This instrument may be, and probably is, as yet, in its infancy. It, and the method it applies, can only be perfected by constant work and experimentation both on the part of the profession and of the manufacturers. Each improvement we can suggest, if it only should serve as a means of helping one solitary case, would be well worth our while.
The experiments being made by different methods for treating deafness by sound waves is indicative of the interest the profession has taken in the matter. It is indicative of a lack of something in our usual armamentarium which is greatly longed for by patient and doctor; that is, the means for making the deaf hear and for relieving distressing tinnitus. There has been a dearth in this direction, and perhaps there still is, but I believe fully that we have in aural massage by vibratory force a decided acquisition at our hands.
E. H. LINNELL., M.D.: I would simply like to ask Dr. King how long he uses the instrument, and whether he uses it according to the deafness.
DR. KING: Yes, decidedly. In an intense case of deafness I would have to use it a great deal longer. The central attachment I never carry over three or five minutes, and the whole treatment I don’t think is over carried over twenty or twenty-five minutes in one case, and usually averages from ten to fifteen.
HAROLD WILSON, M.D.: I have only to suggest, what I have elsewhere called attention to, the possibility of another mechanical device for securing vibratory motion. It is well known that in the make and break of a current of electricity, in the circuit of which there is a telephone, we get an influence upon the make and break of the current in the telephone. Now, it is a simple matter with which these makes and breaks are made as to obtaining any number of vibration that you wish. You may, by a mechanical device of some rotary motion, if you choose, make and break the current as rapidly as you please until you have reached several thousand vibrations a second, or you may even make the vibrations so slow us to be easily counted.
The application of this suggestion has been put in force in my own practice, more or less, in the use of the telephone as connected with the induction-coil ordinary battery. The more intense the current, the more intense the sound. You can easily see that it is mere question of mechanics to secure these two sounds-intensity of vibration and rapidity of vibration. I will say, furthermore, that it has this advantage. There is no noise in the office, which I think is not altogether true of the vibrometer. I would suggest that so far as the vibrometer is concerned, if it could be made to be noiseless to anybody but the patient, it would be a decided improvement. In that respect the telephone is a decided improvement, because there is no noise except to the patient, because the noise is right at the ear of the patient.
If I were seeking for a perfected instrument in this line, I would go outside of the banjo idea. As we have the most perfect writing machines, which have no connection with the ordinary method of writing, and sewing machines, which have no connection with sewing by hand, so it occurs to me that possibly the securing of he vibratory motion upon the ears might be obtained in a totally different way from that which you get when you listen to the drum of the guitar or an ordinary musical instrument, and I would suggest that the make and break of a telephone open a very fruitful field for mechanical experimentation.
H.C. HOUGHTON, M.D.: In my study of this subject I made the acquaintance of Mr. Bernhardt, of New York City, who is a personal friend of Mr. Emil Berliner, the inventor of the Emil Berliner Telephone, which is the instrument by which the Bell Telephone Company maintain their monopoly at present. Mr. Berliner is the inventor of the graphophone, and has, I think, covered this whole matter which Dr. Wilson has mentioned.
As ordinary Bell telephone receiver is put into the circuit of an ordinary induction machine, and you can use it just as the English people use the audiometer, and as you remove the coil you modify the vibrations, which is covered with another disk and a tube, and that tube covered with a stethoscope tube, which is the same as we use for the phonograph or vibrometer, and, as Dr. Wilson has suggested, you can modify the intensity, and of course the whole matter is adjusted by the attachment of the cord, so that you can have fine vibrations. The intensity of the vibrations is regulated by the distance to which you uncover the cord. The only difficulty in the adjustment is that it has been so severe that it is really uncomfortable, and the noise of the instrument is reduced to the minimum for office use.
A.B. NORTON, M.D.: I will also add that in regard to the objection Dr. Wilson makes to the noise, there is no doubt it is an annoying thing in the office, and in that line I have some men at work on my suggestion. We are devising another machine, or instrument, which is to be entirely enclosed in a cabinet, so there will be no noise whatever in the room if it is made a success. The idea is a little crude, and I am quite uncertain whether it will amount to anything or not. Then, in the line of what Dr. King was speaking in regard to Mr. Goodwin-he called, at New York, to see me last week.
I made two little suggestion to him, which I think would be in line with his advancement. One is the number of the picks. The present vibrometer has four picks I suggest the experiment of trying twelve or sixteen picks, which will make a more continuous sound; it may be of some value. Then, in regard to regulating the speed of the machine: you regulate that now by a series of buttons, so as to get three different speeds. We will have a very slight, intermediate speed, and a very rapid speed. My experience with the vibrometer is especially favorable. I think the idea is in the right direction, and it is simply a matter of instrumentation.
