Contributions to aural surgery / [W.R. Wilde].

  • William Wilde
Date:
1844-1848
Catalogue details

Licence: Public Domain Mark

Credit: Contributions to aural surgery / [W.R. Wilde]. Source: Wellcome Collection.

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    the subject of this case, a female, aet. 29, was received into hos¬ pital ; semicomatose, vomiting, with a slow pulse, pain in the head, and a copious foetid discharge of purulent matter from the right ear. Five days after admission she died; on examina¬ tion it was found that “ the brain was dry superiorly, and the veins enormously distended with dark-coloured blood ; at the base of the brain, on the right side, was an abscess, in the sub¬ stance of the brain itself, not encysted, and filled with a green foetid pus. Sero-purulent matter was effused at the base of the brain. The petrous portion of the temporal bone was carious to a considerable extent; the dura matter covering it was dis¬ coloured, and there was purulent mater beneath it.” “ It had been a question,” he adds, “ whether the disease of the brain or that of the bone was the earlier. In his case they appeared both to proceed pari passu.” We are not informed, however, how long the discharge from the ear had existed. Were I to form an opinion on this case, I would say it had existed long before, and had produced the affection of the bone, and subse¬ quently that of the brain. Authors speak of abscesses and col¬ lections of matter within the cranium finding their way through the petrous portion of the temporal bone, into the external audi¬ tory tube. This is a doctrine I cannot subscribe to—-it is un¬ supported by facts ; it is much more probable that if the brain was the original seat of disease, that death would have ensued long before this matter would find an outlet through the very hardest bone in the whole bodv. Finally, otorrhoea may be occasioned by malignant disease of the petrous portion of the temporal bone itself, of a most re¬ markable case of which I have been most kindly furnished with the particulars by Mr. Cusack:— An apparently healthy boy, seven years of age, was brought to him on account of a discharge from one of the external meati. Upon examination, a small polypus was discovered in the passage; this was removed, but on the third day following it was found to have grown as large as ever ; it was again repeatedly removed
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