A clinical manual of the diseases of the ear / by Laurence Turnbull.

  • Turnbull, Laurence, 1821-1900.
Date:
1872
Catalogue details

Licence: Public Domain Mark

Credit: A clinical manual of the diseases of the ear / by Laurence Turnbull. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    acute meningitis, and sporadic or epidemic cerebrospinal menin- gitis, is due to purulent otitis interna, a complication—perhaps a metastasis—of the purulent inflammation of the meninges, in the same way as purulent choroiditis is not an infrequent complication of the same diseases. Voltolini's opinion, that the whole affection in such cases is an inflammation of the labyrinth alone,—otitis labyriuthica, mistaken for meningitis, —lacks both foundation on pathological anatomy and clini- cal analogy. Among the general diseases which are liable to produce deafness, constitutional syphilis furnished a valuable example in a case, showing a pure attack of Meniere's disease, in a pa- tient who soon after had an analogous affection of his eyes This being exudative irido-choroiditis, chiefly of a serous character, it may be inferred that the labyrinthine affection also was a serous exudative inflammation. Severe fevers— for instance, typhus or typhoid; acute exanthemata: variola, scar- latina, rubeola; eclampsia infantum; erysipelas; pustular and eczematous eruptions on the head; mumps, angina Ludwigii, and sunstroke are all apt to produce deafness without material changes in the middle ear. The most probable anatomical lesion in all these cases seems to be serous or hemorrhagic inflammation in the labyrinth. The lesion producing deafness after childbirth may be of the same nature or metastatic, as in severe puerperal fevers ; aneemia, in certain cases. We may, therefore, subdivide otitis interna inUo three kinds: 1. Hemorrhagic: sudden and traumatic deafness. 2. Serous exudative, or simple: idiopathic Meniere's dis- ease, and the deafness from syphilis, severe fevers, acute ex- anthemata, erysipelas, and other constitutional diseases. 3. Purulent: a primary disease of traumatic origin, per- haps also spontaneous and sui generis (Voltolini), and second- ary in simple and cerebro-spinal meningitis, puerperal fever, and other pysemic diseases. The dmgnosis of inflammation of the labyrinth is mainly supported by the symptoms of permanent irritation and pa- ralysis of the auditory nerve :—tinnitus auriumand deafness, —accompanied by transitory cerebral symptoms:—headache, 29