Address on vertigo of bulbar origin : delivered before the Harveian Society of London at the Annual Meeting, Jan. 16th, 1890 / by Thomas Buzzard.

  • Buzzard, Thomas, 1831-1919.
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: Address on vertigo of bulbar origin : delivered before the Harveian Society of London at the Annual Meeting, Jan. 16th, 1890 / by Thomas Buzzard. 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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    allowed that irritation of the nuclei of bulbar nerves will occasion symptoms indistinguishable from those which would be produced by irritation of the periphery of the nerve. The most important evidence bearing upon this point is derived from a case published by Dr. Sharkey,* in which the characteristic symptoms of Meniere's disease were due to the presence of an intra-cranial tumour lying against the pons varolii and involving the auditory nerve. In the short space at my command on the present occa- sion I cannot adduce examples illustrative of this subject in any detail, but will refer briefly to a few. A very hard-worked professional man, thirty-seven years old, began to suffer in September, 1888, from depression of spirits and tinnitus aurium, and went into the country to recruit. Whilst there he had an attack of vertigo, followed by vomiting and a feeling of great illness, from which after a few days he improved, but later on four occasions ex- perienced a return of the symptoms at intervals of about a week. The attacks then left him, and when I saw the patient about six months afterwards there had been no further return. His hearing was then not quite satisfactory, and there was .some tinnitus (noise of a fife) in the ears, especially the right one. During the attacks he had been (to use his own expression) nearly stone deaf. I found that he could turn his head to either side without becoming giddy. This patient's father inherited and suffered severely from gout, and the patient himself three years previously had a slight attack of gout in the ball of one big toe, which lasted a week. He had been accustomed to eat a good deal of meat, to drink a fair amount of Australian wine, and to take but little exercise. Let me draw your attention to a point which appears important. During the attacks the patient said he had been nearly stone deaf. It is clear that a deafness which is paroxysmal in this way can- not be dependent upon organic disease, and that we must look elsewhere than in the internal ear for an explanation ' of it. A stout, well-nourished, temperate man, forty-six years of age, was taken with vertigo, relieved it was thought by brandy, but followed two hours later by a very violent re- turn. This was coupled with vomiting, profuse sweating and violent palpitation. There was deafness and tinnitus in the