Report of the Edinburgh Ear Dispensary : with notes of one hundred cases of diseases of the ear treated in succession during the first months of 1861 / by Thomas Keith.

Date:
1862
Catalogue details

Licence: Public Domain Mark

Credit: Report of the Edinburgh Ear Dispensary : with notes of one hundred cases of diseases of the ear treated in succession during the first months of 1861 / by Thomas Keith. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    Taylor, set. 12; Jan. 29.—About three years ago, first had attacks of earache, followed by temporary duluess of hearing. These attacks increased in frequency, and were generally followed by slight discharge, which for some time ceased spontaneously after a week or two. For the last twelve months, however, the discharge has been profuse, and latterly, her hearing has become much impaired. The watch is heard on application to the right ear, and at the distance of six inches from the left. The right Eustachian tube is impermeable, the left free. In the right meatus are several small polypi, filling up the inner half of the passage, and concealing the membrana tympani. In the left is a polypus the size of a large bean. This was removed by Wilde’s snare, and the smaller growths in the right ear were broken up as much as possible, and when the bleeding had ceased they were touched by the galvanic cautery. The subse- quent progress of the case was satisfactory. The remains of the polypi were touched twice a-week, sometimes with one escliarotic, sometimes with another. Upon the whole, the nitrate of silver, though somewhat slow in its operation, was the best. The strong nitric acid answered very well. A small pellet of cotton wool held in Wilde’s ear-forceps was dipped into the acid, and then applied through the speculum. In this way the smallest polypus or granula- tion may be touched without the slightest fear of the acid spreading upon the sensitive walls of the meatus. The potassa cum calce was also used; but it did not answer so well, causing more pain than either the nitrate of silver, nitric acid, or the galvanic cautery. At the end of two months the discharge had ceased. The hearing distance had increased to five feet in the right ear, and to three feet and a half in the left. The membrana tympani, however, remained in both ears somewhat dull and thick. 16. Right Membrana Tympani destroyed—Congestion of Left Tympanum and Membrana Tympani.-—William Wood, a?t. 25.—Has had very imperfect hear- ing with the right ear- since an attack of measles in his childhood. About ten days ago he suddenly became deaf in the left ear. The hearing distance is one inch. The right membrana tympani is nearly removed, a small edge only being left. The mucous membrane of the middle ear is seen to be thick and red. There is, however, but a slight mucous discharge. The left meatus is dry and red at its inner portion, the membrana tympani is very concave, and of a dull red colour. The space of reflected light is very large; there are numerous enlarged vessels running across the membrane, and there is great vascularity along the course of the malleus. The Eustachian tube is impervious. The application of a few blisters behind the ear, with the use of a stimulating gargle, removed the deafness in about a fortnight. 17. Catarrh of Middle Ear with discharge through the Membrana Tympani.— Daniel Macfarlane, ait. 18.—Since an attack of scarlet fever many years ago, has been liable to occasional fits of deafness, accompanied by discharge from the left ear. The present attack came on Avith cold in the head tAvo months ago, and has lasted longer than on any previous occasion : the discharge has also been more copious. The hearing distance is four inches. The meatus is found to be full of a thin ropy discharge ; on removing which, there is visible a small perforation close to the loAver edge of the membrana tympani. The membrana tympani is of a bright red colour, and there are several large granulations along its inferior margin. These were destroyed by the nitrate of silver; and by the daily use of the syringe and free counter-irritation, the discharge subsided, and in about three Avecks the opening in the membrane closed, and the hearing returned as good as ever. 18. Chronic Inflammation of Meatus—Excessive Itching in the Ear.—James O’Donnel, act. 30.—Complains of an intolerable itching in both ears. lie Avas a patient at the dispensary about a year ago, on account of chronic inflamma- tion, Avith discharge, of the meatus. He Avas then cured of this and remained