FEMINISM

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are a large number of chronic cases of tympanic disease which can be permanently benefited by minor permeatal procedures. I cannot agree with Dr. Faulder White that a wave of surgical prejudice in favour of mastoid operations has cast a dark shadow over intrameatal surgery. The details of the special operative procedure practised by him under the title of " otectomy " appear to me to be very similar to the minor operations which are done every day by aural surgeons with considerable success. He tells us in his letter that permeatal surgery has been deplorably neglected in our country, and I am confident he is right if he refers to the practice of thirty years ago, when in every town and village in the land patients could be found suffering from permanent deafness and disorders of the ear which had never received any kind of treatment. Parents then ignorantly neglected the aural troubles of their children and regarded "1 a running of the ear " as a constitutional error, which ought not to be rashly checked; but fortunately all these old myths are rapidly passing away by the progress of education and the growing influence of our science, and to-day minor operations are performed in the early stages of suppurative otitis with the best resalts. Dr. Faulder White does not consider it surprising that 70 per cent. of his cases obtain improved bearing power after undergoing the operation of otectomy, and this is certainly a favourable result; at the same time, it does not indicate greater success than that which follows all intrameatal operations, provided the destructive changes have not extended to the nervous structures of the internal ear. In conclasion, I desire to congratulate Dr. Faulder White on his successful management of the interesting case of a lady who had suffered from an infected ear from early life, and upon whom he performed the operation of otectomy. Dr. Faulder White's silence on this occasion was, indeed, golden. She had consulted many specialists before, and they had acted in the same judicious manner, but the result of the successful operation evidently came upon her as a very agreeable surprise, which, no doubt, added greatly to the pleasure she experienced from the unexpected increase of her hearing power -I am, etc., Portsmouth, Oct. 18th. J. WARD COUSINS.