. A Reference handbook of the medical sciences : embracing the entire range of scientific and practical medicine and allied science. ous cicatrized cases. The healing is from withinoutward in the gaping cases (Politzer), and may leave noscar behind ; but generally a marked whitish linear cica-trix will remain, or the gap may be closed by a delicatedistensible membrane as after perforation by purulentinflammation. The blood effused in the wound-marginswill be absorbed, or will migrate across the membrane ;the injection, which may have been extreme, will disap-pear, and any defect of hearing, du
. A Reference handbook of the medical sciences : embracing the entire range of scientific and practical medicine and allied science. ous cicatrized cases. The healing is from withinoutward in the gaping cases (Politzer), and may leave noscar behind ; but generally a marked whitish linear cica-trix will remain, or the gap may be closed by a delicatedistensible membrane as after perforation by purulentinflammation. The blood effused in the wound-marginswill be absorbed, or will migrate across the membrane ;the injection, which may have been extreme, will disap-pear, and any defect of hearing, due to the lesion itselfand not to labyrinth trouble, will pass away. Wheresuppuration has taken place, the case simply passes intoa condition of purulent otitis media, and is to be treatedas such. In catarrhal otitis media the membrane can long retainmuch of its normal lustre, and its curvature may remainunaltered ; but the various layers will usually be gradu-ally implicated, its opacity will increase through injec-tion, infiltration, and maceration of the epidermis ; andinterference with the normal ventilation and drainage of. Fio. 4189.—Globular Protrusionin the Upper Posterior Quad-rant of the Right MembranaTympani, through the bottom the tympanum will retain the secretion and cause unduepressure upon the inner surface of the drum-head. Theconsequent pressing outward of the membrane may begeneral, and cause a flattening of its normal funnelshape ; but usually the relative weakness of one partcauses it to yield, and a limited protrusion results. Thisis most frequently seen in the upper posterior quadrant,both for reasons already given, and because the fibresare here longer and less well supported. It may be notunimportant, also, that this portion of the membrane ismost nearly horizontal, so that gravitation may exercisesome influence upon it. Behind it lies the opening intothe mastoid antrum and cells, and the secretion escapingfrom them may easily be held in contact with t
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectmedicine, bookyear188
