A treatise on nasal suppuration, or suupurative diseases of the nose and its accessory sinuses / by Ludwig Grünwald.

  • Grünwald, L. (Ludwig), 1863-1927.
Date:
1900
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on nasal suppuration, or suupurative diseases of the nose and its accessory sinuses / by Ludwig Grünwald. 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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    plug the nostril up above the moistened surface, the discharge ceases, and it is obvious that nothing exudes from the surface. The second ' proof of the surface origin of the secretion in ' ozaena' is a negative one, founded upon anatomical results— upon the fact, namely, that in the majority of cases no focal disease, and especially no empyemata, have been found. This would be decisive, if it were not that a careful analysis of the original anatomical reports in this matter shows that in most cases the conclusions deducible from them are the exact opposite of those that have actually been drawn, and quoted by writer after writer without knowledge of the original evidence. In order to make this matter clear, I must ask my readers to follow me in a brief review of the original evidence, as much of it, at least, as was accessible to me.''' What I ask of my readers' patience is a small matter as compared with the demands upon my own, necessitated by this comparison of original reports, and the reviews of them. I. Hartmann (^■*). A woman of 26, dead of phthisis. Since her twelfth year she had been in the habit of expelling through the nose every second day a large shell-shaped crust. Post-mortem.—Both sphenoidal sinuses very small (the right the size of a pea, the left twice as big), lined with hypertrophic mucous membrane, so that the right cavity was almost obliterated; the left contained yellowish liquid secretion. The other cavities normal. The posterior upper (!) parts of both sinuses filled with thick dirty-greenish, ragged masses with a penetrating odour. This was especially the case above the choanse, on the roof and lateral walls of the nose, and between and behind the turbinals. After washing the parts, the septum was found covered with tough mucus and thickened foetid secretion, sticking to the roof of the nose (?) and the region of the Eustachian openings. An ulcer as big as a lentil- seed was situated in front of the right tubal opening. And this case has actually been quoted repeatedly as yield- ing a negative result in respect of the accessory cavities ! It has been generally recognised as ' ozaena.' ' In this case the secretion could neither have come from the normal ethmoidal * The reports of Zaufal and Gottstein are not accessible to me.