Manual of diseases of the ear : including those of the nose and throat in relation to the ear, for the use of students and practitioners of medicine / by Thomas Barr, M.D.
- Barr, Thomas, 1846-1916
- Date:
- 1901
Licence: In copyright
Credit: Manual of diseases of the ear : including those of the nose and throat in relation to the ear, for the use of students and practitioners of medicine / by Thomas Barr, M.D. 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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![»•] may be simply heat, fulness, and pressure. Afterwards, however, it goes on to sharp penetrating pain in the ear, which generally extends to the neighbourhood, to the temple above, towards the occiput behind, or to the forehead in front. It may be accompanied by throbbing or hammering in the ear, aggravated at night. In the purulent form, the pain often ceases with rupture of the membrane, and the appear- ance of discharge from the ear. In some cases, however, the pain continues after rupture, or returns after a period of intermission. The external auditory canal is another common source of pain, especially when it is the seat of furuncular or circumscribed inflam- mation. The pain in this case is usually aggravated by moving the auricle, pressing the tragus, or by mastication. 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 of the canal. In eczema of the external canal the sensation is more that of troublesome itchiness. Mastoid inflammations are important sources of pain. In mastoid periostitis there is usually oedema or abscess over the mastoid area, with jutting outwards of the auricle, and great tenderness on pressure. In purulent collection in the mastoid cells, there may be little or no oedema over the mastoid, but only an appearance of bulging of the bone itself, with pain on pressure, especially over the antrum. There is sometimes in such cases, however, very little pain apart from pressure. In chronic purulent affections of the middle ear, while in most cases no pain may be experienced for years, there may arise at any time severe pain from an acute inflammatory attack, from pressure of retained discharge or cholesteatomatous matter, from caries or necrosis, or from furuncular inflammation in the canal. Intense pain in an ear affected with chronic purulent disease, extending to the side or back of the head, may be the first symptom of a cerebral abscess or other intracranial 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. Non-inflammatory Pain. The second or non-inflammatory variety of pain—frequently termed otalgia—is often connected with dental caries. It may be associated with pains in the vicinity—in the neck, temple, or cheek. It is sometimes a manifestation of a neuralgic condition due to anaemia or other constitutional defect. Intense pain is also sometimes experienced in the ear during the course of tonsillitis, without any signs of inflammation in the ear. Rheumatic pain in the](https://iiif.wellcomecollection.org/image/b24932553_0071.jp2/full/800%2C/0/default.jpg)
