. Modern surgery, general and operative. mmers and to Moores tests,but does not refract polarized light nor easfly ferment wdth yeast. Treves^states that cerebrospinal fluid cannot flow from the ear in fractures of the middlefossa—(i) unless the line of fracture crosses the internal meatus; (2) unless theprolongation of the membranes into the meatus is torn; (3) unless a com-munication exists between the internal ear and tympanum, and (4) unlessthe drum-membrane is torn. Miles, of Edinburgh,- claims that bleeding fromthe ear foUowed by a flow of cerebrospinal fluid is not pathognomonic offract
. Modern surgery, general and operative. mmers and to Moores tests,but does not refract polarized light nor easfly ferment wdth yeast. Treves^states that cerebrospinal fluid cannot flow from the ear in fractures of the middlefossa—(i) unless the line of fracture crosses the internal meatus; (2) unless theprolongation of the membranes into the meatus is torn; (3) unless a com-munication exists between the internal ear and tympanum, and (4) unlessthe drum-membrane is torn. Miles, of Edinburgh,- claims that bleeding fromthe ear foUowed by a flow of cerebrospinal fluid is not pathognomonic offracture of the middle fossa of the base. He maintains that when the drum isruptured we may have these signs; when bone is not broken the chief sourceof the blood being the vessels of the pia and temporosphenoidal lobe, the bloodand cerebrospinal fluid flowing inside the sheath of the auditory nerve, passinginto the vestibule, through the lamina cribrosa, and from the vestibule into the1 Applied Anatomy. - Edinburgh Med. Jour., Nov., Fig. 580.—Extensive fracture of the base of the skull(American Text-Book of Surgery). Fractures of the Base 889 middle ear, finding exits from this space by way of the Eustachian tube and alsothrough the rent in the drum-membrane. Profuse mucous discharge may flowfrom the ear after an injury without fracture when the drum is ruptured, thefluid coming from the cells of the mastoid. It must be understood that frac-ture of the base may exist when there is no flow of blood or of serous fluid. Afracture of the middle fossa is usually compound, , even when thedrum is not ruptured, by the Eustachian tube, and there is often paralysisof the seventh or eighth nerve or of both of them. In fracture of the posteriorfossa there is usually respiratory derangement and blood accumulates beneaththe deep fascia and produces discoloration in the line of the posterior auricularartery {Battles sign), the discoloration first appearing near the tip of themas
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