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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    tympani, and that the inflammatory action had extended unchecked over the tympanic cavity and its contents, and had probably also affected the vestibule and labyrinth, there can be little doubt. As a consequence ot this, lymph had been deposited in large quantity between the various layers of the membrana tympani, and upon the surface of the middle ear, producing a thickening of the membrane, and probably binding it by bands of adhesion towards the pro- montory, interfering thus with its proper vibration, hindering the free motion of the chain of bones, and probably also giving rise to thickening of the mem- brane of the fenestra rotunda. As the results of disease were so visible and manifest, no reasonable expecta- tion could be held out of recovery of the hearing. In the hope, however, of removing the congestion which still lingered about the deeper parts ot the ear, and of relieving the tinnitus, from which the man suffered exceedingly, he was directed to blister freely over the mastoid process. This he continued to do two or three times a-week, and at the end of three months he reported himself as being entirely free from the distrcssing.sounds. The hissing noise had dis- appeared, and had given place to a slight tidal murmur, which was only occa- sional and gave little inconvenience. Beyond his being feebly sensible of the ticking of the watch when pressed against the temple, there had been no improvement in the hearing. 2. Dischargefrom left Ear—Aperturein Membrana Tympani.—John Peters, tet. 17 ; Jan. 1.—Since an attack of scarlet fever eight years ago, has had discharge from the left ear, accompanied by deafness. At present the hearing distance is one inch. On examination the meatus is found to contain a large quantity of zinc ointment, which the patient had been for some time in the habit of using to check the discharge. The inferior margin of the membrana tympani, to the extent of about two lines, is separated from its bony attachment, but there appears to be little or no loss of the substance of the membrane itself. Filling the aperture, and growing from the bony margin and from the hollow at the inner extremity of the meatus, are numerous large granulations. These were touched three or four times, at intervals of a week, with the solid nitrate of silver. * At the end of a month they had disappeared, and the discharge had also ceased. The membrana tympani seemed to have regained its attachment to the bone, for no aperture could be detected, and the patient could not blow air through the ear as formerly. The hearing had much improved, the watch being easily heard at the distance of five or six feet from the ear. Ten months afterwards, his hearing continued quite good. 3. Small Perforation in Membrana Tympani after Scarlet Fever.—John Fyfe, set. 24 ; Jan. 1.—Has had discharge from the right ear for twelve years after scarlet fever. For long the discharge was profuse; but for several years past, since he began the daily use of the syringe, the quantity has diminished and the hearing has improved. At present the hearing distance is ten inches, and the discharge is slight. There is a small perforation about the size of a No. 3 shot, near the lower and anterior edge of the membrana tympani. The rest of the membrane is perfectly healthy and translucent. On filling up the aperture in the drum with a small pellet of cotton wool, the hearing distance is at once increased from ten inches to two feet and a half. It is obvious, however, that from the smallness ot the aperture, and the difficulty of retaining the wool in the proper position, the patient will not be able to derive any benefit from its employment. This man Was seen about eight months after this. The discharge had ceased, but the aperture remained as before. 4. Inflammation of Tympanum ami Membrana Tympani in both Ears.—David Ford, set. 38, a thin, delicate-looking man; applied Jan. 8.—He has gradually lost his hearing since a severe cold he got after a wetting about five weeks ago. Has only suffered from occasional attacks or rather shoots of pain; the tinnitus lias all along been very distressing, especially at night when he lies down.