Guide to the examination of the ear and hearing : for the use of students / by Thomas Barr, M.D. ... and J. Stoddart Barr, M.B.

  • Barr, Thomas, 1846-1916
Date:
1908
Catalogue details

Licence: In copyright

Credit: Guide to the examination of the ear and hearing : for the use of students / by Thomas Barr, M.D. ... and J. Stoddart Barr, M.B. 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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    ]>ain in an ear affected with chronic purulent disease, extending t the side or back of the head, may he the first symptom of an intra o cranial complication. Slighter and more intermittent pain may be complained of in connection with simple exudative catarrh of the middle ear or with interstitial or sclerotic processes. If great pain is experienced in such conditions, it generally means an intercurrent acute inflammation. The external auditory canal is another common source of inflammatory pain, especially when it is the seat of furuncular inflammation. The pain in this case is usually aggravated by moving the auricle, pressing the tragus, or by mastication. This, as a source of pain, is often over- looked, and careful examination of the skin of the meatus with the help of a probe is necessary. Less frequently there is pain in the external canal from eczematous inflammation, from the pressure of cerumen in the osseous portion of the canal, from the presence of fungi, from exostosis, and from caries or necrosis of the osseous walls. In chronic eczema of the meatus the sensation is more that of troublesome itchiness. Non-inflammatory Pain. The second or non-inflammatory variety of pain is often connected with dental caries, especially of the molars of the lower jaw, and is then often associated with pains in the vicinity—in the neck, temple, or cheek. Intense earache may be experienced in tonsillitis, without any signs of inflammation in the ear: also in carcinoma of the tongue or throat. It is sometimes a manifestation of a neuralgic condition due to anaemia or other con- stitutional defect. Rheumatic pain in the articulation of the lower jaw, felt during movement or pressure, is often thought by patients to he due to ear disease. A sensation in the ear, as if of a plug of cotton, sometimes complained of by persons with good hearing, has evidently a nervous origin. o It is very important, as a guide to treatment, to distinguish between the inflammatory and the non-inflammatory forms of pain. Objective examination is of course the onlv reliable means of doing so, and should v o never be omitted in such cases. We usually find in the inflammatory variety more or less defect in the hearing as well as subjective sounds in the ear; and it is often distinctive of the non-ifammatory pain that it has been experienced for a long period, even for months. It is well always to inquire whether the patient has been liable to earaches in childhood, or later on, as these may indicate past inflammatory attacks.