DEAFNESS, AND THE CARE OF THE EARS. 215 



To remove impacted wax, the same baking soda (bicarbonate 

 of soda) is the best preparation to use. A teaspoonful of the 

 soda should be mixed with just enough warm water to dis- 

 solve it ; this should then be dropped into the ear until it is 

 filled, and allowed to remain in contact with the wax for five 

 or ten minutes. It is to be repeated three times during the day ; 

 and then the ear should be thoroughly syringed with a quart 

 of hot water. No other syringe than the fountain douche should 

 be used. 



For ordinary purposes a good douche can be extemporized 

 from an old quart bottle by attaching a convenient length of 

 rubber tubing to its mouth, and, filling the bottle full of the hot 

 water, invert it and allow the water to flow through the tubing 

 into the ear. 



Other forms of deafness are too deeply seated to be dealt with 

 by any one but a specialist. 



The earliest symptom of beginning deafness in many cases is 

 a ringing sound in the ears. Many patients describe it as a noise 

 all through the head rather than in the ear itself. It is at first 

 intermittent and occasional. The ringing may be present for 

 some time, scarcely perceptible, when suddenly the sound will 

 change, becoming much louder, and the note jumping high up in 

 the scale, where it will continue to ring quite loudly for some 

 minutes, and gradually die away, to appear again some time 

 afterward. It may reappear in a few hours, as the trouble with 

 the ears progresses. Ringing in the ears may also be the prelude 

 to an acute attack of earache ; but it is here followed very soon 

 by pain, which so predominates over the ringing that it is no 

 longer heard. 



If the hearing is properly tested just as soon as the ringing in 

 the ears has become more or less constant, some degree of deaf- 

 ness will be detected. As the case progresses, even before all the 

 so-called superfluous hearing has been destroyed, the patient will 

 realize that he is becoming deaf. For this condition there is 

 nothing to be done by the patient himself. Advice from a phy- 

 sician should be obtained just as soon as diminution of hearing is 

 suspected. 



Much can be accomplished, however, by the patient toward 

 preventing the deafness becoming worse. Careful attention 

 should be devoted to the general health, to keep the nose and 

 throat in as healthy condition as possible — to prevent "taking 

 cold," especially colds in the head. Exposure to changes of 

 weather should be avoided; the feet never being allowed to be- 

 come wet, or, if they do become wet, the shoes and stockings 

 should be changed for dry ones as soon as possible. Turkish 

 baths and plenty of outdoor exercise are strongly to be recom- 



