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Show 80 01‘ THE EAR. or me ran, at once foresee danger from suppuration and caries of the temporal bone, for though it contain the organ of hearing, yet it takes more importance, in this instance, as a bone of the 435W mum ‘ l t -. r X. 5. r,m-w,v\2 awyxrvrww rs me... i "V ~ «- A a" I '%‘1._..;_.:.,_»-_ nWw'h‘ -‘ ‘3‘ cranium. The worst character of the disease is when, after the patient has had violent pains, he is attacked with shivering and fever, and the organ is destroyed, and the passages of the ear are full of pus, and the bones of the tympanum have come away. This discharge may continue long, Without any further apparent bad consequences than the loss of the organ, but if there comes drowsiness, and oppression, and a feebleness or degree of paralysis in the opposite side of the body, then the petrous portion of the bone is carious, the dura mater attached to it has partaken of the disease, and the side of the cerebellum and base of the cerebrum are diseased and covered with pun rulent matter. The abscess sometimes forms in the mastoid cells, and mak» ing a slow progress, such as characterises the scrophulous action, after a time the tumefaction of the integuments over the mastoid angle of the bone betrays its presence. The bone in some instances becomes carious, and the finger can depress the integuments into the bone, and, when this is opened, it is not merely a disease of the bone which we discover, but the sur face of the brain is exposed, and the probe can be introduced deeper than the thickness of the temporal bone ; a circum‘ stance which shews the danger of the experiment. Thrice I have seen such suppuration fatal by the communication of dis ease to the brain, before the spoiled bone gave way outwardly; and I have ascertained the nature of the disease by dis» section. We learn from this View of the subject, how carefully we ought to attend to symptoms when there is disease in the ear, lest it should become irrecoverably bad, and end in communi» eating the disease to the brain. We must bleed, and purge and foment, to allay the pain and inflammation, if it be active Blisters are to be applied behind the car, if a slow continued action is proceeding within; and where we can ascertainthat 3] there is caries in the posterior angle of the bone, with den» ger of the confinement urging the progress of the diseased action to the brain, we have to apply the trephine and penetrate into the cells of the bone; even when this is done if the petrous portion of the bone be carious, there remains only a hope, that by great care, soothing the action, and guarding against the matter collecting, we may gain time, so that the diseased bone may separate, and an abscess in the brain be prevented from forming. |
