Two cases of thrombosis of the lateral sinus consequent upon purulent inflammation of the middle ear : opening of sinus : ligature of internal jugular vein : recovery / by Thomas Barr, M.D., and J.H. Nicoll, M.B.

  • Barr, Thomas, 1846-1916.
Date:
[1899]
Catalogue details

Licence: Public Domain Mark

Credit: Two cases of thrombosis of the lateral sinus consequent upon purulent inflammation of the middle ear : opening of sinus : ligature of internal jugular vein : recovery / by Thomas Barr, M.D., and J.H. Nicoll, 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.

    8/16 (page 6)
    (October ])r. Alexander sent the following notes: “David D. is now walking about daily, but is rather breathless on any exertion. He has practically no cough except in the morn- ings, the expectoration has diminished gradually, and now there is only a little nummular spit in the mornings, and this is entirely devoid of any gangrenous odour. He is now putting on llesh rapidly, and I should think that he must have increased to the extent of at least a stone. The tem- perature has only been taken in the morning, when it was normal. The physical signs over the left lung are quite normal, except that the respiratoiy murmur is rather puerile. Over the front of the right side there is no dulness, but on deep inspiration and on coughing there are still some crackling rales; over the back the rales are also present on deep inspira- tion, but in the lower half of the right lung there is a large- cavity with loud rales. The rales all over the right side are diminishing gradually, and the lung is evidently healing up.” 12th November, 1899.—Dr. Finlayson examined patient to-day and found no definito^ signs of cavity in the right lung, oidy dulness at certain places with .some moist rales, also a want of due expansion on right side in front. Patient reports that there is scarcely any cough or expectoration. The most striking change is the notable increase of flesh. Instead of the emaciated phthisical look, he is quite full in the face and plump in the body. He thinks he has gained about two stones since the early part of his illness. There is a deep gi’oove in the scalp extending from the mastoid to the external 'occipital protuberance, and the long gap in the bone seems to be converted into dense fibrous tissue (see Fig. II.). There is an aperture still remaining behind the auricle. This leads into a dry cavity which represents excavated mastoid, tym- panum, and meatus. The purulent process in the ear .seems to be entii’ely at an end. The temperature still rises somewhat in the evening, though normal in the morning. There is also some shortness of breath during exertion. Observations.—The following points are worthy of emphas- izing:—1. The serious significance of rigors, high temperature, pain behind the mastoid, sickness and vomiting in connection