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.
**Calcarea carbonica corresponds to chronic ear troubles in scrofulous children. There is itching of the membrana tympani, defective hearing, humming and roaring in the ears, purulent otorrhoeas with perforation of the drum, polypi, etc. Deafness from working in water.
**Nitric acid may prove useful in mastoid abscesses and syphilitic ear troubles.
**Kali bichromicum. Inflammation of middle ear; ulceration of membrana tympani with tenacious, stringy and purulent discharges; pains sharp stitching in character. Also a valuable remedy in the later stages, when, on account of pharyngeal involvement, the Eustachian tube is hard to inflate.
**Aurum has a congestive roaring in ears, sensitiveness to noise, foetid otorrhoea, boring pains in mastoid, caries and perforation of drum.
**Baryta carbonica is to be thought of in deafness associated with swelling of the tonsils. Also in noises in the ears from arterio-sclerotic conditions.
**Phosphorus. Deafness to the human voice, common in the aged or where the patient is constantly blowing small quantities of blood from the nose.
Very valuable in suppurative middle ear diseases, with swelling of parotid glands and offensive breath. It suits especially scrofulous and syphilitic ear conditions. It is especially valuable in proliferous middle ear diseases, hardness of hearing due to swollen tonsils. The discharges are thin and acrid, the ears, teeth and face ache, symptoms worse at night, and characteristic is a feeling of stoppage and of internal soreness as if raw, and also roaring in ears.
**Mercurius dulcis. Chronic inflammation of the middle ear, with deep toned roaring. The membrana tympani is thickened, retracted and immovable by inflation. It suits especially Eustachian catarrhal deafness.
**Graphites has catarrh of Eustachian tube and hardness of hearing, which is better riding in a carriage. Gluey discharge will indicate as well as eczematous manifestations. **Carbo vegetabilis. Otorrhoea following exanthematous diseases; ears dry.
**Carbo animalis. Cannot tell whence sound comes.
**Iodine cured for Dr. Hughes a case of catarrhal deafness.
Very valuable in suppurative middle ear troubles, especially in cases complicated with caries or necrosis of the bones and attended with a thin, ichorous and offensive discharge containing little pieces of bone. Perforations of the membrana tympani heal rapidly under **Silicea. A peculiar symptom leading to the remedy is an itching and tingling in the locality of the Eustachian tube. There are also shooting pains through the ear and profuse perspiration, sudden snuffing, cracking sound in the ear like the explosion of a percussion cap. It promotes repair of the drum head. It is most frequently indicated in persistent chronic otorrhoea with oversensitiveness to sounds. Dr. Moffat advises changing to **Lapis albus after use of **Silicea for too long a time.
Hepar sulphur. [Hep]
Also valuable in suppurative otitis media, and is useful in earache when suppuration impends. There is great soreness and sensitiveness to the slightest touch, acute exacerbations of the trouble with increased discharge, which is thick, creamy and somewhat offensive. Patients requiring **Hepar are irritable and sensitive to the slightest draft of air. **Lachesis. Roaring and singing in the ears, relieved by putting finger in ear and shaking it, therefore catarrhal.
**Crot.. Stuffed feeling in ear and a sensation as if wax were trickling out.
**Conium. Increased quantity of dark wax.
**Hepar suits especially otorrhoeas dating from scarlatina.
This remedy is useful in roaring and buzzing in the ears, words and sounds re-echo unpleasantly. It suits a catarrh of the Eustachian tube.
**Chenopodium has deafness to low tones, while the higher ones are heard distinctly. Its special field of action is in affections of the auditory nerves.
**Sanguinaria has humming and roaring in the ears, and painful sensitiveness to sounds.
**Salicylic acid. Meniere’s disease and simple deafness with tinnitus. **Arnica has proved of benefit in Meniere’s disease. Pain in the cartilages of the ears, as if bruised, is another indication.
**Bryonia is highly spoken of by Dr.Dudley Wright, of London, in Meniere’s disease, as suiting those cases where the vertigo comes on from any sudden motion, as on rising from a seat.
Is useful for a most offensive discharge from the ears and syringing does no good, the ears are red, raw, and the discharge excoriates.
**Psorinum is even better than **Sulphur in case of offensive discharges from the ears; there is with this remedy a general unhealthy condition of the patient, pustules appear on the face, around the nose, mouth and ears, the blood is impure and the system run down. It is a remedy not to be despised in ear affections, and is especially to be considered in cases of chronic otitis media, probably of psoric origin, in which other remedies and methods of treatment have been tried unsuccessfully.