Herpes at the orifice of the external auditory canal cured by tonics and the local application of yellow oxide of mer cury. L. S. Somers (Am. Medico-Surg. Bull., Oct. 31, '95).
The itching of eczema is as trying in the canal as in any other location, and there is a strong temptation to scratch, abrade, and infect the surfaces. Furuncle is apt to follow, and autoinoculation may establish a series. As elsewhere, there are two sets of glands open to in volvement: the superficial sebaceous hair-glands and the deeper coiled glands, here secreting cerumen instead of sweat. The latter may actually enter the peri ehondrium or periosteum; so their sup puration may not only cause swelling of the whole aural region and displace the auricle in a way suggestive of mastoid abscess, but may really cause caries of the bony wall. Bence slight eczemas deserve treatment as a prophylaxis, even when no redness or desquamation marks their existence.
In eczema of the auricle and external auditory canal the use of a wash of Van Swieten's solution, diluted with three or four times its volume of water, recom mended. The parts are then dried with absorbent gauze, and dusted, morning and evening, with iodol. This form of treatment is of service in ease of "moist eczema." For "dry eczema" after 'using the wash, as above, the parts are dried, and the following ointment is applied: Iodol, 15 grains; lanolin, 1 ounce. Cha tellier (Annales des Mal. de l'Oreille, etc., July, '93).
Induration is present in most chronic eczemas, and the resulting rigidity of the auricle and canal is often our only diag nostic sign. Something of this sort will generally be found in the other ear when one only is affected with furuncle. The right ear is more often affected in adults, probably as it is more often scratched.
Furuncle may be extremely painful and a series occurring in a patient out of health may positively endanger life through exhaustion. The first appear ances should be vigorously treated, there fore, and the later stages sedulously cared for until resolution is complete.
Furuncles often appear after the re moval of impactions of cerumen. For this reason a boric-acid wash should be applied before removing such masses:— II Acid. boric., 45 grains.
Glycerine et aq. destil., 1 '/, ounces.
Twice daily, for one or two days be fore the final syringing for removal of the impaction, this solution is instilled into the affected ear. Loewenberg (Jour. de Med. de Bordeaux, May 12. '89).
Staphylococcus pyogenes produces fu runcles. They are forced into the folli cles of the skin usually by mechanical irritation. Schimmelbusch (Archiv fur Ohrenh., '89).
Furuncles of the auditory canal are associated frequently with general fu runculosis; in the majority of cases the staphylococcus pyogenes aureus is the offending micro-organism; next in fre quency, the albus and citreus. Mag giora and Gradenigo (Giornale della reale Accaddemia di Med., Torino, July, Aug., '91).
Gout is a frequent cause of furunculo sis. When arising from this disease, the inflammation in the canal is relieved by the following treatment: The ear is to be washed with an alcoholic solution of boric acid; it is then painted with a solution of bichloridc of mercury,-1 to 2000; the parts are then to be covered with a preparation of the yellow oxide of mercury in vaselin. Internally, the patient is given liquor potassii, U. S. P., 10-drop doses in water; also, quinine muriatis, 2 grains until 8 grains have been taken, if there is very severe pain of neuralgic character. The diet is to be regulated strictly, so as to exclude all saccharin articles. Lawrence Turnbull (Times and Register, Oct. 3, '91).
A cotton-wool tampon is made of uni form diameter, and of such a thickness as to fit tightly into the inflamed meatus, and long enough to reach the drum. The tip of the tampon must be cut straight across, so as not to taper. It is dipped in the following ointment:— Oxide of zinc, 40 parts; carbolic acid, 6 parts; white vaselin, 300 parts; then warmed and dipped, and warmed three times. The tampon is then pushed into the meatus with a screwing movement, and, after removal of the probe, is left for twenty-four hours. The plug is re moved at the end of this time, and the patient can renew it twice daily. This treatment gives better results than any other. Lamann (Monats. f. Ohrenheilk., Feb., '99).