A treatise on nasal suppuration, or suupurative diseases of the nose and its accessory sinuses / by Ludwig Grünwald.

  • Grünwald, L. (Ludwig), 1863-1927.
Date:
1900
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on nasal suppuration, or suupurative diseases of the nose and its accessory sinuses / by Ludwig Grünwald. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

    45/366 (page 27)
    II. The Ethmoid Bone. According to the anatomists, the changes found in the mucous membrane covering this bone are slight. Zuckerkandl (^'') only met with three cases''' of empyema of the ethmoidal cells, and he tells us nothing on this point. Harke, in reporting fourteen cases of suppuration in the ethmoidal cells, remarks in seven of the fourteen that the mucous membrane was swollen, brawny, and sometimes reddened. He found no disease of bone, and this is not to be wondered at, when one considers that almost all his material was derived from acute cases. More has been learned in the course of operations. Jansen C^i) found the ethmoidal cells filled with granulations in eight cases in which he had occasion to lay them freely open. It must, however, be remembered that changes in the mucous membrane of the ethmoidal cells would have to be very great before they could be observed by rhinoscopy, and that is the reason why the formation of polypi is almost the only change of which we find mention. Bosworth (''•^), in speaking of ' intracellular myxomatous degeneration,' presum- ably speaks of what he has seen. In my first paper such a case is recorded. The case which Roth C^') briefly describes was apparently similar: ' There was sw^elling of the anterior end of the middle turbinal, with persistent discharge of pus from the nose. On opening this swelling a polypus as big as a hazel-nut was found inside; there was no disease of the bone, and after removal of the polypus the suppuration ceased without further treatment.' I can largely supplement this list from my more recent statistics of ethmoidal empyema. Cases i to 9. I. Left ethmoidal labyrinth freely opened (after removal of middle turbinal), on account of suppuration which had lasted for years. Two small polypi were found in the cells. * Pp. 363-367, Cases 4, 7, and 33. The case mentioned in vol. ii., p. 207, may or may not have been ethmoidal empyema. It was found in a macerated skull.