Practitioner's handbook of diseases of the ear and naso-pharynx / by H. Macnaughton-Jones.

  • Macnaughton-Jones, Henry, 1844-1918.
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Practitioner's handbook of diseases of the ear and naso-pharynx / by H. Macnaughton-Jones. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    36/204 (page 20)
    causes operating, quite sufficient to account for the tinnitus or deafness independently of the medicine. Turn- bull also says :— We are prepared to state that we have never seen or known of a case of ear disease that was developed from quinine, either in large or small doses, and all the cases that have been reported as such had, prior to the use of the quinine, some form of disease which may have been temporarily augmented by the stimulation of the quinine as antiperiodic or tonic. I certainly have never known it to produce myringitis or tympanitis in children. If ever trouble arose during its administration the aural complications could be more truthfully ascribed to the catarrhal or general septic condition than to the quinine. Still both Weber-Liel and Politzer incline to regard quinine as a cause of permanent deafness—though the former is such a strong advocate for its use in all stages of malarial otitis, both as a preventative and curative agent. Politzer says :— It is necessary only to mention the well-known effects of quinine, salicy- lic acid, morphine and chloroform, which exercise a temporary, but often also a lasting influence on the functions of the auditory nerve. Even in the case above quoted, in which permanent mischief appeared to follow the large dose of the alkaloid quinine, the man was occasionally an inebriate, while there was a history of previous hardness of hearing. This undoubtedly the quinine permanently accentuated. As Dr Lauder Brunton remarks, the hallucinations of mania, the prodromata of the epileptic fit are produced by the irritation of the hearing centre, so the tinnitus of quinine intoxication may be due to this toxic irritation of the same centre, independently of any local auditory phenomena that follow its use. That the tinnitus is produced rather by hypersemic than aniemic conditions in the tympanum and labyrinth, is rendered more probable by the action of such drugs as hydrobromic acid and ergot in relieving it. ANESTHETICS AND MORPHIA. With regard to ansesthetics, I can call to recollection, with a rather unusually large experience of the administration of a variety of ansesthetics, not a single instance in which deafness or permanent tinnitus followed their ad- ministration. I might say the same of morphine. I happen to know at the present moment two individuals who have on their arms and on parts of their legs hardly an available spot left for the insertion of the hypodermic syringe, from the state of skin brought about by con- stant injections, that have produced morphine craving—in neither instance is there tinnitus, and the hearing is normally acute. OCCUPATIONS. That certain occupations predispose to deafness in a variety of ways is the experience of all aurists. For example, TurnbuU^ has specially studied the effects of their calling on the hearing power in locomotive and otlier engineers, firemen, and conductors. From the shrill noises of the engines, the rapid passage on the exposed locomotive through the cold air in all vicissitudes of weather, the constant exposure, and oftentimes loss of sleep and want of rest, such employees are liable to deafness. That such deafness may be dangerous to passengers, if it pre- vents the engine-drivers or conductors hearing signals, the approach of other locomotives, or loud voices, is obvious. It may be more so even than colour- blindness. The watch, as Turnbull shows, is not the only test which should be tried for these persons. It is better to test them with different sounds and various tones, the voice in conversation, gongs, bells, &c. Railway travelling, especially at night, certainly predisposes to deafness. I have noted several cases in which incessant railway journeying caused, or at least induced, a temporary tinnitus. This occurred to myself. I believe it to be associated with the vibration and noise of the train, the want of proper rest, and the imperfect sleep. I have an idea that medical men who pass a large proportion of their time in broughams must suffer in hearing more or less. All such predisposing causes will operate in degree, according to the col- lateral influences present, as, for example, other abnormal conditions of the organs of hearing or general morbid states, or the existence of hereditary deafness. ^ Jo^tr. Amer. Med. Assoc., Nov. 29, 1884.