Inflammation of the Meatus. Otorrhoea.
This is quite a common complaint among delicate children; and may occur as the result of scarlet fever, or be excited by currents of cold air, by rotten teeth, or by deranged stomach and bowels.
Symptoms. Fever, headache, intense pain in the ear, and swelling of the glands of the neck. After a time, a reddish, watery discharge comes on, which soon grows thicker and mattery. The fever disappears with the appearance of the thick matter. An examination with the speculum shows the whole meatus to be swollen, vascular, and covered with a slimy matter.
Unless great attention be given to cleanliness, the discharge becomes very abundant and fetid, and lasts for a long time; and if neglected, will be likely to lead to very serious consequences, even the decay of some of the bones of the head.
Treatment. While the inflammation is acute, and there is fever and pain, the diet should be confined to mere liquids, as rice water, gruel, etc., and the bowels should be opened with some preparation of salts, the ear being gently syringed, occasionally, with warm water or decoction of poppies, and being covered with a warm poultice of flax seed or bread and milk. In place of a poultice, a soft linen bag, filled with bran, and dipped in hot water, may be kept on the ear.
The pain and fever being gone, and the mattery discharge having come on, the case is to be treated like other chronic diseases of mucous membranes in scrofulous constitutions, by tonics, alteratives, warm baths, and out door exercise.
The ear may now be gently syringed out with castile soap and water, and immediately after with a weak solution of alum, or sulphate of zinc, one grain to a dram. This may be done twice a day. Or, a little of a mixture of two drams of solution of sugar of lead and half a pint of water may be dropped into the meatus, and, after remaining two or three minutes, be allowed to run out. If the discharge be very fetid, two drams of solution of chloride of lime, with half a pint of water, will make a suitable wash with which to syringe it, applying, once a day, a solution of tincture of iodine I dram to the ounce of water. Should the discharge stop at any time, and pain and fever come on, lay aside these astringent applications, and go back at once to the leeches, purgatives, poultices and fomentations.
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