An American text-book of the diseases of children .. . generally contains pus andthe pyogenic bacteria. The perforation is less often the mere pushing apart ofthe tissues, although frequently assuming a pouting, nipple-like form, for thereis generally some loss of substance: and in the cases due to scarlatina anddiphtheria the destruction of the membrane may rapidly be extensive or of the inner surface of the drumhead is only one indication of thedestructive influence of the inflammation or its products: and as the attic andantrum are generally involved, as well as the tympanu
An American text-book of the diseases of children .. . generally contains pus andthe pyogenic bacteria. The perforation is less often the mere pushing apart ofthe tissues, although frequently assuming a pouting, nipple-like form, for thereis generally some loss of substance: and in the cases due to scarlatina anddiphtheria the destruction of the membrane may rapidly be extensive or of the inner surface of the drumhead is only one indication of thedestructive influence of the inflammation or its products: and as the attic andantrum are generally involved, as well as the tympanum proper, the dangers tomeninges, blood-vessels, and mastoid are real and great. Paracentesis may bepromptly called for, either to make or enlarge an opening, if the symptomspoint to retention of secretion : and the temperature should be carefullywatched for evidence of extension or exacerbation of inflammation. Tender-ness of the mastoid and other neighboring parts is to be frequently sought; 1114 AMERICAN TEXT-BOOK OF DISEASES OF CHILDREN. Fig. Swelling of the Mastoid Region, pnshinauricle out and forward. the and it, with or without swelling, redness, or oedema, calls for redoubled pre-cautions. The position of the auricle should be critically compared with that of the other side, especially by studyfrom directly behind the head (Fig. 5),for displacement is almost invariablypresent if there be any surface involve-ment of the temporal. The size andform of the auditory canal should benoted, so as to detect any bagging, es-pecially of the upper back wall, by re-tained secretion. The position of the per-foration is probably of small importance,unless it be in the flaccid membrane, asan indication of suppuration partly orwholly isolated in the cavities of theattic; and its form depends principallyon its size. The opening at the apexof a pouting, nipple-like protrusion hasimportance, however, since it is in itselfan evidence of incomplete relief of pres-sure, is rather prone t
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Keywords: ., bookcentury1800, bookdecade189, booksubjectchildren, bookyear1895
