5/21/31 Report by Dr. M. L. Richardson:
Mrs. [
5610],
417 - 22nd St.
Virginia Beach, Va.
Report on examination made May 20, 1931.
Diagnosis: Otosclerosis - a type of ear disease
characterized by head noises and progressive impairment
of hearing.
Etiology: The conditions of which you now complain are
really secondary to a long standing nasopharyngitis (catarrh)
which causes a thickening of the mucous membrane lining the
postnasal spaces and around the Eustachian tubes and then
extended to the tubes and middle ears. It has also produced
adhesive bands from the ear tubes to the back wall of the
nose binding the tube and hindering its normal actions. The
ear tubes are thus unable to perform their normal functions
of ventilation, drainage, and circulation to the ears, and
the normal offices [orifices?] of the ears are gradually
impaired.
Prognosis: Taken at this stage the usual result of treatment
is to stop progress and give definite and permanent relief
and improvement.
Discussions: No treatment to your ears or tubes can be of
any permanent help so long as the condition described in the
postnasal spaces and around the ear tubes remains to feed
trouble anew to the tubes and ears.
The plan of treatment proposes therefore:
1st - A corrective finger operation to remove and destroy
the excess tissue and adhesions in the postnasal spaces, and
two after treatments in next 10 days, and
2nd - A month or six weeks later a second finger operation
to reconstruct the ear tubes, restoring them to size opening
and position, re-establishing ventilation, drainage and
circulation to the ears, and
3rd - Six weeks after treatment must immediately follow the
above - two or three treatments per week - to maintain the
corrected tube conditions, and to prevent the formation of
adhesions until the restored conditions will remain without
further help.
To avoid disappointment it is well to caution that material
benefit to hearing or head noises must not so much be
expected during the course of treatment as later, treatment
restores conditions on which ear health depends, function
follows structure.
My treatment is definite, systematic, and progressive, and
will give happy results only when carried out completely as
outlined. The treatment outlined here is the minimum I dare
offer you, the conditions to be remedied here have been years
in forming and time also is necessary to correct them. Cure
depends on the healing powers of nature, and nature takes her
own time and can be aided but not hurried. Although no
physician can guarantee anything about a human body, even
that a condition will not progress in spite of suitable
treatment, the expectation in your case is given only after
careful tests and examination, a record of results in similar
cases, and a consideration of your favorable age and general
health.
Treatment is all given in my office. The oxygen gas
anaesthetic which is given twice, although complete in its
effect is not unpleasant to take, recovery from it is prompt
and without unpleasant after effects.
My fees are usually - corrective finger operations (2)
$100. each. All other necessary treatments $5.00 each.
I expect those who are able to accept my usual fees, at the
same time I am always ready to make some accommodation to
those who might otherwise be denied treatment. I do this by
suitable reduction of the two operating fees, the others to
remain as given.
Sincerely yours,
7/31/31 See her next reading,
5610-4, for which she was
present.



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