Essentials of the diseases of the ear arranged in the form of questions and answers : prepared especially for students of medicine and post-graduate students / by E. B. Gleason.

  • Gleason, E. Badwin.
Date:
1898
Catalogue details

Licence: Public Domain Mark

Credit: Essentials of the diseases of the ear arranged in the form of questions and answers : prepared especially for students of medicine and post-graduate students / by E. B. Gleason. Source: Wellcome Collection.

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

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    The first stage of the disease seems to he a dilatation and engorge- ment of the capillaries, with an exudation of serum and round cells, both from the surface of the mucous membrane and also into its substance. The capillaries are engorged, the mucous membrane is swollen and cedematous; an exudate is constantly moistening its surface. The inflammatory exudate within the substance of the mucous membrane itself contains large numbers of round cells, which proliferate and also increase in size by a process of elongation, so that they are finally converted into newly-formed connective tissue, sometimes causing cords, bands, and membranes similar in appear- ance to cicatricial tissue following suppuration. During the earlier stages of the disease the thickened mucous membrane is redder and rougher than normal, soft and easily de- pressed with the end of a probe. As a result, however, of the gradual increase of connective tissue and the absorption of the more fluid parts of the exudate, the mucous membrane, while still much thicker than normal, is pale and quite smooth. This condition represents a stage intermediate between hypertrophy and atrophy of the tympanic mucous membrane. As a mechanical result of the ultimate contraction of the newly- formed connective tissue, the glandular elements of the mucous membrane disappear, and it finally resembles more and more closely scar-tissue. The mucous membrane becomes smooth, thin, and secretes but little fluid. In some cases atrophy or sclerosis of the mucous membrane of the tympanum rapidly occurs without any pre- existing stage of hypertrophy. Such cases are often the result of syphilis, or they follow purulent inflammation of the mucous mem- brane with or without perforation of the drum-head. It should not be supposed that the changes in structure above described progress evenly throughout the entire mucous membrane. Often depressed, scar-like spots of atrophy are seen in the midst of the rough, succulent, and swollen mucous membrane characteristic of the hypertrophic stage of chronic aural catarrh. Not only are the mucous and submucous structures involved in long-continued catarrh of the middle ear, but the bony structures are affected as well, and, ultimately, the labyrinth also. The cavity of the tympanum generally becomes more roomy, and as a result id' interference with the nutrition of the parts chalk deposits take place