Supposing the morbid condition has passed beyond the line of the so-called catarrhal from and has eventuated in suppuration.
In many cases, as you well know, this point seems to mark the climax of the inflammatory action, and resolution follows.
But this by no means ends the difficulty in some instances, even where the membrane becomes repaired. Products of inflammation remain in the tympanum to organize and interfere with the delicate machinery therein.
You as specialists know the importance of the speculum and the air-bag, in preventing the development of adhesions and closure of the tube. But you have important aids in your remedies to assist in carrying on the process of resolution by absorption of the remains, and reduction of the swelling and infiltration. Our friends again here show their poverty, unless they trespass upon our bounty. Kali mur., Merc., Puls., the Calcareas, Hepar, Silica, all stand ready with a helping hand.
But in case resolution does not follow after the suppurative stage is reached and a chronic pyogenic condition is established you are confronted with a serious problem.
Now as a rule it is useless n aural suppuration to depend on internal medication alone, although there are perhaps few conditions more indicative of a perverted systemic state, and showing more need for constitutional treatment. The local conditions must be complied with, and unless this is done, your remedies are of little value.
But after cleaning and dressing the suppurative tract, such remedies as Aurum, Hepar, Mercurius, Silicia, Calcarea, Sulphur, Arsenicum, Lycopodium, come in as powerful levers to so modify the constitutional state that the local measures employed have far greater efficacy, and vice versa the local treatment being judiciously used, the medicinal treatment finds fewer obstacles in its way.
A block between two pieces of gearing, disarranges the machinery and limitless fuel and steam does not produce smooth running, but put the local conditions of the machinery in proper order and the motive power does its work.
It is this mutual dependence between local and systemic treatment that I wish to especially emphasize, and thus assign to our specific therapeutics their proper field of action. This argument holds good through all the varied forms of aural pathology that we meet.
Perhaps the most intractable form of treatment catarrhal condition. Taking the most advanced form of treatment of the present day, the air-bag, pneumatic speculum, vibrometer, telephonic attachment, surgery of the ossicles, naso-pharyngeal treatment, etc., one is simply removing the blocks in the machinery, and the more perfectly that is done, the clearer is the way for the more satisfactory action of constitutional remedies.
The ideas are not applicable to aural therapeutics only. Throughout the whole range of human pathology the same principle applies, and intelligent practitioners everywhere are recognizing the fact that there is more in treating human ailments, than the suitably selected Homoeopathic remedy.
Nutrition, climatic conditions, sanitation, hygiene, general and local, the elimination of mechanical obstacles by mechanical means, are indispensable to the best action of the remedy, and the more quickly this general fact is appreciated by us as a school, and the internecine warfare-as to the size of the dose, the degree of attenuation, who are true and who are false Homoeopaths-ceases, the sooner will be ushered in that wished for day, when the law of similia assigned to its proper relations and limitations, will be recognized by the world at large, as offering to suffering humanity its best medicinal aid.
DISCUSSION.
HAYES C. FRENCH, M.D: In the discussion of Dr. Sterling’s admirable paper we are not unmindful of the paucity of remedies that have been found, even by our Homoeopathic brethren to have any definite or constant affinity for the tissues involved in painful and destructive aural troubles.
Under the classification of general and specific agencies for meeting ear diseases Dr. Sterling says: “They general means include all local measures, nutrition, hygiene, sanitation, etc.; the specifics, our remedies.” To my mind this classification seems indefinite and unphilosophical. I doubt if many disciples of Hahnemann will be found willing to admit that our remedies are specific in the sense herein implied, from the fact, that the symptomatology that leads to the selection of an efficient remedy for the ear, may be found to have no definite relation to the condition of the organ at the time, but to quite remote ones.
In selecting an ear remedy upon its clinical reputation the results seldom justify the appellation of “specific,” and if we chose it in response to the totality of the symptoms, whatever may be the result, it could not in harmony with the philosophy of our law of cure be said to be specific to the ear trouble. Again, in acute suppurative otitis, with incarcerated pus in the middle ear, what could be more specific than the relief obtained by the incisive offices of a lancet? And this certainly does not belong to the classification-“our remedies.”
In all curative ear troubles, due to mechanical causes, experience has taught most of us that the more specific results have usually been obtained by means of mechanical or surgical agencies, and in the domain of prophylaxis the same has been true, as in the example of impacted cerumen cited by the author in his paper. Even in the few remedies for which our Old-School colleagues claim the virtue of specifics, our use of the same agents in accordance with the law of similars has always shown the falsity of the claim and the narrow limitations of the specific action, as for example the demonstration that the action of quinine is after all limited in its antiperiodic efficacy to definite forms of tertian intermittents.
Would that there might be some solid ground on which to found our claims to specific remedies for the painful and often intractable diseases, especially of the middle ear and the labyrinth. It is astonishing what specific results sometimes attend the exercise of a little good “horse sense,” even against the general teachings of the books and the professors.
In one of our first cases of suppurative otitis media, after cleansing the meatus thoroughly twice a day for two weeks, following the dressing with pledgets of absorbent cotton in he outlet, with no appreciable diminution of the discharge, the mother of the patient blandly suggested that the ear might do better if stooping the canal with cotton were discontinued; and as soon as it could be done without sacrificing the dignity of the doctor, the advice was acted upon to the great benefit of the patient and subsequent advantage to the doctor-loose bandages, allowing free vent to the pus, being substituted.
