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Related post: the blood flowing from what subsequent growth
showed to be a sebaceous tumor in the meatus, the
drumhead being unbroken, and in the other from Over The Counter Benzoyl Peroxide
the tympanic mucous membrane, the membrana tym-
pani having been previously destroyed. Had either
of these patients sustained a head injury during Benzoyl Peroxide Buy
menstruation and fallen into strange hands, a basal
fracture might very probably have been diagnosti-
cated, but with no more justice and probably no-
more correctness than in Rushmore's case.
Admitting then that free traumatic aural hemor-
rhage may occur without fracture of the bone, let
us look at the Clindamycin Phosphate Benzoyl Peroxide Gel subject from another standpoint.
The notable exception, previously referred to, was-
Erichsen. He writes {Science and Art of Surgery,
vol. i. Benzoyl Peroxide Shampoos p. 536) :
" Bleeding from one or both ears, after an injury to the
head, cannot, by itself, be considered a sign Benzoyl Peroxide Gel 2.5 of much im-
portance. If, however, the hemorrhage be considerable, Benzoyl Peroxide Cleanser
trickling slowly out of the auditory meatus in a continu-
ous stream, if the blood with which the external ear is
filled, pulsate, and more especially if the bleeding be-
associated with other symptoms indicative of serious mis-
chief within the head, and if Buy Benzoyl Peroxide it has been occasioned by
a degree of violence sufficient to fracture the skull, we
may look upon the hemorrhage as strong presumptive
evidence that a fracture of the base of the skull has taken
place."
Here is a fair description of our case. The hem-
orrhage was Acne Treatment Benzoyl Peroxide copious, calling for plugging of the
meati, it trickled away in a continuous stream ; there Cleanser With Benzoyl Peroxide
were the other symptoms of severe concussion of the
brain, and the man had fallen seven stories landing
upon his feet, and had again been struck in the head
by a heavy beam that had travelled down the seven
stories after him. But Erichsen, with all these signs
present, holds that the evidence is still only pre-
sumptive.
On this point Gauthier claims that after an injury
from a fall upon the head, there may ensue loss of
consciousness for a longer or shorter time, followed
by dulness of intellect for several days, loss of hear- Shampoo With Benzoyl Peroxide
ing on one side and hemorrhage from the ear, even
also a serous aural discharge, and Benzoyl Peroxide Topical Gel all these symptoms-
be due to a ruptured membrane with no fracture
Digitized by
Google
DKCBMBBK 22, 1888.]
A CASE OF NEPHRO-LITHOTOMY.
693
present. In support of this view he adduces nine
cases.
Accepting these theories as true, it is difficult to
see why our case should be diagnosticated as a frac-
ture, and it becomes necessary in most cases of head
injury to hold the diagnosis in abeyance until re-
covery has shown the improbability of such fracture
being present, or an autopsy has positively estab-
lished the truth.
The mere, fact of recovery having occurred must
throw a strong doubt on the diagnosis. The im-
portance of the contiguous organs, not merely to in- Where Can You Buy Benzoyl Peroxide
tellect, but to life, and 2.5 Benzoyl Peroxide Gel the force necessary to fracture
the strong basal bones, with the nervous shock ac-
companying, must clearly justify the dangerous prog-
nosis attached to such an injury. If such Pregnancy Benzoyl Peroxide cases as
have been narrated are to be styled fracture of Where To Buy Benzoyl Peroxide the
base, Clindamycin Phosphate And Benzoyl Peroxide Gel then the experience of past ages must be
thrown aside and this injury be considered a light
one, instead of one almost invariably fatal.
In looking over the records of St. Michael's Hos-
pital I have found thirty cases of simple, uncompli-
cated fracture of the base, of which twenty-one died,
one was not improved, Where Can I Buy Benzoyl Peroxide and seven were cured.
Omitting the "not improved case," which I con-
sider must have been intended for "remaining," this
gives a mortality of seventy-six per cent., certainly
not a high rate for one of the most dangerous in-
juries in all surgery, and the inference is inevitable
that some of these cases were not fractures at all.
Nancrede, in The Medical News of January 28,
1888, quotes Wagner, who claims that all his cases of
fractured base who survived the first twenty-four or
forty-eight hours, being twenty-three in number, re-
covered, and apparently ascribes his success almost
wholly to the attention given to antiseptic details.
Bearing in mind the promptitude with which pa-
tients Benzoyl Peroxide Where To Buy with basal fracture usually die, Wagner's re-
port might almost as well read that those cases which
survived recovered, and one feels strongly Benzoyl Peroxide Acne Treatment inclined
to doubt the accuracy of the diagnosis.
If the hemorrhage in our case was not due to a
fractured base and lacerated sinus, whence did
it come ?
It will be recollected that a heavy beam fell after
the man, striking him on the lower jaw and break-
ing off part of the alveolar process of one side,
also that on the anterior and superior aspect of the
external canal was a red and swollen spot, and it
seems not improbable that Acne Treatment With Benzoyl Peroxide the articular process of
the maxilla had been forcibly driven back against its
socket, and perhaps fractured the wall of the external
canal.

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