Clinical contributions to otology from the practice of Dr. C.R. Agnew / reported by D. Webster.

  • Webster, David, 1842-1923.
Date:
[between 1870 and 1879?]
Catalogue details

Licence: Public Domain Mark

Credit: Clinical contributions to otology from the practice of Dr. C.R. Agnew / reported by D. Webster. Source: Wellcome Collection.

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    / y' Clinical Contributions to Otology. 3 tender and painful without change in the character of the dis¬ charge.” The patient arrived at New York a little more than two weeks after the above letter was written. He stated that the pain in and about the ear had been very severe for nearly three weeks, and had increased in severity so that he had not slept at all for the last four nights. He also had a constant roaring in the ear. The tissues over the temporal bone were so swollen as to push the auricle off from the side of the head about three-quarters of an inch. The swelling extended considerably in front of the ear, at least two inches above, and backwards nearly to the occiput, and the whole area was the seat of great tenderness. The walls of the external auditory canal were swollen and boggy, and prevented a complete view of the membrana tympani, but after syringing out the pus with warm water, by using a very small speculum a bubble of pus could be seen protruding from the depths and on inflating by Valsalva’s method this bubble was lifted, but there was no “ perforation whistle.” The ear seemed to be totally deaf to external sounds, but heard the turning fork when applied to the forehead or vertex. The same afternoon Dr. Agnew made an incision down to the mastoid, about one inch and three-quarters in length, and cutting down through the periosteum very thoroughly. The depth of the wound was about one inch at its deepest portion, and the tissues cut through were tough and brawny, and the bone was roughened in spots. Little or no pus made its appearance, and the amount of bleeding was moderate. Lint was stuffed down to the bottom of the wound throughout its whole extent, and hot poultices of flaxseed or slippery elm were ordered to be applied about every two hours. The following day the patient reported that he had rested well, and there was marked amelioration of all the symp¬ toms. In a day or two a slight discharge from the wound set in, and this was encouraged by continued poulticing, the tent in the wound being changed every two or three days. The ear was gently syringed with warm water from time to time, and occa¬ sionally inflated by Politzer’s method. There was a gradual sub¬ sidence of all the symptoms, and in a little over a month Col. D. was allowed to return to his home in Pennsylvania. The discharge from the ear soon ceased, and the organ still remained well when we last saw him more than four years later. The ear did not re¬ cover useful hearing, however.