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XXX. Infection of the Ear with Vincent's Microorganisms—Report of Sixteen Cases

At a meeting of the nose and throat section in December, 1911, I had the privilege of reporting upon the aspects of this disease as observed in the wards of the New York Foundling Hospital. Twenty-four cases were then collected and certain observations with regard to the disease recorded. These were (1) the fact of its occurrence in debilitated children, (2) its apparent contagiousness, (3) its amenability to local treatment, and (4) its good prognosis. Since then a number of articles have appeared which support the above observations and certain new data have been collected which will undoubtedly enable us to grapple more effectively with this disease. In looking over the literature, however, one is struck by the scarcity of case reports of this affection as observed in the ear. Only two papers and one textbook give it mention. The group of sixteen cases that I now present are, therefore, of considerable, if not unique, interest. Of these sixteen cases, thirteen were confined to the middle ear and meatus, and three had mastoiditis; two of the latter were considered inoperable and died from meningitis; both had complete facial paralysis. One case was operated upon and recovered. The two fatal cases were autopsied. On autopsy it was found that the whole middle ear and mastoid process were necrosed, nature having performed a complete radical operation. The lateral sinus and the dura of the middle fossa were extensively exposed. It is worthy of note that these cases begin insidiously, without rise of temperature or complaint of pain, attention being called to the condition by the presence of discharge at the