An American text-book of diseases of the eye, ear, nose and throat / edited by G.E. De Schweinitz and B. Alex. Randall.

Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: An American text-book of diseases of the eye, ear, nose and throat / edited by G.E. De Schweinitz and B. Alex. Randall. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    bv Politzer's method should be tried with care and gentleness. It sometimes gives great relief to pain by equalizing the pressure of air within and with- out the tympanic cavity. With closure of the Eustachian tube, absorption of air takes place through the mucous membrane lining the tympanic cavity. This produces a partial vacuum, draws inward the drum membrane, causing pressure through the chain of ossicles upon the labyrinthine contents, and at the same time retards the flow of blood, causing or increasing venous con- gestion in the lining mucous membrane and exudation into the cavity. When the effect of this procedure is favorable, it may be repeated once or twice daily ; but when it increases pain or gives no relief, its use must be postponed until later in the treatment of the case. No simple measure is so helpful as the application of dry heat. The hot-water bag of India-rubber is the readiest means of applying heat. This, when tilled, should be covered with soft cloth and laid upon the pillow in contact with the ear. But still better, because of its lightness, is a bag loosely filled with common salt and heated in an oven. Moist and warm applications, like poultices in all forms, are to be avoided. They soon become uncomfortable by evaporation, and tend by maceration of its dermoid layer to promote rupture of the drumhead, already perhaps softened in its inner layer. They may also serve as the means of conveyance of all sorts of infectious germs, and in the end complicate far more than they benefit the disease. For this reason are injurious most of the popular remedies and poultices of all the vegetables in the kitchen-garden. So, too, all the varieties of vegetable oils and animal greases are harmful, their sole value having been to carry heat. The vapor of chloroform may be used with much benefit in mild cases in children. A few drops of the liquid may be placed in a spoon, and the vapor, which is much heavier than air, be poured like a liquid into the ear. Chloroform liniment applied about the ear with a bit of flannel is also valuable. Aseptic aqueous solutions con- taining local anodynes and anesthetics may be used judiciously in the early stage of an attack-. The sulphate of atropia, four grains to the ounce of solution, is efficacious. Cocain hydrochlorate, in solution of from four to twenty grains to the ounce, is still more effective transiently ; and better still is the combination of these two with morphin, e. g.: ~Bf: Sol. cocain hydrochlorat., 10 ^ fej ; Atropia? sulph., gr. j ; Morphia? sulph., gr. ij. Of this, five or six drops from a spoon previously dipped into hot water may be poured into the ear.1 The local abstraction of blood furnishes one of our most effective measures. The application of two or three leeches to the tragus, or just in front of it, may cut short the whole trouble. After they have filled them- selves with blood and fallen off, the bleeding from the bites may generally be allowed to continue until it ceases spontaneously. This subsequent bleed- ing makes the natural leech more effective than wet-cupping. When leeches are not at hand, the artificial leech furnishes an excellent substitute, or any small knife can puncture the skin in front of the tragus, and any small cupping-glass will serve if the special instrument be not at hand. An ounce or two of blood may be taken, and if the relief experienced be but temporary, the process may be repeated. But when the simpler measures tried in quick succession have failed, or when the onset of the disease is such 1 Smaller dosage must be adopted if perforation be present.