Rest and pain : a course of lectures on the influence of mechanical and physiological rest in the treatment of accidents and surgical diseases, and the diagnostic value of pain / by John Hilton ; edited by W.H.A. Jacobson.

Date:
1892
Catalogue details

Licence: Public Domain Mark

Credit: Rest and pain : a course of lectures on the influence of mechanical and physiological rest in the treatment of accidents and surgical diseases, and the diagnostic value of pain / by John Hilton ; edited by W.H.A. Jacobson. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    neous occurrence of toothache and earache. The same nerve that supplies the auditory canal and the anterior portion of the ear supplies also the teeth ; hence, in all probability, this associated pain. I think you may take a further step in the other direction, and say that earache is often accompanied with a stiffness of the jaws, the fifth nerve supplying the masticatory muscles which fix the jaw and also the articulation. So we know perfectly well that disease affecting any part of the anterior third of the tongue is a very common cause of pain in the auditory canal, the tongue and the auditory canal being supplied by “ 4. This sympathy is an example of a reflected sensation, in -which the connexion between the nerves concerned takes place in the nervous centre. “ 5. Cases occasionally occur where a cough is solely dependent on the existence of some source of irritation in the auditory canal. Two cases are quoted, one of a cough of eighteen months’ duration, which was only cured hy the removal of a plug of cerumen and the application of silver nitrate to a little ulcer found beneath the plug; the other, a case quoted by the late Mr. Toynbee, in which an intractable cough ceased at once on the removal of a small piece of dead bone from the external auditory meatus. The writer goes on to state that the impression produced by irritation of the auditory canal in these cases is probably conveyed by the auriculo-temporal nerve to the deep origin of the sensory root of the fifth, which is in close proximity to the deep origin of the vagus in the floor of the fourth ventricle. Here a change is in all prob- ability effected in the grey matter, which results in the stimu- lation of the vagus. The irritation is referred to the larynx because the medulla oblongata is wont to receive impressions from that organ through this nerve. As a consequence, the respiratory muscles are set in action to free the larynx of the supposed irritation. Sometimes the cough is accompanied by vomiting from excitation of the cranial origin of the vagus.” Dr. C. Fox also gives other instances of the connection between the fifth and the vagus: e.g. the cough from teething, which it is so important to diagnose from the cough of bronchitis, etc., and which usually ceases as soon as the gum lancet has been judiciously employed. Again, the sympathy between the ear and the stomach is shown by cases arising where a derangement of the digestive organs is the sole cause of deafness (cf. the amaurosis occasionally produced by dys- pepsia), or by the case quoted by Arnold where a child suffered from obstinate chronic vomiting, which was at once removed by extracting from each ear a bean introduced in play.—[Ed.]
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