Case 1.—Chronic sclerosing inflammation of the middle ear.
J. B., a negro, age 25, employed as a waiter. His general condition is good, but there is a rheumatic diathesis. His previous history is of but little value. Has had little or no treatment. Has steadily increasing deafness which became apparent in the left ear first, about three years previously. This has become so great that it seriously interferes with the proper peformance of his vocation. There is arterial tinnitus but he complained of it only when questioned. There has been no pain; no discharge. The deafness has become decidedly worse during the preceding four months.Auricles and external canals normal, except for the absence of cerumen in the latter. Tympanic membranes pale; mobility slightly decreased; not depressed. Light reflexes quite normal. Handles of mallei were defined through their entire lengths. The Eustachian tube only slightly occluded; that on the right