A treatise on nasal suppuration, or, suppurative diseases of the nose and its accessory sinuses / by Ludwig Grunwald ; tr. from the 2nd German edited by William Lamb.

  • Grünwald, L. (Ludwig), 1863-1927.
Date:
1900
Catalogue details

Licence: In copyright

Credit: A treatise on nasal suppuration, or, suppurative diseases of the nose and its accessory sinuses / by Ludwig Grunwald ; tr. from the 2nd German edited by William Lamb. Source: Wellcome Collection.

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    Many of my patients referred their illness quite definitely to a bad cold in the head ; others ascribed it (bilateral ethmoidal empyema) quite as positively to an attack of pneumonia. Typhoid was the probable cause in a case of left antral and bilateral ethmoidal and sphenoidal empyema, whilst two other cases (circumscribed suppuration with caries, and bilateral ethmoidal and sphenoidal empyema) were referred with some probability to diphtheria and scarlet fever respec- tively. The probability was pretty strong in the latter case, for the patient was a surgeon, and remembered when he was 3^- having scarlet fever, followed by chronic otorrhcea on both sides. ‘ I cannot exactly say when the snuffles began,’ he says; ‘ one or two years after the scarlet fever I had it very much as I have now.’ Influenza is frequently assigned as a cause. Two patients ascribed the origin of their empyema to head injury, received during military Service; the one man had a fall from his horse, the other was severely cuffed by his drill-instructor. Such Statements must, of course, be taken for what they are worth. Amongst traumatic cases may be included two of nasal tuberculosis, in which the disease spread from the lower turbinal to the outer wall, opening into and infecting the antrum. Amongst cases due to accidental injury must be included those acute inflammations set up by operations on neighbouring organs. Langenbeck (25) had two cases of acute empyema of the antrum in connection with the Operation for resection of the second division of the fifth. Jourdain (20), Schütz (27), Jeanty (28), and Siebenmann (29) had a similar experience after tooth extraction. The same thing occurred apparently in one of my own cases ; three months after the extraction of a first molar tooth by a dentist, an empyema of the antrum appeared, which presently discharged through the empty socket. This mode of infection may also occur without surgical interference, as in a case observed by Spitzer (:i0), in which a tooth grew into the antrum. The conveyance of infective pus from one cavity to others in the course of operative treatment comes under the head of traumatism, and also cases like those recorded by Hartmann (32)