A manual of diseases of the ear, for the use of students and practitioners of medicine / by Albert H. Buck.

  • Albert Henry Buck
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: A manual of diseases of the ear, for the use of students and practitioners of medicine / 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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    convex and smooth, and the skin of normal color, but it looked as if it had been blistered. Fluctuation could be dis- tinctly felt in both. An incision through the entire length of each swelling gave escape to a considerable quantity of a yellowish, glairy fluid. The swellings did not collapse after the evacuation of their contents. In each was found a cav- ity of about the size of a hickory-nut, lined by a smooth, shining membrane. The anterior wall of each was about a line thick, and was apparently composed of thickened perichondrium ; the pos- terior wall was formed by the cartilage. Under the daily appli- cation of tincture of iodine to the interior and exterior of the swellings, the auricles gradually diminished in thickness, and at the end of two months they had regained their normal size and shape. The only deformity remaining when I last saw him was a wrinkled condition of the fossa helicis.'' Finally, in a third case which came under my observation, the conditions found were essentially different from those observed in the two preceding cases. The patient, a man thirty years of age, and in robust health, consulted me on the 11th of December. 1878. He stated that four years previously both of his ears had been frost-bitten, and that from that time to the present he had had four sores on the left ear and two on the right, as the results of the acute inflammation which immediately followed the freezing of the parts. All efforts to make these ulcers heal permanently had failed, although during the summer season some of them would present all the appearances of having spontaneously healed. As soon as cold weather returned, however, these spots again became scabbed over. Upon examination. I found four spots on the left auricle and two on the right, occupied by scabs of moderate thickness. They were nearly circular in shape, and measured from five to eight millimetres in diameter. Five out of the six scabs were located on the outer aspect of the helix, above the level of the orifice of the external auditory canal : the sixth was located on the anthelix. on the same level with the external orifice. The edges of the scabs seemed to rest upon healthy skin. After they had been removed, it was ascertained that they each covered an ulcer with sharply defined and undermined edges. The bottom of each ulcer was smooth, hard, and of a pale color. The undermined edges had a markedly bluish hue. which faded gradually into that of the perfectly sound skin. Xitrate of silver, tincture of iodine, and pure nitric acid were tried in succession, at brief intervals, but none of these reagents seemed to induce the slightest evidence of a healthy reparative process. I then tried the following plan : with a pair of curved and slender-pointed scissors I cut away the bluish undermined edges ; then, as soon as the bleeding had ceased. I applied com- pound tincture of iodine freely to the base of the ulcer, and to the surrounding raw surface. A very thin layer of cotton-wool was next laid upon the exposed surface, and then liquid collodion was applied for the purpose of supplying an artificial scab. At the end of three or four days the collodion and cotton were removed and the ulcer was found to be healing slowly both from the edges and from the bottom. The compound tincture was applied a second time and the wound was sealed up again with cotton and collodion. ]Sme such applications in all were made
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