Auscultation gave a plain gurgle indicating unmistakably the presence of fluid in the tympanic cavity. Patient had come to St. Louis from some distance and was not able to wait for treatment at that time, stating that she had merely come for an opinion and consultation. As she could not be induced to remain for treatment until she should have adjusted affairs at home, paracentesis was deferred. After several days patient returned to the city and paracentesis was performed when the paralysis was about ten days old. The incision was made without causing any pain to patient. It was much like cutting through parchment. The bleeding was very slight and very little fluid came through the opening. A gauze drain was placed in the meatus reaching to the opening. This drain was replaced daily for two or three days, but remaining practically dry it was then left out entirely. The opening was very slow in healing, gaping so that the edges were not in good apposition. Finally it healed over entirely. The atrium became perfectly dry. The facial paralysis improved slowly but steadily, at last, only the slightest trace was present, and that noticeable only to the person looking for it. The hearing did not improve to any decided extent. From the beginning treatment was directed to the nasal cavities and to the patient's general condition. Potassium iodide was prescribed at first and later the following formula: Sig. Teaspoonful after each meal. Case 3. The third case was that of a woman of sixty-five years of age, suffering from chronic rheumatism. The history was somewhat indefinite but she was sure that the paralysis was of at least ten days standing when she consulted me. The facial paralysis was of the left side and was very marked. The exmination revealed no evidence of an acute or sub-acute otitis; but both ears were affected by a chronic non-suppurative otitis of the type commonly called chronic catarrhal otitis media. There was present also a chronic hypertrophic rhinitis. The hearing for the whispered voice was about three yards for the right side and two yards for the left. This was decidedly improved on both sides by catheterization. Treatment was directed to the nose and the ear was inflated by means of the eustachian catheter at intervals of every two days. General tonics and anti-rheumatics were given. The patient has improved in every way and is particularly delighted with the gradual improvement of the facial paralysis which after ten weeks of treatment has almost disappeared. Yet, I can't feel sure that the ear treatment has been the cause of the improvement in the facial paralysis. The hearing is greatly improved. In connection with this last case, I wish merely to mention a case of facial paralysis complicating an acute purulent otitis. This patient called at my office about the same time as the foregoing. The facial paralysis was very marked and the dizziness so great that the patient could scarcely walk. The ears responded rapidly to proper treatment and, on the cessation of the discharge, the facial paralysis and the dizziness disappeared rapidly. I mention this case because it is interesting to observe how much more rapidly the paralysis was cured where early attention was given to the acute ear trouble. In the case No. 3 all acute symptoms had subsided before the case came under my care. The acute case was dismissed in five weeks. The facial paralysis had entirely disappeared before this. The other case is still under observation, but only the slightest trace of the paralysis remains. From the foregoing cases it is seen that Dr. Reik's theory is undoubtedly supported by cases 1 and 2; for in these the acute ear condition was unquestionably present. As for the third case we cannot say positively that an acute or sub-acute condition had not been present, for the case was not seen until the paralysis was at least ten days old; but it is quite probable that it was considerably older than ten days. An early paracentesis in the second or third case might have cut short the course of the facial paralysis which lasted rather long in both cases. The case of facial paralysis complicating an acute purulent otitis was mentioned to illustrate how rapid and complete was the recovery after the healing of the ear condition. In the second case it is interesting to note that there were serious ear symptoms a considerable time prior to the appearance of the paralysis. One objection offered against Dr. Reik's position is that this type rarely, if ever recurs, while we know that acute otitis does recur. It may be that one attack causes immunity by a proliferation of tissue due to the inflammatory process, — a thickening occurring which might obliterate the dehiscency referred to. Granted that such is the case, it supports rather than discredits Dr. Reik's position. NEWS AND PERSONAL MENTION. The annual dinner of the Alumni Association was held on Wednesday, May 24th, at the Hotel Jefferson. Dr. A. Jacobi of New York was the guest of honor. The Rev. Mr. Dodson said grace after which a toothsome collation was served. The following toasts were responded to, Dr. Henry M. Whelpley being toastmaster: The Alumni, Dr. A. H. Koetter, President; The College, Dr. Robert Luedeking, Dean; Our Guest, Dr. A. Jacobi; The class of 1905, Walter E. Fischel, Class President; The Practitioner, Dr. P. Y. Tupper; Student Days, Dr. Henry Schwarz; The Class of 1895, Dr. R. E. Schlueter. The attendance was unusually large. The library has received a number of valuable gifts since our last issue, among which the following deserve special mention. Dr. Ludwig Bremer contributed from his library over one thousand volumes. Various appliances for microscopic work were received from the same source. Dr. Wm. A. Hardaway gave 120. volumes, most of them bound, besides a set of six pictures of men eminent in our profession. The growth of the library has necessitated the devotion of another room in the college building to accommodation of stacks. The ante-room to the surgical amphitheater will probably be used for this purpose. This coming year, a club-room will be provided where students may purchase and eat their luncheon. This will obviate the present necessity of going to neighboring restaurants for the midday meal. Drs. Luedeking, Fischel, Tuholske, Tupper, Behrens and Creveling are traveling abroad this summer. Dr. Warren is working at Heidelberg under Kossel, doing general work in physiological chemistry and a special bit of research on the structure of the albumin molecule. Dr. Sluder is attending rhinological and laryngological clinics in Berlin and elsewhere, while Dr. Budgett is doing some original work at Santa Barbara, California. NEW APPOINTMENTS. Albert E. Taussig, A.B., M.D., Clinical Prof. of Medicine. John Zahorsky, M.D., Clinical Prof. of Pediatrics. John C. Salter, A.B., M.D., Instructor Clinical Chemistry and Microscopy. Louis M. Warfield, A.B., M.D., Instructor Clinical Chemistry and Microscopy. Oliver H. Campbell, M.D., Instructor in Medicine. William S. Deutsch, M.D., Instructor in Clinical Surgery. Wm. M. Robertson, M.D., Instructor in Clinical GenitoUrinary Surgery. Richard H. Fuhrmann, M.D., Instructor in Obstetrics. B. W. Moore, M.D., Instructor in Obstetrics. George Gellhorn, M.D., Instructor in Obstetrical and Gynecological Microscopy. M. J. Lippe, M.D., Instructor in Clinical Pediatrics. E. W. Eberlein, M.D., Instructor in Clinical Pediatrics. |