The remedy is acute otitis, with digging, boring, tearing pains which come suddenly and are most violent; the membrana tympani is covered with injected blood vessels. It is the remedy in earache where the symptoms are too violent for **Pulsatilla. The pains come and go suddenly. All the symptoms are worse at night and are relieved by warmth.
Bayes recommends **Aconite Ix in the maddening pains of otitis, claiming it to be far superior to **Chamomilla or **Pulsatilla. There is dark redness of the parts, stinging, lancinating or throbbing pains and great sensitiveness. It suits earache from sudden change of temperature; it is worse at night and is aggravated by warmth. Its influence is restricted to a brief period immediately following exposure. In this respect Copeland says: “It differs from **Ferrum phosphoricum, which has a much longer period of usefulness.”.
A great ear remedy. It exerts a specific curative power in otitis externa; the ear is hot, red and swollen, and there are very severe darting, tearing, pulsating pains in it which are worse at night. It, too, occupies the highest place for acute inflammation of the middle ear. It is indicated also by profuse thick, yellowish green discharge from the ear, deafness and a feeling as if the ears were stopped up, or as if something were being forced out; there are also roaring noises synchronous with the pulse. It suits especially subacute cases. Itching deep in the ear.
**Plantago. Earache associated with toothache; also, excellent locally. Pain goes through head from one ear to the other.
**Tellurium. A most excellent remedy in otitis media with thin, acrid, offensive discharge, very profuse and long- lasting; canal sensitive to touch.
**Hydrastis is a remedy not to be overlooked in catarrhal inflammation of the middle ear with accompanying nasopharyngeal catarrh, tinnitus aurium and thick tenacious discharges.
**Kali sulphuricum. Useful in typical Pulsatilla cases with orange yellow discharges.
Ferrum Phosphoricum. [Ferr-p]
This remedy is a most useful one in ear affections, suiting congestive and inflammatory stages of most troubles, more especially in anaemic subjects. It is a reliable remedy in acute earache; it has tinnitus like **Pulsatilla, but no special deafness, and like Borax it has sensitiveness to sound. The pain is throbbing or sharp stitching and occurs in paroxysms. The following is Dr. Wanstall’s practical resume:
1. A tendency of the inflammatory process to be diffused instead of circumscribed.
2. Dark beefy redness of the parts.
3. A muco-purulent discharge with tendency to haemorrhage.
4. The establishment of the discharge does not relieve the pain.
5. The pain is in paroxysms.
Copeland asserts that for earache after exposure to wet there is no better remedy.
**Kali muriaticum is one of the most useful remedies in tubal catarrh and catarrhal conditions of the middle ear, it seems to clear the Eustachian tube, which is closed in these cases, causing deafness, subjective sounds and retracted membrane tympani. It is useful in chronic suppurative conditions reducing the proliferation, checking the granulation and hastening repair. Slowly progressing deafness will often yield to the remedy. It is also a remedy for obstinate eczemas about the auricle, especially if accompanied with the gastric disturbances of the remedy. “The most valuable single remedy for the deafness following purulent or catarrhal otitis media.”–Moffat.
**Magnesia phosphorica has a purely nervous otalgia, worse in cold air and relieved by warmth. Bellows gives it first place in nervous earache.
**Kali phosphoricum may also be a remedy in chronic suppurations of the middle ear, with offensive dirty pus, brownish and watery.
Almost specific in infantile earache; the pains are violent, worse from warmth, the cheeks are red, the patient is restless, fretful and there is great hyperaesthesia and much suffering. Patient worse at night and from slightest cold.
**Borax. Child starts up nervously with the pain; muco- purulent otorrhoea.
**Dulcamara. Earache returning with every change of weather, worse at night. Relieved by application of dry heat.
**Sanguinaria. Climacteric earache.
Corresponds to otitis media, with rupture of the membrane tympani, and great soreness of the mastoid portion of the temporal bone. It suits also chronic suppurations of the ear with bursting headache and chilliness; the ears are hot, and the pain to the throat, the drum is perforated and there is a yellow purulent discharge. It is to be differentiated from **Hepar in that the area of sensitiveness is greater than with **Hepar, and it lacks the nocturnal aggravation of Mercurius. Dr. Weaver, of Philadelphia, states that he has seen cases where every indication would point to mastoid operation relieved by Capsicum, and cautions against using it too low. He uses the 6X dilution. Sub-acute inflammation of the Eustachian tube with great pain and a sense of dryness and heat in the throat indicate **Capsicum.