A manual of diseases of the ear / by Albert H. Buck.

  • Albert Henry Buck
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: A manual of diseases of the ear / by Albert H. Buck. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    charge from an inflamed middle ear. Among the internal or constitutional causes may be mentioned a predisposition to. ec- zema (rheumatic ? gouty ?). An inflammation of the medullary spaces or of the air cells of the surrounding bone, may give rise secondarily to a diffuse otitis externa. Direct violence is also not a rare cause of this form of disease. The physical characteristics of a diffuse inflammation of the external auditory canal are, at first, a general redness and swell- ing of the skin lining the osseous portion. The membrana tym- pani almost invariably participates in the inflammation, though sometimes only to a very slight degree. At a later stage of the affection, an exudation of a thin, serous fluid will be found to have taken place from these red and swollen surfaces, and at a still later period the discharge will be found to contain small white flakes, or even large white sheets, representing the cast- off uppermost layers of epithelium. Eventually, ulceration may take place. Symptomatology.—! am quite confident that I should fail if I were to attempt a description of the symptoms which characterize a diffuse inflammation of the external auditory canal (osseous por- tion). This description might be quite truthful for some one particular case, but for all the others it Avould be inaccurate. The better plan, it seems to me, is to describe a few typical cases, and then to call attention to the salient points of these. I warn my readers, however, that these typical cases, although valuable because they furnish proof that the disease in question may have an independent existence, are in reality quite exceptional. In actual practice they must expect to find the great majority of cases so complicated that the statement of the correct anatomical diagnosis would require a comparatively long description. ]So short title, such as will be found at the beginning of this or other chapters of this treatise, would be likely to convey to the mind of any person who might read it, more than a very crude concep- tion of the pathological picture presented. It is often a very difficult task for the physician to acquire a clear conception of the actual sequence of events in any given case of ear-disease ; and this is particularly true of the form which I am now endeav- oring to describe. Now and then we have the opportunity of seeing a case of primary inflammation of the skin lining the osseous portion of the external auditory canal, which is so free from complication that we can no longer doubt the existence of such an independent form of aural disease. The following case is one in point : The patient, a lady, twenty-two years of age. and in a fair gen- eral condition of health, stated that four days previously she had experienced quite a sharp pain in both ears. From that time for-
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