The diagnosis and treatment of auditory-nerve vertigo / by W.R. Gowers.

  • Gowers, W. R. (William Richard), 1845-1915.
Date:
1877
Catalogue details

Licence: Public Domain Mark

Credit: The diagnosis and treatment of auditory-nerve vertigo / by W.R. Gowers. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    some, she almost lost consciousness ; could be roused with difficulty. She said that she had many times actually lost consciousness for a few minutes. During the attacks there was slight flushing of the face. The eyelids were closed ; on opening them, there was no dilatation of the pupils. The eyes were all the time iii the median position, never turned either to the right or the left, even when the sense of falling to the right was most intense. The duration of the attacks varied from a quarter of a minute to several minutes. The vertigo commenced suddenly, but ceased gradually. The definite character of the vertigo led to a careful examination of the state of hearing. It was found that a watch was heard less acutely with the right ear than with the left. (Right at one-third, left at two- thirds the normal distance.) She could hear all the notes of a piano ; but, after listening for a little time, the upper and middle notes sud- denly ceased to be heard. After a little time, she could hear them again. The upper notes, she said, constantly sounded a long way off and faint, like the strings of a guitar. She had noticed lately that her daughter's voice, in singing, sounded distant and squeaky, quite unlike its ordinary character. Audition through the bones of the skull was tested with the tuning- fork. Placed in contact with the top of the head, she said she could bear it in the left ear only. Placed on the left parietal eminence, she heard it invariably louder when the meatus was closed than when it was open. Placed on the right parietal eminence, she could hear it only faintly, and, when the meatus was closed, she could not hear it at all. Examination with a watch yielded the same result. The meatus was free from obstruction. She had been troubled with occasional singing and whistling noises in the right ear. Sight was unimpaired, except by presbyopia. The ocular muscles were unaffected. Smell and taste were both diminished. Neither peppermint, assafoetida, nor camphor could be recognised. Neither citric acid, salt, nor sugar could be tasted on either side. Quinine was tasted a little. No pain was referred to the ear, but neuralgic pain and tenderness over the right side of the head were complained of, and, on examination, there was distinctly defective tactile sensibility in the parts supplied by the right fifth nerve. There was a good deal of general weakness and prostration, and she was liable to occasional attacks of great prostration, sense of dyspncea, surface pallor, without marked failure of pulse. She was disturbed at night by starting in her sleep, accompanied with a sensation of falling : she would wake in a