Earwax

“ Acute Otitis.—Inflammation of the ear seldom occurs in childhood, unless as a complication, or as a result of some infectious disease. Any disease which affects the throat in any way may be the cause of the inflammation of the ear. Such diseases are, "cold in the head," tonsilitis, grippe, "sore throat," or pharyngitis, measles, scarlet fever. It is much more common in children than in adults. The younger the child, the more liable it is to develop ear trouble when suffering from any of the above diseases. The presence of adenoids favors the development of ear complications. ”

“ Many cases, indeed, have occurred of injury to the ear, producing permanent deafness, from descents in diving bells, undertaken by persons ignorant of the way in which the ear is made; though the simple precaution of frequent swallowing suffices to ward off all mischief. For, if the Eustachian tube is thus opened, again and again, as the pressure of the outside air increases, the same compressed air that exists outside passes also into the inside of the drum, and the membrane is equally pressed upon from both sides by the air, and so is free from strain. ”

“ There is danger from the closure of the tubes by inflammation, because the inflammation may creep up to the middle ear and cause serious trouble, both there and in the mastoid region adjoining. Earache in children should be carefully watched, since it usually means that the middle ear has been invaded by the same inflammatory condition that is present in the throat in colds, and may do serious damage to the delicate structures there. Often in children, and sometimes in adults, the hearing is impaired by the accumulation of wax in the ear canal. ”

“ Cold water should not be allowed to enter the auditory canal. If the wax accumulate, never remove it with a hard instrument, lest the delicate membrane be injured, but with a little warm water, after which turn the head to let the water run out, and wipe the ear dry. The hair around the ears should never be left wet, as it may chill this sensitive organ. If an insect get in the external ear, pour in a little oil to kill it, and then remove with tepid water. The object of the Eustachian tube is to admit air into the ear, and thus equalize the pressure on the membrane. ”

“ A third view is that the filaments from the hair cells, rather than the basilar membrane, respond to the vibrations and in turn stimulate the terminations of the nerve fibers.
Fig. 155—Diagram showing how wax may plug the auditory canal and cause deafness. Hygiene of the Ear.—The ear, being a delicate organ, is frequently injured by careless or rough treatment. The removal of the ear wax by the insertion of pointed instruments has been found to interfere with the natural method of discharge and to irritate the membrane. It should never be practiced. ”

“ Detection of slight deafness may lead to the discovery of serious defects of nose or throat. Inflammation from cold or catarrh may cause deafness, which if neglected may permanently injure the ear. Often deafness is due to an accumulation of wax. A running ear should receive immediate attention, as it is an indication of inflammation which may imperil the integrity of the eardrum, and, if neglected, may eat its way through the thin partition between the ear and the brain and cause death. ”

“ The skin, too, covering its outer half, is furnished with a belt of little glands which secrete a yellow, viscid, and bitter substance, called "ear-wax," which is especially obnoxious to small insects. As the outer layer of this wax-like material loses its useful properties, it becomes dry, and falls out of the ear in the form of minute, thin scales, a fresh supply being furnished from the little glands beneath. In its form, the auditory canal resembles the tube of an ear-trumpet, and serves to convey the waves of sound to the middle portion of the ear. ”

“ When the adenoids encroach upon the Eustachian cushions, the patient suffers from deafness, frequent attacks of earache, and sometimes from suppurative otitis media with a discharge from the ear.
Among the rarer conditions attributed to adenoids are asthma, inspiratory laryngeal stridor, persistent cough, chorea, and nocturnal enuresis.
A diagnosis should never be made from the symptoms alone; an attempt must be made to examine the naso-pharynx by posterior rhinoscopy and by digital examination. The interior of the nose must always be examined and any further cause of obstruction excluded. ”

“ If the patient is a woman, who because of offensive breath is barred from society, she will become morbid and hypochondriacal in time. There is so much of the thick mucus hanging on the walls of the pharynx that the openings into the eustachian tubes are filled up and in a short time a certain degree of deafness appears—roaring in the head and other manifestations of ear trouble. As soon as the hearing is noticed to be abnormal the patient will be ready to consult some physician. ”

“ Give adults milk and other liquid foods. If persistent, see doctor.
Earache.
Caused sometimes by bad teeth, but generally by cold or hardened ear wax.
Hold ear over cloth wrung out of hot water, on which are several drops of alcohol. Syringe ear with warm bicarbonate of soda water—1 tsp. to a cup; or peroxide of hydrogen water—1 tbsp. to a cup of water.
One drop laudanum, or one drop arnica to three drops very warm olive oil, dropped into ear with a medicine dropper, often relieves pain; or cotton may be saturated with the warm olive oil and placed in the ear and covered with dry cotton. ”

“ If a person on blowing the nose violently, feel a swelling in the ear, from the membrane of the tympanum being forced outwards, the tube is open; and though the tube be closed, if the beating of a watch placed between the teeth, or pressed against the side of the head, cannot be heard, the operation cannot relieve, as the sensibility of the auditory nerve must have been destroyed. In a closed Eustachian tube, there is no noise in the head, like that accompanying nervous deafness. ”

“ Whenever water is forced from the mouth and nostrils into the middle ear through the Eustachian tube, inflammation of the middle ear is almost sure to occur, even though the water be warm. According to the author, several thousand severe cases of aural disease result annually from bathing in New York City alone. ”

“ The chief source of injury, however, to the ear is from the introduction of solid substances into the auditory canal, with the design of removing insects or other foreign objects that have found their way into the ear; or with the design of scraping out the ear-wax. For displacing a foreign object, it is usually sufficient to syringe the ear gently with warm water, the head being so held that the {226}fluid easily escapes. If a live insect has gained entrance to the ear, it may first be suffocated by pouring a little oil upon it, and afterward removed by syringing the ear as just mentioned. ”

“ Food particles collect in the mouth and provide culture material, and there are many crypts and irregularities of surface which oppose mechanical cleaning. Infection of the middle ear, the most common cause of deafness, takes place by means of the Eustachian tube which connects the cavity of the ear with the mouth. Organisms from the mouth can extend into the various large salivary glands by means of the ducts and give rise to infections. The tonsils, particularly in children, provide a favorable surface for infection. ”

“ Many eyes are ruined by neglect and maltreatment.
EAR BATH. Water applications are made to the ear by means of fomentations, compresses, the douche, or the spray. Compresses and fomentations are useful in inflammations of the structures of the ear, including abscesses which often form in the walls of the external canal. Alternate hot and cold applications are useful in causing the absorption of inflammatory deposits, and thus restoring the hearing. The douche, administered with the fountain syringe, is a valuable means of removing foreign bodies and insects. ”

“ In nearly every case of earache it is necessary to treat the throat, as this is, as a rule, the seat of the trouble. An antiseptic gargle of equal parts of Borolyptol and warm water is an excellent mixture. It should be used freely every two hours. Children suffering from earache should be kept indoors. If the examination should show that it is not necessary to lance the ear drum, some local measure may be adopted to allay the pain. Putting the child in bed with the head resting on a hot-water bottle may be all that will be necessary. ”

“ Now if this tube swells so much that it entirely closes, as so often happens in cases of "cold in the head" as well as in constant irritation from adenoids, then may follow a vast train of difficulties—earache, mastoiditis, etc.—with the result that the tiny bones in the middle ear which vibrate so exquisitely may become ankylosed (stiffened) and deafness often follow. Everything known must be done to prevent baby's catching "cold in the head." If the sinuses become infected it may also lead to serious consequences. ”

“ For thirty years this patient had heard nothing with the right ear, and very little with the left. I stimulated, with a stiff, curved cotton-tipped probe (instrument shown in Fig. 6 may be used) , the area lying between the last tooth and the angle of the jaw—carefully “covering” all the gum surfaces—sides as well as biting surfaces.
In addition, I hooked an instrument behind the soft palate (see D, Fig. 11) , and “stretched” it gently forward. This, I have found, powerfully stimulates the circulation of the “ear zones,” and is most helpful—particularly in catarrhal deafness. ”

“ If there is more motion of one ear than the other, if the head is jerked to the one side, if there is a measure of deafness in the one ear (to be ascertained rather in the intervals between attacks) , if there is disease of the pharynx, the Eustachian tube or pouch, or swelling about the root of the ear, if there is wax, scurf, or acarus in the ear, if the animal rubs it frequently, aural vertigo may be suspected. ”

“ After the removal of any object from the eye, it is desirable to frequently wash it out with a saturated solution of boracic acid. This mixture will allay any inflammation and will tend to restore the normal condition more quickly and more satisfactorily than if the eye were left to heal itself.
Foreign Bodies in the Ear.—When a foreign body gets into the ear mothers are unnecessarily alarmed because of a failure to appreciate that the ear is a closed passage. It is impossible for any object to get into the ear itself; the depth of the external passage is only about one inch in an adult. ”

“ The eardrum is not absolutely essential to hearing, but it is of great importance to exclude sources of irritation, dust, water, and germs which are likely to set up middle-ear trouble. More ordinary after-effects are chronic discharge from the ear following acute inflammation and perforation of the eardrum, which may mean at any time a sudden return of pain with the occurrence of the more dangerous conditions just recited, together with deafness. ”

“ Eczema of the external meatus is often associated with eczema of the auricle and of the surrounding parts. Not infrequently there also exists a chronic middle-ear suppuration, which may be the cause of the eczema. Intense itchiness is the most characteristic symptom, and a watery discharge may also be complained of. Deafness and tinnitus are dependent upon the accumulation of epithelium and débris. After the ear is syringed the skin may present a dry, scaly appearance, while sometimes fissures and an indurated condition of the outer end of the meatus may be noted. ”

“ These dangers, however, follow almost entirely on long-continued discharges from the ear, but do not attend that acute inflammation of the passage to the ear which is often met with in childhood, and the symptoms of which sometimes cause needless fear, from being taken for those of inflammation of the brain. Attacks of earache are most frequent before the first set of teeth have been cut, and are by no means rare in young children, who are perfectly unable to point out the seat of their sufferings. ”

“ Causes.—It occurs as a primary or secondary disease. The first condition is rare and the result from injury, exposure to cold and dampness, or from syphilis or tuberculosis. Secondary disease is catarrhal or pus-like in form. This results from an extension of middle ear disease through the antrum, as a rule. The disease may develop at any time and endanger the life of the sufferer.
Symptoms.—Dull constant pain behind the ear and tenderness on pressure, more severe at night, the tenderness is very apt to be followed in a short time by redness and swelling of the skin in the same region. ”

“ Of much graver importance, of course, is the internal inflammation of the ear, formerly complicated at times with an acute earache, with which he has now been afflicted for a number of years. Just what the affection is no one has yet been able to determine. It grows worse in cold and wet weather, and that is about all that is known of it. ”

“ A German paper gives some interesting statistics relative to ear disease, which have been collected from different aural surgeons. From these, we gather that males are more subject to ear disease than females. Out of every three middle-aged persons, there is found one who does not hear so well with one ear as with the other. The liability to disease increases from birth to the age of forty, after which it decreases as old age is reached. Of six thousand children examined, twenty-three per cent. show symptoms of ear disease, and thirty-two per cent. ”