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*The Middle Ear.*—The middle ear, or tympanum, consists of an irregular cavity in the temporal bone which is lined with mucous membrane and filled with air. It is connected with the pharynx by a slender canal called the Eustachian tube.
These include the pharynx, nasal passages, mouth, bone cavities of the face in fact pretty much every hollow space in the head, every space that will resound in response to vibration and assist in multiplying it. Moreover, the cavities of resonance by their differences in shape in different individuals determine the timbre or quality of individual voices.
This emphasizes the fact that the old theory of leaving wounds of this nature open was erroneous. Solly reports the case of a tailor of twenty-two who attempted suicide by cutting through the larynx, entirely severing the epiglottis and three-fourths of the pharynx. No bleeding point was found, and recovery ensued.
An operatic tenor came to me with a tendency to break in scale-sounding, and with a nasal or catarrhal color to all his tones above E. I found attached above and back of the soft palate a mass as large as a hickory nut and completely blocking up the dome of the pharynx.
According to Guyot-Daubes, these organs, in a straight line, extend a distance of from 55 to 62 cm., and consequently the performer is enabled to swallow an instrument of this length. The length is divided as follows: Mouth and pharynx, . . . . . . . . . . . . 10 to 12 cm. Esophagus, . . . . . . . . . . . . . . . . 25 to 28 cm. Distended stomach, . . . . . . . . . . . . 20 to 22 cm. 55 to 62 cm.
This watcher, awake while all others slept, ranged the palace, and raised from hour to hour the cry of the farmyard, repeating it as often as was necessary, and thus supplying a clock. This man, promoted to be cock, had in childhood undergone the operation of the pharynx, which was part of the art described by Dr. Conquest.
If the follicles in the back part of the pharynx or throat appear distended, and even the tonsils themselves are affected and these again are part and parcel of this same mucous membrane we can say this is due to one of several causes: either to a reflex condition from the stomach, due to over-eating or over-indulgence of some other equally deleterious sort, or to inactivity of the bowels, or to suppressed perspiration, or to improper or undue use of the vocal organs.
These rapidly increase in area and thickness, till they coalesce and form a complete covering to the parts. In the pharynx the false membrane is less adherent to the surface than it is when the disease affects the air-passages.
With bulky food it consists of three steps, or stages, as follows: 1. By the contraction of the muscles of the cheeks, the food ball, or bolus, is pressed into the center of the mouth and upon the upper surface of the tongue. Then the tongue, by an upward and backward movement, pushes the food under the soft palate and into the pharynx.
The gradual reassertion of nature, as indicated by the clearing up of the inflamed mucous membrane of the nose, the thickened condition of the pharynx and the chronically congested cords, was an all-sufficient reward for anxious thought spent upon an important subject. You may ask what was the remedy in this case. It was simply advice given and heeded, together with needed incidental treatment.
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