This title suggests that we treat discharging ears. We used to do just that and bad habits are hard to break up. But we can say conscientiously that now all our efforts are aimed at the patient, not the ear. With the patient better all parts of him are improved or cured and no law is violated.
With acutes we try to get all in the patient that is acute, leaving nothing out, and chronic symptoms are kept in mind for future use.
Treatment of discharging ears should start with prophylaxis. Proper care of acute otitis media prevents complications and sequelae, such as discharge. Cases receiving the proper remedy, Belladonna, Pulsatilla, Chamomilla or whatever, do not go on to suppuration. So selection of the right acute remedy involves some responsibility.
After pus formation is inevitable, where heat gives the only relief, especially in the phlegmatic type, exceedingly over- sensitive, chilly, irritable, hard to get along with, sharp throbbing pain, in those where suppuration is developing, Hepar will make an opening and in a bad case even suppurate out bits of necrosed bone as does Silica.
Hepar follows Mercurius well and is useful and necessary before giving Silica, if Silica be indicated; a likely sequence in otitis media. Calcarea sulphurica, similar to Hepar, often helps where the discharge shows no tendency to clear up.
Silica acts best where inflammation and mastoid tenderness develops slowly and will cure where the entire picture would otherwise demand prompt surgical interference. Hepar has also performed satisfactorily in this same role.
With Silica, discharge is watery, offensive or not, malnourished type with pale waxy skin, sensitive to noise, disgusted with life, dread of undertaking anything (Lycopodium) and heat helps. Fluoric acid is an antidote for its over-action.
Mercurius, especially in chronic suppurative otitis, offensive sweat, which does not help, sensitive to both cold and heat, emaciation, weak, trembling, bad breath, flabby tongue, tooth- marked on edges. Discharge green, thick, bad odor, glands swollen. May be dark red swelling behind the ear, shining, throbbing, burning, stinging.
Lachesis, similar to Mercurius, heat aggravates, despondent, weak, very sensitive and trembling, light touch aggravates and < after sleeping, loquacity, left-sided, hot sweat, purplish swelling, thick dark offensive discharge.
Crotalus horridus should be thought of in most malignant mastoid with impending dissolution, apparently past hope, purplish swelling, pitting, mottled, marbled or splotched skin and violent burning pains. In these bad cases along with Crotalus horridus consider Arsenicum, Anthracinum, Lachesis, Secale and Pyrogenium.
Arsenicum here would show some of its outstanding characteristics, quick prostration and emaciation, burning pains, < from rest and cold, mental restlessness and twelve to one aggravation, wants a sip of water often and relief from sweat (opposite of Mercurius), discharge thin, bloody and cadaveric.
Any remedy may of course be indicated, depending on the syndrome presenting in the patient, and naturally our old friends Sulphur and Psorinum and even Lycopodium may carry us across the bridge.
Pulsatillas thick yellow-green, bland profuse discharge especially in the fat, blond, weepy, yielding thirstless type. And Kali sulphuricum with Pulsatillas symptoms but a less mild disposition.
Kali bichromicums ropy discharge from the ear and its many catarrhal symptoms may be the remedy to clear up chronic ear discharge. Even Calcarea and Thuja need consideration where granulation tissue or polypi is present.
Capsicum with its bursting headache, chilliness, burning, stinging pains extending to the throat and hot ear, as well as its reputation in mastoiditis, must be kept in mind.
With Aurum, Beside mastoid and middle ear necrosis, purulent, foetid, bloody discharge, is its well known suicidal depression. EVen Tellurium with bluish puffy ears and acrid, fish-brine odor.
Hecla lava and Fluoric acid may come in and the serial beneficent action of Pulsatilla, Silica, and Fluoric acid may solve an otherwise helpless situation.
We have not mentioned Ferrum phosphoricum which for Dr. Boger seemed to cover much of the territory of inflamed ears, under which the Synoptic Key gives but one drug in the highest rating: Ferrum phosphoricum.
Under Pus from ears he gives Calcarea, Conium, Hepar, Mercurius, PHosphorus, Pulsatilla and Silica. Under Fetor he has Calcarea, Causticum, Silica, and Sulphur with Carbo vegetabilis, Hepar, Kali phosphoricum, Natrum carbonicum, and Thuja, and reserves top rating for Psorinum here as in Excoriated ear. It is wonderful how a vile odor follows Psorinum around and yet in many cures by Psorinum this is absent; sustaining the pronouncement by Margaret Tyler and Wm. H. Clark, that negative symptoms should be forgotten as they just dont count. It is interesting to note that Dr. Boger uses Ferrum phosphoricum in the DMM. potency.
In pre-homoeopathic days we have many times cured (suppressed) chronic aural discharge and so far as we know, without the untoward sequelae one would expect. But we have a feeling that a careful follow through of these cases would show that in benefiting the ear we had visited upon these patients worse conditions deeper in. How one does flounder about trying to get somewhere in this world.
In acute discharging ears where profound deafness shows involvement of the inner ear and symptoms of extension to the meninges are in evidence, especially with headache severe and continued, Belladonna 1M. has served me well.
AKRON, OHIO.
DISCUSSION.
DR. PULFORD: Discharges from ear are cured in a good many different and peculiar ways. About four years ago, I think it was, we had a small-pox “epidemic.” They all wanted to be vaccinated with Variolinum. I was passing around Variolinum. About two weeks later I was very much surprised when a lady called me up and said, “I have a daughter who has been suffering for several years with leucorrhoea and discharging ears, and we have never been able to get any relief. Right after she began taking the Variolinum, both cleared up”.
DR. BOGER-SHATTUCK: Speaking of the ears, last year before I went east we have a number of cases come into the childrens ward with unexplained high temperatures. These temperatures persisted quite a while. There seemed not to be any remedy which would get them down. It finally came my turn to come up to bat on the hospital service. I looked these cases over, which had been x- rayed for lungs, and they had had all kinds of technical diagnoses.
The aurist took them over and said there was nothing wrong with their ears. I went into the ward and gave one child (I carry my 200ths with me) Ferrum phos., another one Phosphorus and another one silica on symptomatic prescribing. The next morning when I went into the hospital, the nurse said, “Every child in the hospital has running ears. What kind of medicine did you pass out?”.
DR. KAPLOWE: I dont recall whether Dr. Moore mentioned Tellurium, but the one case that stands out in my mind now is a case that was cured by Tellurium 1M., after the ear had been discharging for about three or four years. I dont think it was a coincidence, because about two months after Tellurium has given, there was no more discharge.
DR. MOORE: You have never been able to repeat that?.
DR. KAPLOWE: I have never had occasion to.
DR. MOORE: There are any number of drugs, of course, that can be used in anything. In acute otitis it would be Belladonna. Just a short time ago I had a case, nothing special about it except I finally dug this out: every time that fellow would belch, his ear would hurt. That was the time of pain. There are just two remedies under that, Sulphur and Tarentula. Tarentula cleared it right up. That would be a very unusual remedy for acute otitis media.
