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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    external auditory canal is bathed in pus. A small, slightly pro¬ jecting red spot, on the upper part of the posterior wall of the auditory canal, very near the membrana tympani, attracted our attention, and upon further examination we found this to be the mouth of a fistulous opening through which the end of a bent probe could be easily passed into the mastoid antrum. The ears were inflated by Politzer’s method, and he was in¬ structed to have the left syringed gently, three times a day with warm water. The patient returned to us three weeks from the date of his first visit with some swelling and tenderness over the mastoid. He had not had any acute pain, but complained of a constant dull aching, “ like the feeling produced by a boil.” A free incision down to the mastoid, over an inch in length was made, but no pus was found. A tent was introduced and poultices applied, and he was sent home again to be under the care of his family physician. When he came to see us again in three weeks, the swelling and tenderness of the mastoid had passed away, the wound was healed, and the hearing distance had risen from nails 1, to nails at 8/ The fistulous communication between the mastoid cells and the exter¬ nal auditory canal still persisted. Case VI.—Acute inflammation of the middle ear, terminating fatally from brain complication. June 16th, 1875.—James M., aet. 60, manufacturer, states that he caught cold, last Friday, by getting wet in the excavation under the East River at Hallet’s Point. The following night he suffered from pain and “ pulsation ” in his right ear. For the last two nights the pain has been so severe as to prevent sleep. The auditory canal is red and swollen in the vicinity of the membrana tympani, which is reddened, bulging, and distinctly pulsating. The Eustachian tubes are open. The watch is not heard in his right ear. The pharynx is red, the tonsils are swollen. I punctured the membrana tympani and by inflation by Politzer’s and Valsava’s methods, considerable thick bloody matter was ex¬ pelled from the tympanic cavity. Ordered frequent use of the warm douche, and an opiate to relieve the pain. June ijth.—The puncture is healed and the drum-head is again bulging and pulsating. The pain, which was temporarily relieved, has returned. 1 repeated the paracentesis, again forced out through the opening the purulent contents of the tympanum by inflation, and ordered a leech to be applied half an inch in on the front wall of the meatus.