Abstract
Although this is not classed as a suppurative disease of the middle ear, it may be the result of the vascular turgescence produced by pyogenic infection of these parts. It has been proven that there is no pathologic difference other than that of degree between acute suppuration and acute catarrhal otitis media. The resisting power of the organism or the great amount of infective material present determines whether the process will appear as a catarrhal or a suppurative process. Since vascular turgescence, hyperplasia and sclerosis are almost always associated to some extent with hypertrophic catarrh of the mucous membrane of the middle ear, they must be considered in any discussion on this subject. There are cases where hypertrophy of the mucous membrane of the tympanum seems to be the predominating result of vascular turgescence of these parts. Some cases of vascular turgescence and hypertrophy of the middle ear progress slowly,
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