On certain anatomical relations between abscess of brain and aural disease / by James A. Adams.

  • Adams, James A.
Date:
[cbetween 1800 and 1899?]
Catalogue details

Licence: Public Domain Mark

Credit: On certain anatomical relations between abscess of brain and aural disease / by James A. Adams. Source: Wellcome Collection.

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

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    associated with disease of the ear, the pathology of which has not, in my opinion, been as yet sufficiently recognised. It was long a popular belief that a running from the ear .was rather a healthy affection than otherwise, and even in the ranks of the profession there may still be found individuals who, although not prepared to contend that otoirhoea is actu- ally beneficial, nevertheless do not regard it as worthy of, or necessarily requiring earnest treatment. But it is substantially a disease, or rather the indication of disease. For the struc- ture and functions of the middle and internal ear are always seriously affected when purulent discharges are of long contin- uance. Such discharges are, therefore, no longer to be regarded as at the worst simply an unpleasant secretion, a mere trouble- some affection having no other result. They are properly to be considered as symptomatic of one, or it nmy be, of several conditions, and the purulent matter itself is further to be looked upon as certainly provocative of a great extension of the original lesion if neglected. As long as dischai-ge from the ear is present, says Wilde, we can never know how, when, or where it may terminate, or to what it may lead. The greater number of diseases of the ear, and nearly all which are characterised by suppurative discharge, involve the walls of the tympanic cavity. Kramer states that 56 per cent of all aural diseases are situated in the middle ear. And when it is borne in mind that there are only barriers of thin bone betv/een the middle ear, the internal carotid artery, the internal jugular vein, the lateral sinus, the internal ear, «&c., and that these barriers are sometimes deficient or imperfect, it is matter of surprise that the extension of diseased action from the ear to the brain is not of still more frequent occurrence than has yet been shown. But although the conservative processes that defend the delicate brain tissues from invasion are powerful, there is accumulating evidence of diseased con- dition of brain, originating more frequently than is commonly supposed from disease of the ear. And of these, abscess of the brain, the result of neglected discharges from the ear, is very frequent. So far, therefore, the practical importance of a running from the ear is evident. But the rationale of the patholo- gical processes involved is, in certain conditions, somewhat obscure. Dr. Barr, Lecturer on Aural Surger}' in Anderson's College, of whose special ability I have on several occasions had