Some points in the symptomatology, pathology, and treatment of diseases of the sinuses adjacent and secondary to the orbit / by Charles Stedman Bull.

  • Bull, Charles Stedman, 1844-1912.
Date:
[1899]
Catalogue details

Licence: Public Domain Mark

Credit: Some points in the symptomatology, pathology, and treatment of diseases of the sinuses adjacent and secondary to the orbit / by Charles Stedman Bull. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    downward and outward, it is probable that the dis- ease has extended to the ethmoid cells. If there are coryza, ozama, and a purulent discharge from the nostril, the nasal meatus has become involved, and the diagnosis is certain. Distention of the frontal sinus can generally be easily recognized by the site of the swelling. It is higher up and farther back than the site of the lacrymal sac, and it has hard, resisting walls. Occasionally a spontaneous opening occurs by absorption of the bony walls, and the symp- toms are then those of a cyst. The orbital symptoms usually advance slowly, though occasionally we meet with a very rapid progress. But there are cases in which a sort of intermittence in these symptoms ap- pears. If the swelling of the mucous lining closes the fronto-nasal canal temporarily, a violent supra-orbital pain will be suddenly produced by the accumulation of fluid within the sinus. Sometimes violent neural- gic attacks occur, usually at the same hour in the morning. These attacks are characterized by contin- uous pain with severe exacerbations, radiating around the orbit and within the zone of distribution of the ophthalmic branch of the trifacial. They are accom- panied by injection of the conjunctiva, lacrymation, and photophobia. After several hours the attack sub- sides. These patients have usually had grippe with rhinitis and profuse secretion. At other times I have seen the attack accompanied at its height by paresis of accommodation. Empyema of the frontal sinus is very frequently preceded or followed by suppuration of the maxillary antrum. The pus from above may flow into the mid- dle nasal meatus, into which opens the ostium maxil- lare, and there set up a similar suppurative inflam- mation, and the flow of pus from the antrum with the attendant symptoms may often be the first signs of disease of the frontal sinus. In rare cases, however, it would seem as if the disease began in the antrum