mortify.

Baron Larrey's work, alluded to at page 48, contains some valuable observations upon wounds of the auricle, and the mode of treating them. Among other matters he mentions a case worthy

of consideration in a medico-legal point of view. An officer of the French army stated that he was attacked by a stranger, who cut off his ear, but Larrey, on examining the wound, discovered that it had been done by the teeth. He also mentions the case of a soldier, whose meatus had been grazed by a musket-ball, and the parts adhering subsequently, the external aperture was thus hermetically closed by the cicatrix. As the man's hearing remained perfect, this case attracted great attention, and he was introduced at one of the meetings of the Philomathic Society, in the winter of 1815-16, as a singular instance of the preservation of hearing after he had "lost, according to his own statement, several small pieces of the meatus itself, besides all the small bones of the ear!" No doubt a French soldier is a very intelligent person, but whether his word should have been taken by the Savans with respect to the loss of the ossicula auditus is questionable; and whether the Baron should have published the case as a "surprising circumstance," without having made some attempt to explore the state of the membrana tympani by dividing the external cicatrix, is still more so. I mention the case, however, in order to show the looseness which prevailed among medical writers, even of the first eminence, with respect to diseases of the ear, twenty years ago.

TUMOURS OF THE AURICLE.

Morbid growths of the auricle are by no means uncommon: steatomatous and sebaceous bodies form in the concha; I have three times removed firm, encysted tumours, each the size of a hazel nut, from the posterior end of the helix. Hypertrophy of the lobe has proceeded to such an extent as to reach to the neck. Boyer, in his Treatise on Surgical Diseases, has related the case of a large pendulous lobe of that description, which he removed. The following case of fibrous tumour of the lobe, No. 19 in the Registry, is a good example of its kind.

M. S., a female, aged 19, has a hard, firm, ovoid tumour, occupying the centre of the lobe on each side, but largest on the left-of which the accompanying woodcuts afford faithful representations. It is of a stony hardness, and is quite distinct both from the cartilage above and the fleshy part of the lobe, which it appears to pass through. The skin covering it is smooth, and of