DISEASE OF THE EAR.

Samoa Times and South Sea Gazette, Volume 2, Issue 88, 7 June 1879, Page 2

DISEASE OF THE EAR.

Bv Professor Stanicii. Obstruction of tho faucial orifice of tho eutstaohiou tube by thickened mucus membrane and their treatment:— Cases of this disease, when uncomplicated with auy affection of the tympauum, ordinarily yield to the use of general remedies and applications to the fauces without touching tho outer ear. The object to be aimed at is the reduction of the congestion and hypertrophy of tho mucus membrane surrounding the orifice of the tube, so as to allow the muscles again to exercise their function of opening it; aud for this purpose considerable patience and pei-soverance are doubtless frequently required; since in many strumous pei-sons, especially if young, tho tendency to congestion and thickening is vory great. .Gkxerai. TREATMENT -The most efficient ul' this are abundant and active oxercise in tho open air, ami warm clothing; Manuel should be worn next to tho skin, youths tho Manuel jacket oxtending from tho nook to tho ribs may not only bo worn, but in cold weathor iu front, whore the client is exposed, a small additional piece of Manuel may be worn suspended from the neck. The throat should not be wiopped up, with handkerchiefs, 4c, and they only servo to weaken it by keeping it warm for a cortain time aud thon ou their removal leaving it oxposod frequently to a colder air within doors than had prevailed without, thus bringing ou relaxation of the mucus membrane.

Where a single tie handkerchief is worn within doors, no addition is needed on going out; and where, in children, the throat is left bare within horfce a small silk handkerchief loosely tied is all that is required without. I give these particulars on those points because experiencu frequently convinced me of their great importance. The surfaoe of the body should be daily sponged or rubbed with a coarse towel that has been dipped in cold water and then wrung out. As the children who suffer from the affection under consideration have usually a languid circulation and deficient nervous energy the towel bath appears to be a remedy advantageous in both respects. The towel should be very coarse, and onlv one part of the body should lie rubbed at a time ; the skin, especially that of the neok, throat and spine, should be brought to ruddy glow. This bath may be used either in the moniing or the evening, but once daily w sufficient. If the patient be so delicate that he cannot well bear the slight shock produced by the cold water, tepid water may be used. In addition to this bath, indeed, to surpersedo it, especially in youths tjf from 12 to 14, by whom it is not likely to be oarried out effectually, the tepid or cold plunge bath may be resorted to. Where it can be practised, sea bathing should not be neglected; but in all cases of entire immersion it is advisable to wear an oil-skin cap, to keep the head dry, and this, not becausa.the application of water to the head is objectionable, but because there is so great difficulty in perfectly drying the hair, and the slow evaporation from it is often decidedly injurious. Plunging into the fresh water river in warm weather is not prejudicial. In the treatment of the cases in question too much stress cannot be laid upon the necessity of exercise, bracing ai , and cold bathing. I have known them to overcome the most obstinate cases of obstruction of the faucial orifice of the eustachian tubes, where all local remedies had given the slight or only temporary relief. Care should also he taken as to the diet of the patieut; pasty, sweets, fat, kc, should be avoided ; vegetable may bo sparingly partaken of ; and the principal food should be bread, especially that containing the bran ; meat and light puddings, as rice.sago, &c. Children should not be overworked in their studies, should retire early, and their sleeping-room should be airy and well ventilated, and above all it is important that the head should l>« kept above tho bed-clothes. To overcome tho very prevalent habit of breathing through the mouth, whereby the cold air keeps up a constant irritation of the faucial mucus membrane, tho patient should be directed to sit down quietly for a certain time daily, and practice the habit of nasal respiration. Although it may at first seem difficult, the unions membrane of the nose soon yields, and the air passes freely. All medicines that impart tone to tho system may in turn be resorted to. Cod liver oil, iron in various forms, iodide of potassium and the mineral acids, and vegetable bitters will bo found useful.

Local Treatment.—The most efficient local application is undoubtedly the nitrate of silver, which generally may be used in solid form, with Messrs. Wciss's caustic holder, the end of whioli is capable of being turned at such an angle that tho caustic may be passed behind the soft palate and applied to the mucus membrane of the orifice of the tube, as well as to that of the fauces of the tube. Should the tonsils be enlarged the solid nitrate of silver may be rubbed over their surface, and over that of tho faucial mucus membrane about once a week : and it should produce considerable irritation and a copious flow of mucus. Stimulating gargles are also to bo used; those combining acids and astringents are of service. Cold water is often beneficial; and in order to ensure the application of lh« cold water to tho orifice of tho tubes as well as to improve the condition of the mucus membrane of tho uares, the water inav bo drawn up through the nose, ami passed out by the mouth. When there is much congestion of the faucial mucus membrane a leech or two, or a vesiccating paper, may be applied over the region of tho tonsils.