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Certain local changes are admitted as indicating need of the mastoid operation. If one or more of the so-called vital indications be present, the demand is emphasized. Apart from these, cases are observed where there is room for legitimate doubt before and after operation; before, because there are no distinctive local signs of pent-up secretion, and yet we see phenomena most easily accounted for by assuming that such a condition exists; after, because no pus is found, and even if the patient recovers, doubt intrudes if operation were really needed to effect cure. The following cases illustrate this fairly well:
—John S., age 30, a white laborer, was admitted to the Maryland University Hospital, February 19, 1896. He had been injured the same day by the falling of an embankment. A fractured pelvis was found. He made an uninterrupted recovery for four weeks, when, the evening temperature, normal
WOODS H. THREE CASES OF SUPPURATIVE OTITIS MEDIA; SEVERE SYSTEMIC AND REMOTE DISTURBANCES; RECOVERY AFTER MASTOID OPERATION AND REMOVAL OF POLYPI. JAMA. 1898;XXX(12):655–656. doi:10.1001/jama.1898.72440640023003f
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