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Up to a comparatively recent date an acute inflammatory process within the tympanum was scarcely considered worthy of consideration, from a surgical point of view, unless it was of so severe a type as to involve the osseous structures in immediate relation with the tympanum. The general practitioner, and quite frequently the otologist, advised what was then the "conservative treatment" of these cases. The patient was allowed to suffer pain until spontaneous evacuation of the inflammatory products occurred.
It is hardly necessary for me to point out that this plan was erroneous. It was, perhaps, excusable for the reason that only within the last few years has much been written upon the special anatomy of the middle ear. Thanks to the investigations of Blake and Bryant of Boston we no longer consider the middle ear as a single cavity, but divide it into two portions, the atrium and the vault,
DENCH EB. THE SURGICAL TREATMENT OF ACUTE INFLAMMATIONS OF THE MIDDLE EAR.. JAMA. 1898;XXX(12):660-662. doi:10.1001/jama.1898.72440640028003j