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Catarrh Eustachian Tube

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EUSTACHIAN TUBE, CATARRH OF.—The passage by which the ear communicates with the nasopharyngeal space is called the Eusta chian tube (see Fig. 6o). All acute inflammations of the nose and of the pharynx (especially coryza and tonsilitis), as well as enlargement of the nasopharyngeal tonsil, inflammations and ulcers in the nasopharynx, and polypi of the nose, may cause an obstruction of the Eustachian tube ; this will prevent sufficient ventilation of the middle ear, and produce a sensa tion of fullness and dullness in the ear, impairing the acuteness of hearing. No serious disturbances remain if the catarrh is cured in time, and its cause removed. See EAR, DISEASES or.

EXCITEMENT.—In the healthy person the mental condition designated by this name is merely transitory, but if prolonged or frequently repeated, it may become a true psychic disturbance. This pathological state of excitement often appears as a symptom of considerable importance in many nervous, hysterical, epileptic, alcoholic, and other mental diseases. Under certain circumstances it may lead to a condition of actual confusion, in which the patient may do harm not only to himself but also to others. It is advisable to keep such persons under appropriate supervision, by the aid of two nurses if possible. They should he put to bed and kept there, as complete rest in bed affords one of the best means of combating this state of excitement. In addition, warm baths and hot packs are also of value. Of drugs it is sometimes found necessary to employ various sedatives and hypnotics.

EXERCISE.—Rest and activity constitute the two great antitheses of medicine, upon the alternation of which the life of every portion of the body depends. The rules for rest and exercise are among the most difficult problems concerning which the physician must decide. Rest is enjoined in cases of severe illness or chronic disease, in order not to weaken the system, and to afford an opportunity for new energy to be gathered. During the progress of the recovery, exercise is again gradually taken up. In any given case of illness these questions always arise : when shall the patient be allowed to sit up when may he leave the bed ; when may he walk about the room ; and, finally, \VIM] shall he be permitted to leave the house ? The length of a walk must be carefully determined, taking into account the weather conditions as regards temperature, humidity, and the wind. It

should be firmly impressed upon the patient that, in medicine at least, one walk of half an hour is a great deal more exercise than two walks of fifteen minutes each. Later on, these walks, which may be taken indoors during unfavourable weather, may be supplemented by respiratory exercises. As a rule, the pace should he set at So steps to the minute, weaker patients taking hut 6o steps, and those more robust from ioo to 120 steps. Breathing may be regulated in accordance with the number of steps. For example, the act of inspiration may be made to extend over three steps, and expiration over another three steps. Finally, permission may he given to do some climbing, but the ascent at first must he very mild in degree, and here also the respiratory movements may be accommodated to the number of steps. Oertel recommends an inspiration extending over one step and the succeeding expiration including two steps. The climbing of stairs requires the greatest amount of exertion.

Proper exercise is necessary, not only for those who are or have been ill, hut also for those in good health. A healthy person remains so if every organ is regularly active. Organs which are not thus exercised soon degenerate. Those persons who live close to Nature, as it were, must of necessity exert themselves bodily in order to provide for their daily wants ; but a large number of individuals, because of the altered conditions brought about by modern civilisation, are called upon to take hut little bodily exercise, and perform most of their tasks in closed rooms. This applies particularly to persons who follow some calling where mental activity predominates, and of these there are many in our modern cities. Even our periods of recreation are very apt to he spent indoors, and are not characterised by any bodily exertion, for most people remain at home or seek entertainment at public places of amusement.

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