Manual of diseases of the ear : including those of the nose and throat in relation to the ear : for the use of students and practitioners of medicine / by Thomas Barr and J. Stoddart Barr.
- Barr, Thomas, 1846-1916
- Date:
- 1909
Licence: In copyright
Credit: Manual of diseases of the ear : including those of the nose and throat in relation to the ear : for the use of students and practitioners of medicine / by Thomas Barr and J. Stoddart Barr. Source: Wellcome Collection.
Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.
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![»■] and, less frequently, in non-purulent inflammation. In certain cases these symptoms are very marked, and a temperature of 102 F. is not uncommon. Acute mastoid inflammations are also generally attended by rise of temperature. Even in the acute inflammations of the external meatus, some elevation of temperature is usual. When meningitis or thrombosis of the lateral sinus occurs, the feverish disturbance becomes, of course, a very notable feature of the case, and in the latter case presents striking intermissions, each rise of temperature being usually ushered in by a severe rigor. XIII. INTRA-CRANIAL SYMPTOMS. The more serious symptoms indicative of intra-cranial disease, such as delirium, convulsions, stupor, coma, and paralysis, are met with in connection with purulent middle ear- disease. It is to be noted, however, that acute affections of the middle ear may, in infants and very young children, be attended by convulsions without men- ingitis or other intra-cranial disease. In the presence of such symptoms, the existence of otorrlioea is of great significance, and imperatively calls for careful examination of the ear. XIY. OCULAR DISTURBANCES. These, in the form of iritis or keratitis or both, are often associated with hereditary syphilis affecting the labyrinth. In purulent ear disease, changes in the fundus of the eye are not unfrequently noticed, especially if associated with cranial or vascular complications, when distinct optic neuritis is common. It has been shewn, however, that vascular changes in the optic disc, short of optic neuritis, are very common in persons with purulent ear disease even when there is no evidence of intra-cranial complications. Paralysis of one or more of the ocular muscles is a well-known symptom of the intra-cranial complications of ear disease, especially of temporo-sphenoidal abscess, when the third cranial nerve is frequently involved. It has been demonstrated, both by experiments and by clinical observation, that nystagmus may arise reflexly from labyrinthine pressure or irritation, especially in the semi-circular canals, when it is generally associated with pronounced giddiness. The examiner should observe whether the movements of the eyes are horizontal, rotatory, or vertical, corre- sponding with the planes of the semi-circular canals; also, if they are excited or made worse when the eyes are turned to the side of the affected ear or to the opposite side. Nystagmus is observed most frequently in purulent ear disease, especially in labyrinthine suppura- tions, and it is often present in cerebellar abscess. Temporary attacks](https://iiif.wellcomecollection.org/image/b24932577_0107.jp2/full/800%2C/0/default.jpg)
