Politzer's text-book of the diseases of the ear and adjacent organs... / by Adam Politzer ; translated by Oscar Dodd ; edited by Sir William Dalby.

  • Politzer, Adam, 1835-1920.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Politzer's text-book of the diseases of the ear and adjacent organs... / by Adam Politzer ; translated by Oscar Dodd ; edited by Sir William Dalby. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    in cases with continual subjective noises than in those where no noise occurs, or only occasionally. One should examine further if the noises in the ear are increased or diminished by diminished blood-pressure in the ear, during compression of the carotid; or if stopping the external meatus with the finger affects the intensity of fchem ; whether the subjective sensations are altered by reflex action from the cutaneous branches of the trigeminus ; also through pressure upon the mastoid process ; or irritating the skin in the region of the ear ; and lastly, if the intensity is decreased by the tones of high or low tuning-forks. A more rare accompaniment of ear diseases is the pain, which is very intense in acute myringitis, acute middle ear inflammations, especially in children, and in caries of the temporal bone. Where the patient complains of pain in the ear, we must deter- mine if it is located in the region of the external ear or in the deeper portion ; whether it is limited to the ear or extends outward towards the forehead, occiput, or the region of the neck; if the pain is increased by pressure upon the region of the ear, and how often during the course of the disease the pain has occurred, and if it is atypical or in regular paroxysms. Besides, it is important to determine the cause of the pain in every case by objective examina- tion. If we are able to say from an ocular inspection that there is no inflammatory process in the ear, we should investigate whether we have to do with a neuralgia, whether it is located in the external meatus or in the plexus tympanicus, and whether it is a localized ear disease, or accompanies a trigeminus or cervico-occipital neuralgia. One should not forget in such cases to examine the teeth, as, especially in children with carious teeth, the pain radiates to the ear. In the same way, during ulcerative processes in the pharynx and larynx, the pain may radiate to the ear. To the important ear symptoms should be added dizziness, which occurs not only in disease of the labyrinth and in cerebral deafness, but is often observed in those affections of the middle ear which are accompanied by increased pressure in the labyrinth. These patients should be tested by walking with closed eyes and by turning the body on its long axis. One should observe to which side there is a tendency to fall, and whether by forcing air into the middle ear or aspirating it from the external meatus, the dizziness is increased or diminished. Lastly, in judging of the symptoms of the disease, one should be careful not to place too much importance on such abnormal sensa- tions as pressure, fulness, etc., in the ear, as these are placed in the foreground by the patient on account of their disagreeableness. To