The Mode of Continuity of the Fibres of the Auditory Nerve with the Auditory Sense Epithelium and with the Nuclei in the Hind Brain
The Journal of Laryngology Rhinology and Otology
tympanic treatment, as I have said,effects a cure; where this fails, and as soon as it is certain that it has failed, I prefer the radical mastoid operation. In conclusion, I wish to emphasise the fact that in scarlatinal otitis we have an infection of the whole tract, from Eustachian tube to the mastoid cells, antrum, and tympanum, accompanied by a definite osteitis where that tract is bony, and not simply a catarrhal inflammation of the lining membrane of the tympanic cavity. Moreover, the
... y. Moreover, the signs of this osteitis of the mastoid, even when if has gone on to suppuration, are often entirely absent clinically. I have during the last year examined the temporal bone in all cases except two that have died from scarlatinal septicaemia, and have repeatedly found pus and carious bone on the mastoid side where there has been no otorrhcea whatever during life. In two cases during the last year this had given rise to pyamiie suppuration in one or more joints, and was only detected at the autopsy, though in all cases a most rigorous watch was kept on the ear and its adnexa while the child was alive. This being so, it is difficult to regard as adequate the treatment pursued in many fever hospitals, which consists in having the ears syringed by the nurse with one or more antiseptic lotions. The need for the appointment of otologists to fever hospitals is, in my opinion, imperative and pressing. Moreover, the resident staff should be skilled in the ordinary routine procedures of at least elementary otology.