OCR Text |
Show or run EAR. OF THE BAR. MATTER which flows from the ear may be a mere change of secretion in the glandulze ceruminosaa. In this tube into the throat, or perhaps an inspissation of the ear-wax, which both prevents the sound from entering the tube freely, and by pressing on the membrane of the tympanum prevents the free motion of the membrane. In this deafness from the inspissated wax, we need only wash out the tube with a syringe and tepid water. When the Eustachian tube has been obstructed by a disease in the throat, deafness is the consequence. It is in this case that it is proposed to puncture the membrane of the tympanum, that like the hole in the side of a drum it may give free dom to the contained air, and free play to the membrane of the drum ; the perforation becomes a substitute for the case we may inject any mild astringent, as lime water, for Eustachian tube. cleanliness, and anoint the passage with the diluted citrine ointment. Sometimes the passage ulcerates, and there is a great puru~ lent discharge from the ear, or after some occasional increase The patient is placed with the ear towards the direct light of the sun ; the surgeon is behind him, and he turns the head until the light is admitted into the bottom of the tube. The point of the silver probe, (a small stilette is used by Mr. Cooper), is pushed through the lower and fore part of the membrane of the tympanum. As it is found that the perforation in this membrane very soon heals, it has been thought necessary to lacerate it pretty freely, but the greater the injury the greater is the probability of the membrane inflaming, becoming thick, and of consequence, incapable of delicate vibrations. I should imagine that it were better for a time to allow a small probe of silver to remain in the passage of the ear, supporting it by a little cotton in the passage. It is an operation of great uncertainty, and leaves the patient to re- gret the very short enjoyment of the benefit he has been led to expect from it. But I deem it to be of more consequence to speak here of the dangers of deep suppurations in the cavities of the ear. Suppuration may take place in the cavities of the ears, and CHAPTER 11. OF THE BAR. {an in. g of the inflammation, an abscess or sinus forms behind the tube ".q-r, "'24-,""me _$;<-,. "a ... . «Luvs: .1", of the ear. The following consequences may ensue from this suppuration. 1. The thickening of ‘ the membrane of the tympanum. 2. The growth of fungous excrescences from the passage. 3. The destruction of the membrane of the tympanum by the progressive ulceration. 4. The communication of the inflammation and suppuration to the cavity of the tympanum. We must then in suppuration keep a free outlet to the matter, by preventing the swelling of the tube from closing the passage, and by opening the abscess if formed by the side of the tube ; we must prevent the lodgment of the mat. «an: 4..-. H" ter by every possible attention. Our injection should be some mild fluid at first, and afterwards we may endeavour to correct the diseased surfaces: for this purpose a common injection is the muriate of mercury with lime water. If the hearing be dull to all outward sounds, but increased to all vibrations of the head or jaws, and there is a confused and loud noise often heard, there is probably only an adher~ ence of tough mucus, about the opening of the Eustachian a. a (3 401‘? my 3"va 5'7"," ' 79 in the mastoid cells, either from the communication of inflam mation from the outward tube, from the threat, by the Ens. tachian tube, or it may be a scrophulous disease, originating in the bone itself. Any one who thinks of the principle of Pathology, which guides us in our surgery of the head, must |