In 1500 consecutive cases taken from the out-patient record books of the Pennsylvania Hospital there were eleven in which the membrana tympani was ruptured by traumatism. The cases were as follows:
—An Irishman, aged 46 years, a longshoreman, was struck on the head by a hammer weighing 3 pounds, which had fallen forty feet. He sustained a severe lacerated wound of the scalp and was rendered unconscious for some minutes. On recovering consciousness, he was deaf in the left ear and suffered from much roaring noise in it. The left auditory canal contained considerable blood. There was a large laceration in the anterior lower segment of the left membrana tympani. At the end of three weeks' treatment his hearing was normal and he had no tinnitus.
—A longshoreman, five days previous to presenting himself at the dispensary, had fallen thirty feet, sustaining severe contusions of the