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.

    12/26 (page 12)
    night ago, took severe pain in the left ear, which continued for three days, and was relieved by discharge. Hearing distance, contact. The meatus is much swollen, and tender ; the cuticular layer much thickened, and detached in large white flakes; the membrana tympani has a sodden, macerated appearance, and has a small perforation in the centre. The case was in every respect almost identical with that of case 21. At the end of six weeks the hearing had increased to eight inches, and the discharge was gradu- ally diminishing, when lie discontinued his attendance. ' 24. Inflammation of Tympanum and Membrana Tympani— Occlusion of Eustachian Tubes.—William Black, set. 11; Feb. 19.—Has suffered from deaf- ness, with occasional attacks of earache, for a fortnight. The hearing distance is one inch and a half on the right side, and four inches on the left. He com- plains of a feeling of weight or pressure upon his ears, and has constant tinnitus,—the noises being very variable and very loud. The appearances presented on examination are much the same in both ears. The meatus dry, vascular, and very tender; its inner third of a deep red colour. There is great vascularity in the upper portion of the membrana tym- pani, especially along the course of the malleus. The lower portion is dull and concave, and both Eustachian tubes are impervious. He was treated last summer for a similar attack, which was brought on by a cold, from too long bathing in the sea, and recovered his hearing in about a month. On this occasion the attack was much more tedious; and notwith- standing the employment of active measures to check the progress of the inflammatory action, lymph became deposited to a large extent upon and between the layers of the membrana tympani, the usual cerumenous secretion disappeared, the meatus became dry and scaly, and in a short time the mem- brana tympani was of a uniform dull yellow colour. By the end of March the lymph began to be absorbed, and about the end of April the membrana?. tym- pani had cleared to a great extent, and had almost regained their natural trans- lucency. Still the Eustachian tubes remained impervious, and the deafness as bad as ever. On several occasions the Eustachian catheter was passed into the mouth of the Eustachian tube, and air blown into the middle ear. This was invariably followed by slight crackings in the ears ; and for the afternoon the hearing was much improved, but by next morning the deafness had returned as before. This was continued from time to time, with uniformly the same results,—only temporary benefit following the passage of the catheter ; and it was not till the beginning of the warm weather in June, when some loud ex- plosions took place in the ear, and were followed by a perfect cure of the deaf- ness,—the membrana? tympani having at last resumed their normal curvature. 25. Chronic Discharge, with thickening of Membrana; Tympani.—Mrs MTvail, set. 28; Feb. 26.—Has had a copious discharge from one ear for upwards of three years. The membrana tympani has a macerated appearance, like a piece of washed leather, being evidently very much thickened. It was washed over with a strong solution of nitrate of silver. The patient, however, did not again apply at the dispensary. 26. Chronic Inflammation of Tympanum and Membrana Tympani.—Charles Gilchrist, set. 18.—Has been gradually losing his hearing for the last four years. From the nature of his occupation, lie is much exposed to cold and wet; and occasionally, when he has a cold, is almost quite deaf. Hearing distance,— right car, half an inch; left, three inches and a-lialf. Both passages are dry and smooth, and the membranse tympani dull, white, and collapsed. Air enters the middle ear on the left side with difficulty, and not at all on the right. The mucous membrane of the throat is thick and red. He was directed to take, twice a-day, one-sixteenth of a grain of the Inchlo- ride of mercury, with two grains of quinine, to apply smart counter-irritation, and to use a stimulating gargle for the throat; to continue this treatment for six weeks, and then to return. He had come a considerable distance from the country, and up to this time has not reappeared.