Electricity has been successfully employed.
SURGICAL TREATMENT.-Should the disease not speedily yield to remedies, paracentesis of the drum should be performed. When grave brain symptoms accompany evident of the mastoid cells, trephining of the process should be early resorted to. No fear need be entertained lest an artificial perforation of the drum may not heal. The difficulty lies in preventing its healing before the disease is cured. In fact, to avoid this difficulty, the operation must at time be often repeated. Even spontaneous ruptures heal rapidly. Only in neglected and chronic cases, where the aperture is large, does it remain open.
Nor, if the inflammation be cured, is a rupture of great detriment to the hearing. In fact, where the membrana tympani is thickened from chronic inflammation, paracentesis often improves the acuteness of hearing very decidedly.
When the discharge is abundant the practice of plugging the ear with cotton, or wool, is a bad one, since it tends to confine the pus, which should have free exit. Keep the parts clean by frequently syringing with antiseptic lotions. Instillation of peroxide of hydrogen solution (one in twenty) followed by syringing with boiled water or boracic lotion, once, twice, or thrice daily, according to the requirements of the cases. Poultices and fomentations are of no service, and are dirty and disgusting. Relief from pain is best given by the local application of Aconite and Morphine. It should always be warmed before it is used.
GENERAL MEASURES.- The intractable character of this affection is often, in great measure, due to the neglect of that strict cleanliness which is so necessary to be observed. The irritating discharge, if allowed to accumulate within the meatus, undergoes decomposition, and gives rise to changes in the deeper structures of the ear, the nature of which may be inferred from the irritation and excoriation so often existing in the external orifice. A little fine wool, lightly introduced so as not to cork in the discharge, frequently changed, may be put into the ear when the discharge is declining, to protect it, out of doors, in cold weather; but even this should be done with great caution, particularly when the discharge smells offensively, for nothing can be more prejudicial than stopping the ear with cotton-wool to prevent its escape. To correct the foetor of the discharge, which is often very great, a weak lotion of Condy’s Fluid, or better still of peroxide of hydrogen, should be injected. All fluids injected into the ear should be warm.
Carbolic Acid lotion is also of great value in Otorrhoea. The following are the proportions in which it may be safely prescribed-
Carbolic Acid 3j.
Glycerinez3j.
Distilled water z3v. m.
The improvement of the general health of the patient is a point of great importance; for this purpose, change of air, and, in the autumnal months, sea-air, is often attended with most beneficial results. In the absence of sea-air, country air, in a bracing district, is of great advantage. Cod-liver oil is also strongly recommended.
It is a very common and very foolish idea, which has been fostered in the minds of the laity by ignorant or indolent physicians, that it is dangerous to cure a discharge from the ear. It is doubtful whether a single instance of evil results, under wise treatment, can be cited. Of course irritating lotions too often repeated may set up an acute. Otitis based upon the chronic condition, but it very rarely happens; but the idea that the ear in these cases serves as a vent-hole for peccant humours is worthy only of the pathology of the dark ages. The continuance of this disease not only makes the patient a filthy and disgusting nuisance to himself and all around him, but it often greatly endangers life itself. True, where any dyscrasia exists the appropriate specific should be used internally, but an ulcer here can be as safely healed as anywhere on the body, and if not healed incurable deafness of a high degree is certain to follow.
129. Deafness.
VARIETIES AND CAUSES.-
(a) Functional or nervous Deafness.-This variety depends upon constitutional debility; the same conditions which weaken and relax the general muscular and nervous systems act injuriously upon the ear. Functional Deafness is painless; it is better when the digestive organs are unimpaired, the spirits exuberant, and the weather fine.
(b). From disease.- Under this head we may mention-organic changes in the brain; obstruction of the internal ear; Ulceration and Perforation of the tympanum; Paralysis of the acoustic nerve; various acute or chronic inflammatory affections, and disease of the throat (Throat deafness).
(c) Deaf-dumbness.-This is due to congenital malformation of the ear, and is irremediable.
Other causes are-the application of cold; sudden loud noises; blows on the head, as boxing a child’s ears, or fracture, which lead either to Concussion or Rupture of the auditory nerve; swelling of the lining membrane. Accumulation of hardened ear- wax, exfoliated scarf-skin, or other substances lodged in the ear-passage, may cause deafness by obstruction. The Deafness that results from Catarrh is often but an aggravation of pre-existing Deafness-all the share the Cold has in the production of the disease being that of reducing the hearing power a little further, and so rendering the defect more obvious.
PROGNOSIS.-In forming an opinion as to the chances of recovery, or of amelioration, the following circumstances should be duly taken into account-age of the patient; hereditary tendency to Deafness, or the association of the malady with any constitutional disease, or with cerebral symptoms, or with the nervous temperament. If a patient comes to us with deafness who has suffered from enlargement of the Tonsils, chronic Catarrh, Rheumatism, Gout, or secondary Syphilis, our hope of a favourable result will be greatly diminished. Deaf persons sometimes state that they can hear well under exceptional circumstances, as in the noise of a railway carriage, a crowded thoroughfare, or amidst the whirl of busy machinery; these and similar sounds, which suspend the hearing of healthy persons, furnish such a degree of abnormal stimulation as to excite the dull nerve to unwanted quickness of hearing. The inference from this unhealthy condition of hearing must be regarded as unfavourable for the prospect of recovery.
TREATMENT.-The cure of Deafness of course depends on the removal of the cause; in many cases this is practicable; in some it is not. In most cases, however, skilful treatment is successful, and it is very rare indeed after a course of homoeopathic remedies for a patient not to find his hearing power decidedly and permanently stronger. Recent cases are of course most hopeful. But long-standing cases, even when both ears are affected, are generally benefited to a greater or less extent.
EPITOME OF TREATMENT.-
1. From debility of constitution, etc.-Phosphorus (nervous); Chin- Sulph. (nervous and periodic); Iodium, Ac-Phosphorus, Cact. (with Palpitation); Petrol. 3x, Spongia, Arsenicum
2. From cold.-Aconite, Pulsatilla, (recent); Mercurius, K-Hydroid. (chronic); Dulcamara (from damp); Bryonia (with Rheumatism).
3. After fevers, etc.-Belladonna (with giddiness); Pulsatilla, China, Sulphur, Ac. Phosphorus
4. From suppressed eruption about, or discharge from the ear.- Sulph., Hep-S., Aurum
5. From enlarged Tonsils, etc.-Merc Iodium, K-Hydriod., Mercurius- Cor., Iodium
6. From Concussion.-Arnica (also when deafness is accompanied with a crawling sensation in the ear).
7. Noises in the ears (Tinnitus aurium).-Belladonna, China Sulph., Nat-Salicyl. (with deafness); Nux V. or Ignatia (with unnatural sensitiveness to sound); Baptisia roaring, confusion of mind, dullness of hearing); Gelsemium
ACCESSORY MEANS.-If Deafness be found to arise from an accumulation of hardened ear-wax, this should be removed by the syringe and warm water. All reputed remedies which have to be dropped into the ear should be eschewed, however much they are recommended See also General Hints, following.
GENERAL HINTS ON AFFECTIONS OF THE EAR.
(1) Wet or damp ears.-After bathing, care should be taken to dry the head and ears thoroughly.
(2) Boxing the ears.-Parents, governesses, and others who have the care of children, should be aware of an accident very liable to occur from blows on the head or boxing the ears, namely, rupture of the membrana tympani, a membrane which closes the bottom of the meatus, and is stretched something like the parchment of a drum. The accident may be recognized by a sense of shock in the ear, Deafness, and a slight discharge of blood from the orifice; and if examined by an ear speculum, the rent may be seen. There should be complete rest for several days, and a weak Arnica lotion used.
(3) Deafness not stupidity.-Another point of considerable importance is the case in which a child, from being slightly deaf, has been thought to be stupid or obstinate. Very sad it is to think how often a child is thus punished for his misfortune, and it may be irremediable injuries inflicted on the mind or temper of this poor victim of unintentional injustice. It is hardly necessary to insist upon the care which is requisite in examining the state of the hearing power in a child, or to refer to the fact that children will often say, and doubtless think, that they hear a watch when they do not (J.C. Foster).
LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS; MEMBER OF THE ROYAL COLLEGE OF SURGEONS; LICENTIATE IN MIDWIFERY, LONDON AND EDINBURGH, ETC. PHYSICIAN TO THE READING AND BERKSHIRE HOMOEOPATHIC DISPENSARY.
Author of "The Stepping Stone to Homeopathy and Health,"
"Manual of Homoeopathic Treatment". Editor of "The Homoeopathic World."