– The organ of hearing consists of three well defined portions- the Outer, visible ear with the tube leading from it into the head. At the end of this passage is the drum-head, or as it is shortly but less correctly called, the “drum” of the ear. This name should be properly given to the entire chamber behind the drum-head, the “tympanic cavity,” as it is called, or the Middle Ear. Another tube (Eustachian) leads into this from the throat, and when the throat is inflamed this is liable to be blocked and to give rise to “throat deafness”. Behind the middle ear are two chambers which constitute the Inner Ear, containing the expansions of the auditory nerve, the organ of hearing proper. These innermost chambers are shut off from the middle ear by small membranes closing the openings into them, and are connected with the outer ear by a chain of small bones connected with the tympanic membrane on the one side and these membranes on the other. Any one of these portions of the ear may become affected, and result in deafness; and on the other hand, a great change may take place in the outer or middle ear and yet hearing need not be lost. In a treatise of this kind only the commoner of the ear-affections need be touched upon; for the graver kinds medical help will be sought.
External Ear. – Sometimes the external ear and the passage leading from it to the middle ear or drum become inflamed and swollen. The commonest form of this is the formation of pimples in the passage, which give rise to intense pain.
General Treatment. – For general inflammation of this visible part of the ear (pinna) there is little to be done in the way of local treatment. When it affects the passage, an elm-bark poultice, or else a slender piece of fat ham inserted into the ear, will be found to give relief. Warm applications generally are good.
Medicines. – (Every hour until relief is obtained, then less often.)
Belladonna3. – Erysipelatous inflammation of the ear.
Rhus 3. – When the inflammation goes on to form vesicles, or is eczematous.
– Inflammation behind the ear, especially if it exudes a sticky secretion.
– Painful boils or pimples in the canal.
Foreign Bodies, or Insects in the Ear. – If an insect has crawled into the ear, place the patient on his side, and pour into the ear warm olive oil until the canal is filled. The insect will float on the top of it, and may be lifted off.
When a bead, pea, cherrystone, or some such object has been forced into the ear, it is of the greatest importance to have it seen to at once before inflammation has set in. A surgeon must be consulted without delay and if there is not one to be had the greatest care and gentleness must be used in the endeavour to extract the body. This may be done by syringing with warm water if the stream can be made to pass beyond the object. Or it may be done by means of a pair of fine forceps. Or a hair-pin may be used. The free ends being stuck in a cork, while the bent end may be passed into the ear so as to get behind the object, which may then be drawn out. But no one who has not a steady or a skilful hand should attempt to do this operation, as much harm may result.
Medicines. – (Every hour or two according to urgency.)
– If pain and inflammation remain after extraction.
– After Arnica. If the inflammation is great and there is so much swelling that nothing can be got out.
– If there is pain, fever, and delirium.
Discharge. – An ear discharge may originate in the canal of the ear, or in the middle ear or drum. It is usually the latter. A discharge is an affection which may be of very little consequence, but also it may be of very great consequence, and should therefore never be neglected. It is of most frequent occurrence in children. The graver forms of ear discharge originate in inflammation of the Middle Ear, with consequent rupture of the drum: See Middle Ear. When the discharge is established and there is no sign of active inflammation left, the chief indications are to keep the ear clean, to moderate the quantity of the discharge, and when it cannot be arrested to the improve its quality.
It is not always desirable to arrest a discharge from the ears altogether; and it may console some sufferers to know that deafness with an ear discharge is more likely to be cured than deafness with a dry ear.
General Treatment. – The ear must be kept clean by washing out very gently with a syringe. Warm water containing a little borax (half teaspoonful to a teacupful) is the best wash to use. Care must be taken to use no violence at all, but just enough force to send the water into the canal in a continuous stream. After the washing a little cotton-wool should be placed lightly in the orifice to protect from cold.
Medicines. – (Two or three times a day)
Pulsatilla3. – After measles and after small-pox. For swelling of the neck-glands after suppression of discharge.
– After scarlatina, when accompanied by serve headache.
– After scarlatina, following Belladonna; discharge offensive, purulent, long lasting; worse when ward in bed.
– In cases similar to those of Merc, when mercury has been given already.
– After measles, following puls.
Ear-Wax. – Drop warm oil into the ear for several successive nights and then syringe gently with warm water . This will remove the wax without difficulty.
Middle Ear. – Inflammation of the tympanic cavity is a common sequel to measles, scarlatina, influenza and occasionally to serve cold, and it commonly ends in suppuration and discharge by rupture of the drumhead.
This is a membrane which readily heals, but when healing if prevented by any cause there results a chronic discharge. Sometimes the air-cells in the bony prominence immediately behind the ear become inflamed, and then there is risk of the disease spreading to the brain and causing abscess there.
General Treatment. – The patient must be kept as quiet as possible on light diet, and the ear kept warm. A poultice of slippery-elm bark is the best application, but any warm application is good. The pain is usually great.
Medicines. – (Every hour until relief, then at longer intervals).
– Fever, restlessness, anxiety, as soon as the chill is taken.
– After Aconite; great pain.
Bell 3. –
Pain in the ear; throbbing headache; flushed face; delirium; hot skin.
Merc 3. –
After the acute stage.
Noises in the Ears. – These may be due to affection of the internal ear, auditory nerve expansion, or to affections of the middle ear and its chain of bones. It is generally amenable to treatment.
Nux. vom. 3.
– From cold; worse in the morning.
– Worse in the evening.
– In persons who perspire much; worse in the night.
– Buzzing, hissing, singing.
– When the least noise (external) is intolerable.
See also DEAFNESS.
EARACHE. – Sometimes the ears are the seat of pain of a neuralgic character and independent of inflammation. Often, however, it is dependent on a slight cause, as congestion from cold, and care should always be taken to ascertain that no inflammation is present.
The history will be of assistance here; those who have had earache previously will recognise it by their own sensations. Whenever the pain persists or is accompanied by fever symptoms, inflammation is almost certainly present, and medical aid should be sought.
General Treatment. – The chief thing to be done is to keep the patient warm. The same local measures as directed above under Middle Ear, may be adopted.
Medicines. – (Every half-hour until relief is obtained.)
– When it follows a chill.
– Jerking, tearing pains, as if something would be pressed out. External ear hot and swollen, the pain going through the whole side of the face. Especially suited for blonde persons, inclined to tears.
– Especially in children; sweating without relief, tearing extending to the cheeks; pricking deeply, at the same time tearing, pressing, burning pain.
– If the pain returns frequently; is on the left side; aggravated in the evening or before midnight. After Mercurius
– Simple acute stabbing pains; patient very cross; pain intolerable; aggravation by warmth.
– Earache from getting wet or from suppressed perspiration.
Plantago mother tincture.
– A few drops on cotton-wool inserted into the ear will often give relief.