CARE OF THE THROAT AND EAR. 801 



canal. I have seen many cases of abscess and the most severe inflam- 

 mation due to endeavors to clean the ear with the omnipresent hairpin 

 and other objects used for this purpose. The use of cotton in the 

 ear in general is to be condemned. It produces an artificial condi- 

 tion in the outer canal of the ear which reduces its physical resist- 

 ance and makes it more liable to injury from exposure. The ear 

 is sometimes injured by the entrance of cold water. This happens 

 occasionally during ordinary bathing, but more frequently in out- 

 door bathing and in swimming. In surf bathing, where the water 

 is thrown up with considerable force, it is much more liable to 

 enter the external orifice of the ear, and severe inflammation may 

 originate from this cause. 



Salt water has been claimed to be more injurious than fresh, but 

 my personal experience leads me to believe that it is more a question 

 of temperature than of the quality of the water. Some years ago a 

 large reservoir was built by an educational institute near this city, the 

 water, which was quite cold even in summer, being supplied by an 

 artesian well. The tank was used for bathing purposes, but earache 

 soon became so frequent among the boys that the use of the reservoir 

 for this purpose had to be entirely abandoned. In ordinary bathing, 

 the entrance of water into the ear can easily be avoided. In swim- 

 ming or surf bathing it is advisable to use a pledget of lamb's wool 

 to close the opening of the ears. Ordinary cotton soon becomes 

 saturated and is of no use in this connection, but the wool, which is 

 slightly oily, forms an excellent protection in these cases. 



The " running ear " is a diseased condition which should not be 

 tampered with by the inexperienced, but which should not be neg- 

 lected. The old idea that the child will outgrow it, or that it is a 

 secretion of the head which if interfered with would prove dangerous, 

 has been fruitful of many cases 'of deafness and even more serious 

 complications. 



Another condition to which I would call your attention is the in- 

 cipient development of deafness in children. Where the capacity 

 of hearing is quickly lowered from the normal to fifty per cent, it is 

 so striking that the patient is much distressed and even confused. 

 But when this change takes place insidiously from day to day, it is 

 frequently not observed by either the patient or those around him 

 until it has greatly advanced. Children thus affected hear only with 

 difficulty and by straining certain small muscles of the ear, which 

 soon become fatigued, and the child becomes listless and inattentive. 

 I have seen numerous cases in which children have been severely pun- 

 ished for inattention, when this was due to defective hearing. Watch- 

 fulness and early attention in these cases will frequently prevent the 

 more serious forms of deafness. 



VOL. L1V. — 60 



