EAR, DISEASES OF.—Diseased conditions of the auditory apparatus may involve either the external parts of the ear (the concha), the external auditory canal, or the internal ear. Middle-ear inflammations (which see) usually proceed by way of the Eustachian canal, front the throat outward to the middle ear.
1. Diseases of the External Ear are usually due to injuries sustained as by blows or accidents, which may lead to the formation of blood-tumours, to obstruction of the external auditory canal, or even to suppurative inflammation. The last-named condition may arise also from transmission of suppuration from an inflammation of the middle ear.
Blood-Tumours are generally caused by violent blows upon the ear, which result in exudations of blood under the cartilage and skin, so that some parts of the ear swell. Such blood-tumours were of rather fre:luent occur rence in Roman and Greek gladiators, and are still found in wrestlers, prize-fighters, etc. Inmates of insane asylums occasionally suffer from this condition, which may be due either to their own violence or to rough handling by attendants. These blood-tumours usually disfigure the ear considerably.
Foreign Bodies are sometimes found in the external ear, those most frequently encountered being beads, shoe-buttons, beans, peas, seeds, paper balls, pieces of wax, and forgotten pledgets of cotton or onion. Flies, bedbugs, and fleas are rarely found in the ear ; the so-called earwig " never. The removal of foreign bodies from the ear never requires great haste, and it is always passible to avoid such injuries of the organ as are frequently causel by the assistance of unpr3fessional persons hurriedly summoned. Living insects are destroyed by injections of glycerine or alcohol. This being accomplished, the aid of an ear specialist may be called at leisure. Unskilled assistance may cause severe injuries which may eventually lead to loss of hearing, or even to death.
Until the ear has been examined by a physician with the aid of an ear speculum, it may in many cases remain doubtful whether the supposed foreign body is in the external auditory canal at all ; and not a few dangerous operations have been performed by untrained persons to remove a foreign body which was not present. On the other hand, a dead object which does
not swell may often remain in the auditory canal for years, even for decades, without endangering the ear.
Acute Inflammation of the auditory canal may be due to the transmission of middle-ear suppuration. to mechanical injuries caused by scratches, foreign bodies, etc., or to burns resulting from the injection into the ear of hot substances. Most frequently, however, the inflammation is due to the formation of furuncles or pimples in the external ear. The furuncle begins in the membrane of the auditory canal as a small, red point, and is very painful to the touch. It is usually situated near the external opening of the ear, and may either recede of itself or go on to suppuration. The pain and swelling generally diminish after the discharge of a small quantity of bloody pus.
Furuncles rarely occur singly, and after their first appearance they are apt to recur at intervals, so that the symptoms of the disease may come and go for weeks, causing restless nights, and impaired nutrition in consequence of the pain experienced on chewing. Many persons are especially predisposed to furuncles.
Scratching and habitual picking of the ear should be avoided, as it often gives rise to the formation of furuncles. These are also frequently trans mitted from one ear to another by means of contaminated ear-picks and similar objects. When occurring in large numbers, furuncles may cause considerable swelling, which closes the auditory canal and impairs hearing ; hut the patients always recover. The pain which results from inflammation of the auditory canal may be alleviated by the application of hot poultices or by alcohol compresses.
Chronic Inflammation of the skin of the auditory canal is usually painless, leading merely to the discharge of an increased quantity of ear-wax. In the auditory canal this combines with the cast-off particles of skin to such an extent that it can be removed only with difficulty and only by a physician. Small scales and dry particles are discharged from the ear at brief intervals. Itching is the most conspicuous disturbance. Irrigations of the ear should be avoided, as they may aggravate the condition.