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August 1, 1908


JAMA. 1908;LI(5):364-368. doi:10.1001/jama.1908.25410050004002

This condition depends on trophic changes and, in contrast to a multitude of clinical forms that have been described under various names, it has a comparatively simple pathology. The clinical appearances vary with the location and degree of the pathologic change and with the structure and tissue affected. However, since the treatment is not dependent on these circumstances, it is only confusing to go into minute details in regard to the clinical pictures. Not only does the appearance change with every conceivable combination of the part affected but also with every stage of the pathologic change. The forms which the sclerosis may assume are as numerous as the combinations of stages and anatomic parts will allow. For instance, the sclerosis may be located in any part of the tympanum and the various pathologic changes may be going on at the same time. Formerly this great diversity caused considerable confusion in

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