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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    panied the severer attacks of vertigo, give weight to the auditory defect, slight as it is. The occurrence of quasi-convulsive movements is a point of much interest, to vi'hich I will return. The remarkable pos- tures assumed by the patient in his sleep are curious, and may perhaps be connected with the altered action of the organs or centres of equi- libration. May the sudden startings on going to sleep be associated with the same condition? It is a well known fact that they are often related to a distinct dream of defective equilibrium. But slight impairment of the power of hearing a watch or a tuning- fork, when vibrating in contact with the head, is not uncommon, even in persons who do not habitually suffer from vertigo. This is not surpris- ing, since it is almost certain that the apparatus for the recognition of sound and of the position of the body are not the same, although they may be adjacent and even connected and supplied by portions of the same nerve. Even supposing, with Dr. Ferrier, that the semicircular canals are the channels by which the vibrations conducted through the bone reach the cochlea, we do not know that all disturbances of the semicircular canals cause vertigo. But I think some facts to be adduced render it probable that derangement of these canals may bring the centre of equilibration into an unstable condition, in which it is easily excited to sudden perverted action (paroxysmal vertigo) by some abnormal im- pression on the other nerves with which it is connected. It seems, therefore, that a morbid state of the semicircular canals may predis- pose to vertigo, as well as excite it. I shall return to this in speaking of the diagnosis of auditory and gastric vertigo, and shall mention some instances in which the attacks of vertigo appeared clearly predis- posed to by aural, and excited by gastric, disturbance. A probable example of such a relation was afforded by a member of our profession, who, on two occasions near together, was seized with intense vertigo, brief but definite in character, the sensation being on each occasion that of a similar rotation. The attacks occurred after and were attri- buted to the inhalation of tobacco-smoke into the lungs. On subse- quent examination of the sense of hearing, it was found that, while both tuning-fork and watch were heard when in contact with the head, closure of the left meatus rendered the sound considerably louder, while closure of the right meatus made little difference in the intensity of the sound. He had suffered from some ear-trouble in the right ear, after scarlet fever in early life ; the ear was deaf for a time, but gra dually, in the course of years, regained normal power. It is probable that, in this case, some permanent defect in the function of the semicircular