Manual of diseases of the ear : including those of the nose and throat in relation to the ear : for the use of students and practitioners of medicine / by Thomas Barr and J. Stoddart Barr.

  • Barr, Thomas, 1846-1916
Date:
1909
Catalogue details

Licence: In copyright

Credit: Manual of diseases of the ear : including those of the nose and throat in relation to the ear : for the use of students and practitioners of medicine / by Thomas Barr and J. Stoddart Barr. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    x.v] rise to a slight drumming or buzzing sensation in the ear. During the contraction of the abductor tubas in swallowing, even in a normal state of the ear, most persons are conscious of a sound. When, however, the walls of the Eustachian tube are abnormally closely connected by means of catarrhal products, a crack or such like sound often signalizes the sudden separation of the membranous wall by the action of the abductor tubse in swallowing. TREATMENT OF SUBJECTIVE SOUNDS IN THE EAR. There is no actual specific remedy for tinnitus aurium. The treat- ment is usually that of the particular affection of the ear with which this symptom is associated, and our success will pretty much depend upon the nature of that disease. When connected with affections of the external meatus, with exudative catarrh or purulent inflammation of the middle ear, the effects of treatment are usually very satis- factory. When, on the other hand, they are connected with non- exudative inflammation of the middle ear, otosclerosis, or chronic •disease of the labyrinth and auditory nerve, the prospect of completely removing the noises is in most cases very slight. The most we can hope for, in the majority of such cases, is a certain measure of relief. This symptom is found in practice most frequently conjoined with non-exudative inflammation and otosclerosis, and the treatment already -described for these conditions, at p. 389 and p. 399, is the most generally applicable. Such treatment will frequently mitigate the symptoms temporarily or permanently, and this mitigation is usually accompanied by improvement of hearing, although it is sometimes otherwise. When the subjective sounds are attendant upon disease of the internal ear (and this is the case with the most severe forms), the treatment described for these affections must be resorted to (see p. 422). We shall here refer to the use of external applications and certain special internal medicines, as well as to one or two points in general treatment. Counter-Irritation and Embrocations behind the ear have, in some cases, a mitigating influence on the noises. These may consist of vesication, or the application of the tincture or the ointment of iodine or iodide of potassium (Formula 91), or of a spirituous embrocation (Formula 97) employed over the mastoid process. The writer has often found friction or massage behind the ear .and over the tragus with an ointment composed of camphor, oil of peppermint and vaseline (Formula 91) grateful to patients. While some patients state that they find partial relief to the sounds from pouring warm water or warm diluted glycerine into the ear, the pouring of fluids into the interior of the ear is generally useless and may be injurious. The subcutaneous injection of Morphia into the back of the neck is rarely resorted to, and then only in very violent and paroxysmal noises. The Vapour of Chloroform or of Acetic Ether inflated through the Eustachian -catheter (see p. 85) has sometimes a mitigating influence upon severe tinnitus, but only temporarily.