On ocular movements, with vertigo, produced by pressure on a diseased ear / by J. Hughlings Jackson.

John Hughlings Jackson

Date:: [1883]

Credit: On ocular movements, with vertigo, produced by pressure on a diseased ear / by J. Hughlings Jackson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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$noise in it, but bad had some in the left ear, which was, except for this, apparently healthy. She had had severe ^'bilious” attacks, clearly, by her account, paroxysms of auditory vertigo; she had also occasionally very slight and transient paroxysms of giddiness without sickness. There was also a chronic condition, since the so-called bilious attacks she often walked as if drunk, and was there- fore ashamed to walk in the street. She would sometimes, when washing the right ear, stumble to the left. I could not ascertain that her general vigour had lessened before her illness began. She had missed one menstrual period. She told me that pressing on a certain part of the ear {the tragus) made her giddy, and produced a disagreeable feeling in her head, “ something coming over the brain.’^ When I pressed on the tragus I saw her eyes move from side to side, and she told me that objects went from right to left; she did not see them coming back again. She also felt a falling towards the left side. On stopping the pressure the eyes were again still. I could make them move whenever I liked. The two movements, one to the left, which was the first, and one back, were not so different in rate as in the case, already alluded to, of the man who had a paroxysm of auditory vertigo. In the woman’s case, however, the eyes passed more slowly from right to loft than they came back—that is, they came back to the right more jerkingly. The apparent movement of objects to the left coincided with the slower move- ment to the left, not with the jerk to the right. I sent the patient to Mr. Laidlaw Purves, who confirmed my observation as to the ocular movements. He reported also on the state of the ear. The right meatus was full of pus. The membrana tympani could not be seen. The watch could not be heard on the right side. The tuning-fork was heard one third less when placed on the mastoid ; pressure on the pus, as well as on the tragus, caused the ocular movements. Mr. Purves reported, later, “ There is a swelling on the upper wall of the meatus, caused almost certainly by some osseous affection from$

On ocular movements, with vertigo, produced by pressure on a diseased ear / by J. Hughlings Jackson.

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