. Diseases of the ear; a text-book for practitioners and students of medicine. possible with the brain substance. Quite recently, Dr. Whiting, of this city, has perfected aninstrument known as the encephaloscope, by which a clear viewof the interior of a brain abscess can be obtained. This instru-ment is an ear speculum of large size, the lumen of which iscompletely filled by an obturator. The end of the obturator is 590 CEREBRAL AND CEREBELLAR ABSCESS. rounded, so as to admit of the introduction of the speculum,without injuring the delicate brain tissue. After the abscesscavity has been opene
. Diseases of the ear; a text-book for practitioners and students of medicine. possible with the brain substance. Quite recently, Dr. Whiting, of this city, has perfected aninstrument known as the encephaloscope, by which a clear viewof the interior of a brain abscess can be obtained. This instru-ment is an ear speculum of large size, the lumen of which iscompletely filled by an obturator. The end of the obturator is 590 CEREBRAL AND CEREBELLAR ABSCESS. rounded, so as to admit of the introduction of the speculum,without injuring the delicate brain tissue. After the abscesscavity has been opened, the encephaloscope, obturatorin position, is cautiously introduced into the incision, and theobturator withdrawn. By the aid of reflected light the surgeoncan then inspect the entire abscess cavity, and can also see tothoroughly cleanse this cavity under ocular inspection. If mul-tiple abscess is present, he will be able to discover that theprimary incision has not caused a complete evacuation of allthe pus within the brain, and will, in some instances, be able. Fig. 157.—Whitings encephaloscope : A, Instrument ready for introduction ; ob-turator is in position and the handle is attached to the speculum. B, Obturator,speculum, and handle separated. to open up these other foci of infection under direct inspec-tion. The packing of the abscess cavity is much facilitated bythe use of this instrument. Dr. Whiting reports four cases oftemporo-sphenoidal abscess operated upon successfully, andattributes his success in no small degree to the use of thisdevice. After an abscess has been evacuated and the gauze packingintroduced, care should be taken to isolate the adjacent brainsubstance and the meninges from the abscess cavity by meansof gauze packing. The middle ear and antrum should also bepacked off separately to prevent any infection of healthy braintissue which may lie immediately adjacent to infected areaswithin the middle ear. The anterior angle of the wound should
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