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STATISTICS " RELATIVE to the FIRST THOUSAND CASES, of DISEASES of the EAR, THROAT and NOSE,Treatel) in the 'FOURTH 'SCOTTISH GENERAL HOSPITAL, STOBHILL, GLASGOW

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STATISTICS J R Army Med Corps: first published as 10.1136/jramc-28-05-04 on 1 May 1917. Downloaded from 53~ , I STATISTICS " RELATIVE TO THE FIRST THOUSAND CASES, OF DISEASES OF THE EAR, THROAT AND NOSE,TREATEl) IN THE 'FOURTH 'SCOTTISH GENERAL HOSPITAL, STOBHILL, GLASGOW. \ .' I, \. ' \ • I' By QAPTAIN,A. BROWN KELLY, M,D., D.Se. Roy~l Army Medical, Oorps (Territorial Force), , I THE object of this short paper' is /to show tl:~e freque~cy and nature 6f the diseases of the ear, throat and nose met with in a T. F. General Hqspital, The cases referred to here had all1?een admitted to the hospital. Ih addition, a coqsiderablEi number of outdoor cases were treated, or examined with,'r~ference to pension or discharge from the/ Service: these have not 'b(3en included in the statistics. ' The hospital was opened on August 12, 1914; but no cases came under my,care until September 23. The thousandth 'case ;was seen Protected by copyright. n January 21, 1916. T,he ' p~opo:rtion of oto-rhino-Iaryngological cases to the total admissions to,. the bpspital for the year 1915, during which the 'working conditioJ;1s might be regarded as normal, was as follows:- /, ' , Total admissions . • ; 8,'684 j Cases of ear, nose and throat disease ... 866= 9'97 per cent. '.. ,~ Both totals incl,ude readmisE?ions: . those of ear, throat and nose ,patients amounting to 48. The readmissions to the' hospital' probably 'form aboJt 5 p~r ,cent of the total admissIons, but the,ir exact ,number could be summed' up only with considerable trouble'. http://militaryhealth.bmj.com/ It should be po{nted out that the thousand' cases on which these stat~stics are based do not ,represent the total number of cases of, disease of the ear, nose and throat admitted to the hospital between the above mentioned dates. The series does not include cases . treated by the' physician or, surgeon in whose ward tliey lay, but, which were not seen' by me. / In 'estimating ,the freqhency of th~, individual diseases met with; readmissions' have been left out of account, and a th,o,usand consecutive new cases utilized. Of the thou~and cases, 731 were admitted to hospital on account on September 26, 2021 by guest. of an affection, of the' ear, throat or nqse. .The remaining 269, when admitted, :were suffering from a disability bther than that.for ' which I was cons'ulted. The latter' gtoup includes most, of the less importa,nt ,ailments; also those in whidh 'an exami~ation was requested for i slispectecl disease, hut none found (classed ~s "No I ' ,appreciable disease "). J R Army Med Corps: first published as 10.1136/jramc-28-05-04 on 1 May 1917. Downloaded from I" Cases of Diseases of the EaT, ThTOat and Nose' '. .'. Disability, Unfit for' Total,cases present prior to general (7) Tuberculosis- enlistment' service Npse (lupus) 1 l' Pha!ynx (acute)1 1 (died) Larynx ,.'. 1 - 1 (10) Diphtheria~ Paralysis of palate 2 (42b) Syphilis (Secondary)~ , Pharynx .• 6 3 Syphilis (Tertiary)- 'Nose 1 1 Nose and mouth 2 1 5', Pharyn~ 8 1 , ! Pharynx and Larynx .. 1 (21) Influen~a-I " , Sore throat 5 (37) Rheumatism2- Sore throat ,,4 ',' .. '- (127) Vertigo- (b) / Aridit~ry 2 1 1 (133) Hysteria-, Dysphagia 1 Protected by copyright. Aphonia. ; 1 (234 b) Dacryocysti tis 3 1 39 15 4 Ear- (259a) Acute' inflammation, of auricle or ex· 5 ' ... fernal auditory meatus (259b) OhroJ;lic inflammation of auricle' or 9 2 1 external auditory meatus' Suppuration (abscess) of auricle or ex- " 4 ter~al meatus \ i' , (264) Accumulation of wax or epidermis 39, I (265a) Acute inflammation of middla ear 15 '(265b) Ohronic inflammation of middle ear .. 48 22 http://militaryhealth.bmj.com/ (265c) Suppurative inflammation of middle 273 85 ear " (266) Perforation of membrana tympani 11' 4 11(270) Obstruction of Eustachian tube .'. 34 (265b and 271b) Ohronic infla,mmation of mid-, 5 5 " 1 ,dle,,'ear with invol~ement' of lU- / ternal ear Injury to internal and middle ear 33 Ht 15 (275) Tinnitus •. ' 1 1 (1128) Wound of membrana tympani 1 (1129 Foreign 'body in ~ar 2 Gunshot wound of ear .. 4 4 on September 26, 2021 by guest. ,Total aural cases 484 271 132 / * The present attack had set in, or previous attacks had, taken place, priortd, 'enlistment. 1" " ' , , t Various forms of ear disease had been present prior to enlistment, and had rendered the ,ear more susceptible to damage. J R Army Med Corps: first published as 10.1136/jramc-28-05-04 on 1 May 1917. Downloaded from A. Brown Kelly' 541 Disability Unfit for Total cases present prior to general Nose- enlist!llent service (962) Eczema of nasal vestibules .. 4 (277a) Acute rhinitis' , /' 1 'Rhinitis sicca an:teriqr 2 (277bl) Hypertrophic rhinitis 92 56 (277b2) . Atrophic rhinitis' '1 1 i (277b3) Ozrena .; •. 2, 2 '(278e) Abscess of seJiltum 1 (278g) Deviation, of s~ptum 34 32 Soft fibroma (polypus) 6 3 'Papilloma of nasal vestibule l' ", Rhinolith 1 (280) Epistaxis 19 (283b)' Suppuration inaccessory'sinuses of 6 nose Naso.antral polypus .• 2 1 Foreign body in antrum . ,,' 1· (284b) Chronic : inflammation of naso· 1 pharynx (285) AdElI;oid v~getations .'. 15 Gunshot wound of nose 4 Protected by copyright. Total. nasal cases .. .. 193' 124 (338) Asthma .• 5 5 Larynx- (339Aa1). Acute·laryngitis ,18, (339Aa2) Chronic laryngitis. 12 (339Ba) CEdematous laryngitis and pharyngitis 1 (349) Laryngeal paraly~is , ~5 "2 ' 1 ~aryngeal growth I ••. ,I G'unshot wound of larynx 5 1 Total laryngeal cases 42 2 2 http://militaryhealth.bmj.com/ Mouth, Palate and 'Fauces-' . (436b) Vesicular stomatitis ·1 (437) Ulcerative stoma.titis .. :1 (439) Necrosis of jaw \1 a (450) Dental cyst 4 1451) Inflamm~tion of gums' 1 .'. (473) Sore throat 46 7 (susc,eptible) (4,74) Ulceration '9f palate and fauces' 2 :: ~ '.. (475a), Follicular tonsillitis .. 26 8 (susceptible) (475b) Suppurative tonsillitis 19 6 (susceptible) on September 26, 2021 by guest. (476) Hypertrqphy of tonsils 72 49 ;(477) ElongatEld uvula , 1 1 , Abscess of lateral wall of pharynx •• 1 Gunshot woul!-d of palate, etc. ',' 1 , . 176 72 cS Total disea~es' of ph'ary~x, etc. " . 'I J R Army Med Corps: first published as 10.1136/jramc-28-05-04 on 1 May 1917. Downloaded from 542 Oases of Diseases of' the EaT, ThToat and Nose' Disability, ' Unfit for Total ca~es present prior, to general enlistment service Mouth, Palate and Fauces-continued. , '(615) Hypertrophy of lymphatic glands of 2 neck Gunshot wound of neck 1 (638) Enlargement ,of thyroid i , 1 Died' , 'I Oalcino)1la of cesophagus i Speech defects .. ,,2 2, Gassed •• •• .. 10 'No appreciable disease 44 61 3' 'J'otals • . ". 1,000 492 . 138 The ~iseases have be~n classified according to the nomenclature of the Royal College of Physicians of London. - A list, of the diseases is subjoined together w{th their respective totals, also the number of cases in which the disability was present prior to enlist- " ment, and the number thaf'we~e unfit to return to-general service. Protected by copyright. '.N OTES ON CASES. Tuberculosis. ' Lupus of the Nose.-Part of the 'right ala arid septum were ~destroyed, arid as t.he disease was still ~.ctive the man was dis.charged from the Army.' . Acute TUQerculosis of the Pharynx.~Sore throat began 'a few d3:ys ' before mobilization; in trenches ; went sick -on N ovember2, 1914; examined by me on November 13, 1914, and then found to have superficial ulqeratioIY of the faucial pillars, soft palate and uvula; http://militaryhealth.bmj.com/ , tubercle bacilli in'swab ; died, December 20, .19i4. ' Laryngea l TuberculoS'is'7"Sli~ht' case ;' discharg~d ,from Army; , . / Diphtheria. - Regurgitation of fluiqs by nose iLnd history of recent, sore throat in both cases. Syphilis. Seco,n~ary.-Three' of the' six patients contracted the disease after enlisting. :,_ Tertiary.-Twelve 'cases, on(3 in which -the soft palate was on September 26, 2021 by guest. adherent t() 14e posteripr pharyngeal wall was almost cer-tainly heredita:ry~ One patient was discharged chiefly because of epilepsy. Vertigo, Auditory. In- one case the ma~had received 'a bullet w.ound on the crown of the head; he complained also of double ;vision. In the other .\ \. J R Army Med Corps: first published as 10.1136/jramc-28-05-04 on 1 May 1917. Downloaded from .A~, Brown Kelly 543 I " Protected by copyright. http://militaryhealth.bmj.com/ " ; on September 26, 2021 by guest. \, J R Army Med Corps: first published as 10.1136/jramc-28-05-04 on 1 May 1917. Downloaded from 544 Oases oj Diseases of the Ear, Throat and Nose Acc'umulation 01' Wa'x 'or Epidermis, This, class also contains a few cases in which the ears were filled with earth, the men ha;i~g been buried,in a trench or dug- , out. It is surprising how many men from; tlieFront have large '-collections of cerumen. ' Acute Mid,dle Ear Inflammation. The right 'ear was affected in eleven cases; the left ear in £o1,lr -cases .. FOlfr of tq.e ~atients had had previous attacks .. Qhronic Middle 'Ear Inflammation. -, ' Of the total number,.ofcasesof: this class (forty-eight), in only -six was the deafness said to' ,have begun after mobilization or €nlistment. In som~there had been oto~rhooa in childhoo9, and d~a,fness since; in others the' deafness waR attributed to working amidst noise in ship yards or engineering shops: In forty c'ases Protected by copyright. 'both ears were affected; in three; the right ear ~:mly : and in five; 'the left ear only.
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