Minutus

> ...The responses served to remind me of the need to treat the whole case
and ot just look at therapeutics, which I was tending to do as this is a

((( HI Andrew,
Meant as comfort not as a truism: the equilibrium between looking at the
whole case- and addressing the pathology- is a line that is tough to walk.
A case may only be possible to perceive as a lesional layer; even though
the rx determined by physicals alone turns out to be the simillimum for
the whole case -- at least as it appears on the *surface*.

This added point: if mastoid is clearly the locus, this could(conceivably)
have been a problem area *before* the head injury caused structural
failure at that point. Caps has affinity for that area, and has:

===> Caps
swelling... with great tenderness over the petrous bone... tendency to
involve meninges of brain;
===
Caps is a possible that one might overlook. The pathological center of the
case as pointed out by you, and others on the list, is one of meninges;
and apparent deficiency of bone growth. Caps is in this bandwidth - *if*
the locus is the mastoid area.

Characteristic symptoms may be missing or diminished after other rx have
removed them over the last three years. If such is the situation, then
-absence of usual keynotes - may receive at least some discount of
importance in the overall analysis. Also -what his subjective sensation
was --right after the injury (if he recalls and was conscious before
hospital)-- may be useful if available...

Goodspeed.

A