Mother's Remedies Part 80

The external ear is called auricle or pinna. It is an oval funnel-shaped organ. The ca.n.a.l leading in to the membrane (drum) is called the external auditory meatus. It extends inward about one and one-quarter inches and terminates in a membrane.

Membrane Tympani (drum) which separates the external ear from the tympanic cavity. To examine the drum, you must pull the ear backward and outward to make the ca.n.a.l straight.

Membrane Tympani (the drum) Membrane.--This is situated at the inner end of the ca.n.a.l and separates it from the tympanum or middle ear. It is placed like the membrane in the telephone. It is pearly gray in color.

This membrane not only serves as a protection to the delicate structures within the tympanum, but also receives the sound vibrations from without and transmits them to the ossicular (bony) chain of the middle ear.

The Tympanum or Middle Ear.--This cavity just beyond the drum, which forms the greater part of its outer wall, is an irregular cavity, compressed from without inward and situated in the petrous bone. The mastoid cells lie behind. It is filled with air and communicates with the nose-pharynx (naso-pharynx) by the eustachian tube. The upper portion of this cavity, the attic, lies immediately below the middle lobe of the brain, separated from it by a thin layer of bone, which forms the roof of the cavity. This cavity is separated from the internal ear.

[EYE AND EAR 359]

The Eustachian tube.--This is the channel through which the middle ear communicates with the pharynx. With an opening in the anterior of the middle ear, a bony ca.n.a.l pa.s.ses from this point, inward, forward, and downward through the petrous bone, when it merges into a cartilaginous ca.n.a.l, which terminates in a funnel-shaped protuberance, with a slit-like orifice, located in the nose pharynx. This is the eustachian tube. It is lined with mucous membrane like the throat. The air goes up from the throat, through this ca.n.a.l to the middle ear. The mucous membrane of the middle ear is continuous with that of the nose-pharynx through the eustachian tube. So you can readily understand how easy it is for an inflammation of the throat to extend to the middle ear through the eustachian tube.

The posterior wall which has the greatest height, reveals in its upper portion a pa.s.sage (antrum) through which the vault of the tympanum (attic) communicates with the cells of the mastoid process, situated posteriorly.

From this description you see how near to each other these parts are placed and when one becomes diseased the disease can extend to the other part or parts. The brain is separated from some of these cavities by a very thin sh.e.l.l of bone, and the disease can soon affect the brain through infection or breaking through the thin structures that separates the parts.

Diseases of the middle ear and the mastoid are always to be considered serious, and should be very closely watched. A child with a running ear is in danger, for it may at any time become closed up and serious.

ECZEMA OF THE EXTERNAL EAR (Auricle).--This is an inflammatory disease of the skin, and in the poorer cla.s.ses it is very frequent. It is quite a common disease in old age. It develops in other parts of the body at the same time in a certain percentage of cases.

Causes.--Soaps, alkalies, foreign bodies in the ear, removing ear wax and a chronic discharge from the middle ear. There is a tendency to it in some families; stomach trouble, improper food are also causes.

Symptoms.--Itching,--and this is very p.r.o.nounced,--burning feeling. The part is somewhat reddened, fluid oozes out, crusts form, the skin thickens, and scales. Sometimes it swells very much.

Treatment.--Regulate the bowels, give a simple easily digested and proper food for children and adults. Cleanse the inflamed skin gently with castile soap and tepid water once a day. Cloths dipped in some cooling lotion, such as the lead and opium wash, or in plain water to which has been added a little alcohol or eau de cologne, should be wrapped around the inflamed ear during the acute stage and they should be kept wet. Clean vaselin, etc., is good to put on the scabs. The ear should be covered as before directed to keep dirt, dust, etc., out.

[360 MOTHERS' REMEDIES]

HARDENED WAX OR IMPACTED CERUMEN.--This ma.s.s may be mixed with foreign bodies or be made up of "wax" alone.

Symptoms.--A large ma.s.s of wax may remain in the ear for many years without causing any special loss of hearing so long as the plug does not rest against the drum and there remains a pa.s.sage between the ma.s.s so that the sound-waves can strike the drum. Generally the hearing gradually grows less. Loss of hearing may take place suddenly, as after washing the head, or after a general bath, or after an attempt to clean the ear with the end of a towel. Patients will often say the dullness of hearing appeared suddenly. This no doubt was due to the fact that the ma.s.s of wax was displaced against the drum suddenly by an unusual movement of the head or the jaws, or the ma.s.s became swollen through fluids getting into the ca.n.a.l. If the ca.n.a.l is filled there will be more or less deafness, ringing in the ear, and there may be piercing pain produced by the hardened ma.s.s, especially if the jaws are moved from side to side. If the ma.s.s is thoroughly and carefully removed, the hearing may entirely return if it was caused by this wax.

Treatment.--The ma.s.s is best removed by syringing the hardened plug and softening it gradually. Removing it with a currette and forceps without softening it may do injury to the parts. The syringe and hot sterilized, boiled water should be used for some time, and the patient asked occasionally if there is any faintness or dizziness caused by it. It often comes, in a lump after the water has been used for some time. A strong solution of bicarbonate of sodium is also good to use.

FOREIGN BODIES IN THE EAR.--These are not of frequent occurrence. In the case of children these bodies may comprise such objects as pebbles, beads, beans, pieces of rolled paper, fly, bed-bug; insect of any kind may get into ear of adults. If they reach the drum a very unpleasant sensation is produced by the attempt to escape. Sometimes a layer of wax may gather around the dead object. These bodies should be removed, for their presence may produce a swelling or soreness in the ca.n.a.l. If the object is a dried pea or bean the syringe should not be used. The object must be carefully removed. Sometimes an operation is necessary to remove the object.

DISEASE OF THE MIDDLE EAR.--The ordinary cold in the head rarely runs its course without one of the eustachian tubes at least is involved to some extent.

SIMPLE INFLAMMATION OF THE EUSTACHIAN TUBE.--Causes.--Acute colds, inflammation of the nose and pharynx, tonsilitis.

Symptoms.--The ear may feel full and numb, roaring in the ear may occur.

There may be pain on swallowing, shooting up through the tube.

[EYE AND EAR 361]

Treatment.--Remove the cause. Treat the nose and pharynx. Spray and gargle with solutions advised for throat trouble. If it continues the throat should be examined for adenoids, enlarged turbinate bones and so on.

ACUTE CATARRHAL INFLAMMATION OF THE MIDDLE EAR. Causes.--Acute coryza, acute pharyngitis, influenza, scarlet fever, inflammation of the eustachian tube, gargling, bathing, employing the nasal douche or violently blowing the nose.

Inflammation of the eustachian tube is, in many cases, simply the first stage or onset of this disease. The congestion extends beyond the tube and involves to a greater or less degree this cavity. If it continues for a few hours or an entire day, the watery elements of the blood will begin to escape from the distended vessels into the tissues of the mucous membrane and ooze out upon its free surface. If this is copious enough pressure may be developed within the cavity, middle-ear, to cause pain. These cases vary much in severity. In the mildest ones there may be a few twinges of pain in the affected ear, but nothing more; and even in the most severe cases the pain does not last longer than a few hours, although it may return on several successive days. Very many of the earaches of young children, from two to ten years of age, are due to this disease. The pain is very likely to come on late in the afternoon or during the night, while earlier in the day the child may be free from pain. In the milder forms the condition of the drum is similar to that existing in inflammation of the eustachian tube. It is not then much changed from normal. There may be more congestion than in this condition. In a fairly severe case the membrane (drum) a few hours after the onset presents a most striking change. It is a picture of obstructed venous (dark blood) circulation of a high degree. In some cases one or more of these distended veins may rupture and form a blood tumor in the external ear ca.n.a.l. The drum is red and more or less swollen.

Treatment.--Very little is needed for this kind, except care and watching.

Use the simple hot water in the ear carefully or poulticing when there is pain with onions, bread and milk, and puncture of the drum if it bulges or is too tense. Hot water for gargle, steaming of the pharynx. Keep the patient in a room with an even temperature. The patient must not take cold as it might extend farther.

Recovery.--The outcome is usually good in this disease if proper care is taken; Generally in a few weeks the inflammation is gone and the hearing is restored.

[362 MOTHERS' REMEDIES]

SEROUS MUCOUS EXUDATION INTO THE MIDDLE EAR.--The disease just described is often a.s.sociated with an (exudation) watery oozing of fluid into the middle ear, but the following condition is different. Sometimes a comparatively normal middle ear is found to contain a variable amount of either fluid or mucus, or a fluid which represents a combination of both.

The failure of the fluid to absorb is due first to the fact that the drainage through the eustachian tube is still obstructed; second, that the absorbing process in the cavity is not acting normally.

Symptom.--Sudden change from somewhat poor to good hearing and the reverse. It is due to the changing in the position of the fluid. The hearing may be normal when the head is thrown far backward, for the fluid then escapes into the antrum, or when the chin is resting upon the chest.

Another symptom that is peculiar is a feeling of something moving in the ear. This is only felt when the head is moved suddenly. Sometimes the patient says: "I went in bathing and got some water into my ear, and I am unable to get it out." He thinks the water went into the ear by the way of the external ear ca.n.a.l. It was due to the chilling of the surface of the body, or the water accidentally entered into the ear through the mouth, or nose, throat, and eustachian tube, and this caused an exudation of fluid to take place in the middle ear. Hearing gurgling sounds in the ear during coughing, sneezing and swallowing is an important symptom. The drum on being examined varies greatly. The simplest case is seen when fluid contained in the cavity is small in quant.i.ty and consists of a thin serum.

The upper level of this fluid can then be seen like a hair crossing the drum in a more or less horizontal direction. It retains its horizontal position when the patient moves his head backward and forward.

Treatment.--The fluid can be evacuated by an opening made into the drum, but it usually acc.u.mulates again. The proper treatment is to treat the diseased condition of the nose and throat, as described in other parts of this book.

CHRONIC CATARRHAL INFLAMMATION OF THE MIDDLE EAR.--The expression, acute inflammation of the middle ear, is rightly employed when it is applied to a case in which the underlying cause is of a temporary nature, as for example, a cold in the head, and mild attack of influenza, perhaps also in an attack of hay fever. But when the causes are of a more permanent character and the middle ear continues for an indefinite period to be the seat of all sorts of disturbances the combination of these different diseased phenomena receives the name of chronic catarrhal inflammation of the middle ear.

Causes.--Troubles (lesions) located in the upper pharynx, the naso-pharyngeal (nose-pharynx) vault and the nasal pa.s.sages. Adenoids may cause it.

The course of this disease has of recent years been growing more favorable, because the causes are being removed more and more.

Symptoms.--Symptoms of the acute inflammation would be present, and impairment of hearing which sometimes comes so gradually as not to be noticed by the patient. It will be better and then worse. A hara.s.sing, hissing, blowing, ringing, usually accompanies it. Pains soon or later add to the discomfort. One side is usually affected first.

[EYE AND EAR 363]

Treatment.--It must be devoted to removing the causes just mentioned.

Restore the general health. Abstain from alcohol, tobacco and excess of all kinds. Active outdoor exercise, horseback riding, mountain climbing, rowing, walking, etc., are great health producers.

ACUTE SUPPURATIVE INFLAMMATION OF THE MIDDLE EAR.--This inflammation of the middle ear is one in which, at an early stage of the disease, the free liquid poured out a.s.sumes a pus-like character. At the onset the mucous membrane of the eustachian tube and middle ear becomes first congested and afterward oedematous (watery swelling). Then a serous or a b.l.o.o.d.y-serous fluid is poured out into the middle ear; and finally this a.s.sumes all the outward characteristics of pus. In a few exceptional cases this pus fluid will find a sufficient pa.s.sage through the eustachian tube; but in the great majority of cases this pa.s.sageway becomes closed almost at the very beginning of the attack, and then the free exudation; under an ever increasing pressure and on account of the softening and breaking down of the tissues of the drum forces an opening for itself directly through the drum membrane.

Causes.--The same causes that produce the acute variety will produce this variety of the disease. It occurs more frequently during the spring and fall months as the result of changes in the climate. Acute and chronic catarrh of the nose and pharynx are causes. It frequently occurs in connection with scarlet fever and measles. It complicates nose and pharyngeal diphtheria.