Affections of the Ears
by Herbert M. Shelton
DP ND DC DNT DNSc DNPh DNLitt PhD DOrthop
THE HYGIENIC SYSTEM
As intestinal catarrh evolves and passes from the stomach to the throat, it extends into the Eustachian tube and, finally, to the inner ear, laying the foundation for all the "diseases" of the ear. Affections of the ear, as elsewhere in the body, though growing out of the same basic causes, are named according to the portions of the ear most affected. In any ear affection, either one or both ears may be involved.
Cysts of the ear, hyperemia of the ear, dermatitis of the ear, erysipelas of the ear, frostbite of the ear, eczema of the ear, tumors of the ear, etc., are to be cared for as for eczema, frostbite, dermatitis, or tumors, elsewhere. No special consideration will be given to these conditions here.
Polypi in the ears, as in the nose, colon and vagina, accompany long continued catarrhal and suppurative processes. They are to be cared for as advised for nasal polypi.
Definition: Dull hearing or inability to hear at all.
Symptoms: The characteristic symptom in all cases is the impairment or absence of hearing. The impairment is usually hardly noticeable at the start and progresses slowly to complete loss of hearing. There are, until deafness is complete, incessant head noises, with whistlings and roarings and ringings in the ears. There are periods of nausea and other symptoms of poor health. Commonly there is a lack of physical and emotional balance, and a lack of normal social adjustment.
Etiology: It is estimated that at least five out of every hundred people suffer with more or less impairment of hearing, or about six and a half million such sufferers in this country. Eighty percent of these cases are due to catarrhal inflammation of the Eustachian tube and inner ear. Cases follow measles, scarlet fever, and other "infectious" fevers quite often. Many thousands of cases follow colds.
A catarrhal condition starting in the throat and extending up to the Eustachian tube or tubes results in acute otitis media, and mastoiditis. The Eustachian tube may become obstructed by adhesions. Once the inflammation reaches the Eustachian tube, the middle ear and its ossicles may early become seats of pathology and ultimately complete deafness may result. The ossicles may become ankylose. Deafness may also result from external injury to the ear blows, foreign bodies, explosions, etc. Atrophy of the auditory nerve, as from the use of quinine or arsenic, and pathology of the brain involving the auditory center may cause deafness. Deafness not due to external injury is only another of the many thousands of effects of toxemia growing out of enervation, which, in turn, grows out of wrong life.
Prognosis: It is estimated that ninety-five per cent of cases of catarrhal deafness can be restored to normal hearing in their early stages. Why not all cases in the early stages? Echo answers: "why not?". Deafness due to atrophy of the auditory, center, ankylosis of the ossicles, and to other destructions of the structures of the ears cannot be remedied.
Care of the Patient: Catarrhal deafness yields readily and quickly to fasting. We have bad cases of twenty-five years standing, to recover normal hearing in a few weeks. Failure in these cases is due to failure of the patient to carry out instructions. All causes of enervation and toxemia must be corrected and removed. Local treatment of the ear is of no value, except in those cases where there exists an adhesion of the Eustachian tube. This may require mechanical removal, a thing that may often be done with the fingers.
Definition: This is inflammation of the external auditory canal. It is divided into diffuse, circumscribed, hemorrhagic, croupous, and diphtheric forms. These distinctions are of no practical value.
Symptoms: Radiating pains, especially when moving the jaw, or when pressure is applied, ringing in the ears, dizziness, itching, and, when the inflammation is great, impaired hearing; in severe form, loss of appetite and fever, are the chief symptoms. In the croupous and diphtheritic forms there are exudates from the ear.
Etiology: External injury, infection and toxemia are the causes.
Care of the Patient: Thorough and frequent cleansing of the auditory canal is most essential. Other than this, no. food should be taken until the symptoms have subsided.
Definition: This is inflammation of the labyrinth bony or membranous.
Symptoms: These are indefinite and the condition is difficult to distinguish from meningitis, except that the symptoms of otitis interna develop very suddenly. The child is likely to have fever, more or less congestion of the face, vomiting, delirium, deafness, vertigo, convulsions, and coma.
Etiology: It follows inflammation of the middle ear, and is often seen in diphtheria, scarlatina, tuberculosis and caries or necrosis of the temporal bone. The condition may become chronic.
Care of the Patient: Due to the inaccessibility of the labyrinth and the difficulty of drainage (pus often forms) this condition often recovers slowly. A long fast is frequently necessary and great care in feeding thereafter is most essential. All health-building factors are to be employed and all causes of enervation and toxemia removed:
Definition: This is inflammation of the cavity of the middle ear. It is a very common affection in babies and young children who are fed and cared for in the usual manner. Several forms are described, as acute otitis media, or acute catarrhal inflammation of the middle ear; sub-acute catarrhal otitis media; acute purulent otitis media; chronic catarrhal otitis media; and chronic purulent otitis media, or chronic suppurative otitis media; but these distinctions are of no practical importance.
Symptoms: The symptoms are earache, and sometimes discharge from the ear. In some cases there is no ache and the first indication of trouble is the discharge. Fever, crying, and restlessness are the chief symptoms in babies. The child may continually place its hand on its ear. The child will often scream and it keeps this up-no matter what is done for it. In other cases, where there is apparently no pain, there is fever. Most of the long list of symptoms the standard texts list under the above forms of otitis media can be found only by instrumental examination, hence to list them can be of. no. service to .the average reader.
Etiology: Exposure to cold is the cause, according to popular superstition. Medical superstition has it that the condition arises out of an acute cold, an infection in back of the nose, etc. Otitis media is an extension of catarrh which passes up the Eustachian tube to the middle ear and is due to the same things that cause catarrh in any other part of the body. Acute inflammation of the middle ear may be either catarrhal or purulent, but the affection frequently passes from catarrhal to purulent so that in many cases it is extremely difficult to make a distinction. Purulent inflammation of the middle ear usually occurs in connection with acute or chronic naso-pharyngeal catarrh and is due to the same causes that produce acute catarrhal otitis media. Chronic otitis media is the aftermath of one or more acute crises. These conditions are frequent developments in scarlet fever, measles and other infections.
Prognosis: This is good if Hygienic care is employed early.
Care of the Patient: Most cases of this trouble last but a few hours and, while they cause considerable pain, do not result in a discharge or any serious trouble. The old-fashioned "remedy" was to place a hot "poultice" over the ear a bag of hot ashes, hot peach-tree leaves, hot sand, etc., depending on which of these substances one placed his faith in. I recall an instance when my father filled his pipe with tobacco and lit it. Placing a thin cloth over the bowl of the pipe and placing the end of the stem near the entrance of my ear, he blew through the cloth and sent the hot smoke into my painful ear. This soon brought relief, as will heat, however applied. The "virtue" in the poultice did not lay in the ashes or the leaves, but in the heat. Today the hot-water bottle or the therapeutic lamp are used for the same purpose and with about as much blind faith in their "curative" powers.
The heat gives relief from pain, but I doubt that it is in any way beneficial. I am inclined to think it is harmful. I know that doctors and parents tend to consider the condition cured when the pain is relieved. The basic causes of the trouble are not corrected.
These children should be put to bed and all food withheld from them so long as the pain lasts. After this, their diet and hygiene should be adjusted in such a manner as to produce and maintain health. If this is done there will be no recurrence. Do not syringe the ears. Keep everything out of the child's ear.
Definition: This is inflammation of the mastoid, a small piece of the skull which lies directly behind the ear. Two forms internal and external are described. The external form, except as part of the internal form, is rare.
Symptoms: There is deep-seated pain and tenderness over the mastoid process which is likely to radiate in different directions, upward in the temporal region, and downward and forward toward the teeth; more or less fever, swelling, and in some cases pus formation.
Etiology: In cases where earache (otitis media) is treated with beat, dry wiping, syringing, etc, and the causes of the catarrhal inflammation ignored, as is usually the case, the inflammation may extend to the porous bone back of the ear mastoid. This does not occur in the vast majority of cases, for nature is always busy limiting inflammation as much as possible. Mastoiditis will never occur as a "complication" of otitis media, if the earache is properly cared for and not merely suppressed and then forgotten.
Care of the Patient: Operation is the usual recourse. It is a very dangerous procedure and seldom advisable. Rest, warmth, fasting and fresh air will speedily remedy nearly all such cases. Should this care be instituted late and the fever keep up, it may be necessary to surgically drain the abscess. Nothing should be removed except the pus.
Definition: A term applied to a symptom-complex characterized by deafness, ringing in the ears, and paroxysms of intense vertigo.
Symptoms: The paroxysms may occur daily or at intervals of weeks, and may culminate in vomiting or even in fainting.
Etiology: These symptoms are apparently due to lesions in the labyrinth of the ear and may be due to either hemorrhage or to degeneration of the nerve-endings. Or, in some instances, it follows affections of the middle ear. Tumors in certain regions of the brain may also produce these symptoms.
Prognosis: The condition usually lasts throughout life; occasionally when the loss of hearing on the affected side becomes absolute, the other symptoms cease.
Care of the Patient: Fasting, rest and a Hygienic mode of living-offer hope of recovery in many cases.
STRICTURE OF THE EUSTACHIAN TUBE
The Eustachian tubes run from the back of the throat to the ears, one to each ear. Closure or stricture excludes the air from the inner ear and results in partial or, total deafness in the ear on the affected side.
Etiology: Stricture and constriction are due to three causes: (1) pressure by tumors; (2) osseous growths in the bony canal; and most frequent of all (3) chronic catarrh.
The first of these causes may frequently be absorbed by fasting, the third may always be removed by fasting; the second cannot be so removed. Adhesions often form in catarrhal conditions and if these are not broken up by fasting, may need instrumental attention.
ANEMIA OF THE LABYRINTH
This is a deficiency of blood in the labyrinth and is part of general anemia, or from obstruction to the blood supply by a tumor, aneurysm, etc.
Symptoms: Deafness, faintness, ringing in the ears, vertigo, nausea, and vomiting are the chief symptoms.
HEMORRHAGE INTO THE LABYRINTH
This is a slight extravasation of blood in the labyrinth resulting from inflammation or fracture at the base of the skull, concussion of the skull, necrosis of the temporal bone.
HYPEREMIA OF THE LABYRINTH
This is an excess of blood in the labyrinth and is seen in severe otitis media, scarlatina, diphtheria and other acute exanthemata.
Symptoms: Vertigo, giddiness, vomiting, inability to walk steadily, ringing in the ears, and a feeling of fullness about the ears are the symptoms of acute hyperemia.
The above three conditions are mere symptoms and care should be directed at the primary pathology.
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