A manual of diseases of the ear, for the use of students and practitioners of medicine / by Albert H. Buck.

  • Buck, Albert H. (Albert Henry), 1842-1922.
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: A manual of diseases of the ear, for the use of students and practitioners of medicine / by Albert H. Buck. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    the carious region must have dissected a way for itself in the di- rection of least resistance, that is, inward toward the posterior fold. At this point, too, the cutaneous wall is thinnest, and here it was that a second opening established itself. As the mastoid cells were found to be exposed over quite an extent, without at the same time being carious, a condition which I will not venture to explain, it is fair to assume that the immense mass of epithe- lium found in this situation must have been cast off from the mucous membrane lining these cells, cheesy and foul pus having originally supplied the necessary irritating stimulus. 5. Extension of the Ulcerative Process to Neighboring Or- gans.—If we leave out of consideration for the present those cases in which the brain and its membranes and the lateral sinus are invaded by the disease, there still remain those cases in which the chorda tympani nerve, the facial nerve, and the carotid artery become affected. With the exception of a few cases of facial paralysis, the various conditions which I have just enumerated have never come under my immediate observation, and I am therefore unable to give any informa- tion based upon personal experience. Cases of fatal haemorrhage from the caro- Fig. 68.—Cyst-Like Protru- tid artery, dependent upon caries of the rio?QuaedyaSetroPf0thee temporal* bone, will be found in Marcos Risht Membrana Tym- monograph on this subject.1 The only in- pam. (Alter Pohtzer.) * ^ J J stance that I can recall of an affection of the chorda tympani nerve occurring in the course of a chronic purulent inflammation of the middle ear, is that reported by Noyes.*2 6. Cyst-like Tumors of the Drum-Membrane.—I can find in my records but six cases of well-defined cysts of the membrana tym- pani. In four of them there had previously existed a purulent inflammation of the middle ear. In one of these four cases, which I reported in detail, in 1872,A the cyst seemed to have formed be- tween the layers of the drum-membrane. In the other three cases, however, the cyst-like tumor consisted of the posterior half of the drum-membrane, which, having lost its substantia propria through the prolonged pressure of the exudation in the tympanic cavity, had no longer been able to resist that pressure, and so gradually became converted into an elastic diverticulum. A ease of this kind is pictured in Politzer's work (see Fig. 08.) In acute cases 1 have frequently observed, during convalescence, a ■ Marei: De rulceration de la carotide Interne dans la carie du rocher. Paris, Is; i. Bee also a case reported by Hermann (A. f. < >.. I v.. p. ^(J4). Transactions of tin- American < ttological Society, iv^ *. 3 In the Medical Record of November or December of that year.