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ACUTE AND CHRONIC CARIES AND NECROSIS OF THE MASTOID; PACHYMENINGITIS EXTERNA; EPIDURAL ABSCESS.

HERMAN KNAPP, M.D.
JAMA. 1898;XXX(12):653-655. doi:10.1001/jama.1898.72440640021003e.
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Of all the ear diseases, I know none that are, on the one hand, so important and dangerous, and on the other, so gratifying and manageable as the group comprehended in the title of this communication. If left alone they prove fatal in a large percentage of cases; if treated understandingly, they nearly all recover. The grippe has made us familiar with acute mastoid caries. In the first or second week of an attack of acute otitis media there is intense pain in ear and head; tympanic membrane red and bulging; in a few days otorrhea, with or without paracentesis of the drumhead; relief of pain for a few days, then return of it with tenderness and swelling of the mastoid, membrana tympani bulging in upper-posterior part, slight fever, loss of appetite, headache, mental depression; hearing greatly impaired. The further course varies greatly. The discharge may be free for a

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