Ossification of the auricle rare, and in the very few cases on record it has re sulted from senile changes, but writer had case in which it developed in con sequence of perichondritis sero-puru lenta. H. Knapp (Archives of Otol., Jan., '90).
Importance emphasized of distinguish ing between an ordinary cystic tumor and othxmatoma; that such tumors produce deformity is, most frequently, on account of the heroic measures re sorted to for their removal. Lavrand (La Semaine Med., May 7, '92).
Most cases of so-called primary peri chondritis of the auricle are in reality instances of cutitis and lymphangitis of the outer ear. This leads to altered nutrition in the perichondrium and the cartilage. A. Courtade (Ann. des Mal. de ]'Oreille, Aug., '94).
Growths.—Cysts are generally back of the ear and more commonly congenital, however late the apparent beginning.
They may be serous, sebaceous, or tera toid, and should be dissected out entire.
Cysts of the auricle treated by elec trocantery applications. The cyst is opened by incision, its contents allowed to escape, and the sac washed with sublimate solution. The walls are then curetted, and an electroeautery point, made into the form of a small button of platinum, introduced into the sae and the walls seared. The interior is then washed out with sublimate solu tion and a compress applied, covered with iodoform gauze. The parts heal quickly, and with slight or no deformity. Albespy (Revue de Laryn., d'Otol., et de Rhin., Dee. 15, '92).
Fibroma of the lobule is usually a keloid formation sequent upon piercing or the wearing of irritating rings; it is therefore commoner in the negro. It is not apt to attain great size and seems always benign; but thorough eradication is the only safeguard against prompt re currence.
Great frequency of fibrous tumors of the lobe in negroes attributed to the wearing of brass jewelry. Impaction of eerumen is of rare occurrence, not only on account of the large size of the meatus, but also because such collec tions are seldom found in plebeian ears. Turnbull ("Impaired Hearing").
Two eases of lupus seen, the result of perforation of the lobules for ear-rings. Fournier (Jour. de M6d., July 15, '94).
Case of tumors of the auricle ob served. The growths, shown in the ac companying illustration, were fibrous tumors of the lobules, resulting from an inflammatory process induced by pierc ing the lobules for earrings. Bullard
(Virginia Med. Monthly, Sept., '95).
Ereloid occurs more frequently in the negro than in the white race, and is not due so much to the size or nature of the rings worn in the ear, but to the in herent tendency of this race to the for mation of fibroid tumors. The tendency to recur is very great. Scheppegrell I. Med. Jour., Oct. 17, '96).
Other neoplasms are too rare to need discussion Eczematous inflammation of the au ricle is commonly due to its extension from the canal, where it has been set up by irritating discharges. Intertrigo back of the ear or isolated affection of the pinna or canal has often other causes; and in the absence of otorrhcea, gout, or struma, or other malnutrition, is apt to be its basis. It may be a severe affection, with pyrexia and almost phlegmonous swelling; and in such cases it is wiser to isolate, give full doses of tr. ferri chlor., and deal with it as erysipelatous. Lo cally there are generally abundant micro organisms; and whether these are causa tive or not, we should, with all prompt ness, remove the conditions favorable to their growth. Moisture is to be avoided, as well as any oily materials which might decompose and irritate; and any weeping of the surface should be dried by vigor ous use of silver nitrate. Bismuth, calo mel, hydrag. oxidi flavi, or ichthyol in weak ointment should relieve the irri table conditions: oil of cade or more stim ulating salves, the more chronic phases. As a prelude to any treatment, the affected surface should be cleaned as per fectly as possible of all crusts or desqua mation, hydrogen dioxide being probably the best agent, since it also penetrates and disinfects, while bringing to view, as snowy patches, affected areas beneath the surface. The chosen ointment should then be rubbed in, gently, but persist ently, until these deeper patches have been again made invisible by its penetra tion. The prescribing of medication without supervising or personally carry ing out the employment of it will gener ally prove ineffectual. The affection is often stubborn at best and prone to recur, and strict regimen and constitutional medication may be requisite to ward off attacks. Herpes may, in very rare cases, be mistaken for it; but the pain in herpes is apt to be severe before any eruption and the course of the affection is quite different.