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
Catalogue details

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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    XIX.] course of bichloride or of iodide of mercury may be recommended in syphilitic cases. Inunction of half a drachm of mercurial ointment every day into the armpits and inside of the thighs, varying the place in order to avoid irritating the skin too much, may succeed better in some cases. In hereditary syphilis Siebenmann recommends this as more efficient than iodide of potassium; at best, however, the results of treatment are far from encouraging in the hereditary disease. More success can be hoped for in acquired syphilis by a combination of iodide of potassium and mercury. Ointment of iodoform or mercury rubbed behind the ear over the mastoid process may-also be applied in the syphilitic as well as in other cases. Treatment at Aix-la-Chapelle might in such cases be preferred to medicinal treatment at home. Nitrate of Pilocarpine is conveniently used in the form of the tabloids of Burroughs, Wellcome & Co., beginning with one eighth of a grain and increasing gradually to one fourth of a grain, if such be necessary to produce free salivation and diaphoresis; but sickness and vomiting must be avoided. A course of from fifteen to twenty hypodermic injections, one daily, omitting every seventh day, will give this remedy a fair trial. For a few hours after the injection rest in bed is essential. It is not a remedy which should be used in anaemic or very feeble patients. While antisyphilitic remedies should usually be tried, we have unfortunately to admit that they do not, as a rule, act so well in syphilitic disease of the labyrinth as in the same disease in most other regions of the body. Indeed, they frequently appear to exercise little or no influence upon the disease. In the acute exudative affections of the labyrinth, pilocarpine is likely to have a useful effect and we are justified in giving it a trial. Quinine was recommended in Meniere’s disease by Charcot to the •extent of 15 grs. daily. There is, the writer thinks, distinct danger of aggravating the symptoms by such large doses in the early stage of these labyrinthine cases, and he does not employ quinine at all in that stage. Local Aural Treatment does not afford much prospect of benefit in the acute cases. In the more chronic stages the injection into the tympanic cavity through the catheter and Eustachian tube every third day for two or three weeks, of 8 to 10 drops of a solution of iodide of potassium (5 grs. to the oz.), or a similar quantity of a 2 per cent, solution of pilocarpine, may be employed in the hope of exercising a stimulating effect on the labyrinthine absorbents. Acute Congestive Processes in the Labyrinth, when suspected, may be rationally treated by local blood-letting over the mastoid region. AVe know that the stylo-mastoid artery, which supplies the soft parts over the mastoid process, inosculates freely with the internal auditory artery in the tympanic cavity, and in this way a distinct vascular