The nature and treatment of ozaena / by Dr Loewenberg ; translated by Dr Kirk Duncanson.

  • Lœwenberg, B. (Benjamin), 1836-
Date:
1885
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Licence: Public Domain Mark

Credit: The nature and treatment of ozaena / by Dr Loewenberg ; translated by Dr Kirk Duncanson. 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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    definition than a name, the word atrophicans seems to me of doubtful Latinity; and, lastly, it is not the rhinitis that is foetid, but its product. Complications.—According to my experience, and contrary to received ideas, ozeena is never complicated, so to speak, with affec- tions of the ear. I have observed such complications only in about a twentieth of the patients affected with ozaena, whom I have treated during a practice in otology of twenty-two years. To me, then, there exists no affinity between these two forms of disease. I will add, on this occasion, that I have scarcely ever met with diseases of the ear attributable to the presence of mucous polypi of the nose, at least unless there co-existed adenoid vegetations of the nasal pharynx (a combination which I saw lately, amongst others, in a boy of eight years, born of a syphilitic father). Here are, then, two diseases of the nose giving rise to results the most important, and, I add, the most opposite, so far as the respira- tory function of the nose is concerned, for the one absolutely obstructs the nasal fossae, which the other, on the contrary, enlarges to excess, both remaining without effect upon the cavity of the tympanum. From this it seems to me that there is much to deduct from the supposed action of certain nasal affections on the middle ear. The rarity of affections of the ear in cases of mucous polypi which, more than any other malady, cause complete obstruc- tion of the nostrils, also argues against the hypothesis of M. Lucae concerning the injurious effect of the blocking up of the nose upon the middle ear by the aspiration brought about during deglutition. I think that, even when this action takes place, a healthy Eustachian tube allows the different pressures instantly to come to an equilibrium. With regard to ozaena, it is all the more interesting to prove the immunity of the middle ear in this affection, that in consequence of the atrophy of the inferior turbinated bone the faucial opening of the Eustachian tube is found directly exposed to the inspired air, and, besides, is bathed by mucosities in which I have ascer- tained the existence of the characteristic coccus. Symptomatology and Diagnosis.—I shall not speak of the crusts, nor of the foetidity, nor of the signs of atrophy which make con- firmed ozama easily known. I shall only add to the known symptoms the authentication of the coccus by microscopic ex- amination and some phenomena of less importance which I have met with in many cases. There is first a peculiar nasal twang, which appears to me due to the resonance of the sounds of the voice in the greatly enlarged nasal cavities. I have already mentioned the filaments of mucosities, which I have constantly seen stretched between the turbinated bones and the septum. I have also fre- quently observed muco-purulent masses lodged above the middle turbinated bone. These two phenomena, althougli not exclusively
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